Original Article

Society and Mental Health

XX(X) 1–19
Pornography Use and Ó American Sociological Association 2017
DOI: 10.1177/2156869317728373
Depressive Symptoms: http://smh.sagepub.com

Examining the Role of Moral

Incongruence

Samuel L. Perry1

Abstract
While studies have consistently observed an association between pornography use and depressive symp-
toms, data limitations have precluded understanding the nature of this relationship. Drawing on data from
a representative panel study of American adults and building on insights from stress process theory, this
article demonstrates that the connection between pornography use and depressive symptoms hinges on
the (1) (in)congruence between Americans’ moral beliefs about pornography and their viewing practices
and (2) gender. Cross-sectional and longitudinal analyses reveal that American men (not women) who
believe viewing pornography is always immoral but watch it anyway are more likely to experience depres-
sive symptoms compared to others who do not report this incongruence. Results also suggest the con-
nection between viewing pornography and depressive symptoms is bidirectional, contingent on men’s
moral evaluation of its use. For male porn users who morally reject it, pornography use predicts depres-
sive symptoms at low frequencies, likely stemming from cognitive stress or dissonance. For those who do
not morally reject porn, however, only viewing it at the highest frequencies is associated with higher levels
of depressive symptoms, which suggests reverse causation—depressed men likely view higher levels of
pornography as a coping aid, especially when they do not view it as immoral.

Keywords
pornography, depression, morality, gender, stress process

INTRODUCTION X-rated movie in the previous year increased by

Pornography use has become increasingly perva-
sive in the United States over the past few deca-
des, stemming largely from a combination of
greater cultural acceptance and advances in Inter-
net and smartphone technology (Carroll et al.
2008; Lykke and Cohen 2015; Price et al. 2016;
Wright 2013; Wright, Bae, and Funk 2013). While
estimates of pornography use often differ by the
definitions used, available data affirm that Ameri-
cans view pornography in larger numbers today
than previous decades. In their analysis of aggre-
gated General Social Survey (GSS) data, Price
et al. (2016) show that the percentage of American
men below age 45 who reported viewing an
roughly 20 percent between the 1973–1980 and
2008–2012 waves. The percentage of American
women below age 45 who reported viewing por-
nography also increased roughly 5 to 10 percent
during this time.
As pornography use has become more preva-
lent, researchers have begun to explore its
1
University of Oklahoma, Norman, OK, USA
Corresponding Author:
Samuel L. Perry, University of Oklahoma, 780 Van Fleet
Oval, Kaufman Hall, 3rd Floor, Norman OK, 73019-
2033, USA.
Email: samperry@ou.edu
2 Society and Mental Health XX(X)
potential connection to indicators of psychological
well-being, including compulsivity, distress,
depression, and sexual dysfunction (for reviews,
see Grubbs and Hook 2016; Short et al. 2012).
Within this research, a consistent finding is that
persons who view pornography more often are
more likely to exhibit symptoms of depression
(Cooper et al. 2001; Kafka 2000; Nelson,
Padilla-Walker, and Carroll 2010; Owens et al.
2012; Peter and Valkenburg 2006, 2011; Poulsen,
Busby, and Galovan 2013; Stein et al. 2001;
Wolak, Mitchell, and Finkelhor 2007; Ybarra
and Mitchell 2005). Several critical issues, how-
ever, remain unresolved regarding the nature of
this relationship. The first is that causal direction
and mechanisms remain undetermined. Some
research, on the one hand, suggests that individu-
als suffering from depression or anxiety seek out
pornography as a coping strategy (Cooper et al.
2001; Kafka 2000; Peter and Valkenburg 2006,
2011), while others propose that pornography
use itself may be a contributing factor to forms
of psychological distress (Baltazar et al. 2010;
Nelson et al. 2010; Owens et al. 2012; Stein
et al. 2001; Yoder, Virden, and Amin 2005). Sec-
ond, and related to the directionality issue, is that
virtually all studies linking depressive symptoms
with pornography use are based on clinical sam-
ples, samples of adolescents, or convenience sam-
ples of undergraduates, each of which samples on
either dependent variable (porn use or depression)
for different reasons. No research to date has
established whether a connection exists between
pornography use and mental health among the
general public and, equally as important, through
what mechanisms. Resolving these issues is of
pressing concern for mental health researchers.
To the extent that pornography use is associated
with poorer mental health among American adults,
the rapid growth of pornography use among
Americans could serve as either an indicator of
depressive symptoms in the general population
or a harbinger of mental health issues later on.
One promising line of research has begun to
explore the idea that the connection between por-
nography use and mental health hinges on how the
porn viewer perceives or interprets that activity.
Some preliminary research with convenience sam-
ples of undergraduates, for example, finds that
persons who believe themselves to be “addicted”
to pornography are more likely to report feelings
of psychological distress, regardless of how often
they actually view pornography (Grubbs, Stauner,
et al. 2015; Grubbs, Volk, et al. 2015). Other stud-
ies in this vein find that undergraduates who are
more religious are more likely to view themselves
as addicted to pornography and more likely to
report “spiritual struggles” as a result, even though
they tend to view pornography less often than
others (Grubbs et al. 2017; Grubbs, Exline, et al.
2015). While these researchers focus on the mech-
anism of labeling behavior as addictive, I propose
that the more fundamental issue represented
within these preliminary findings is that the con-
nection between pornography use and poorer men-
tal health are likely contingent on one’s (negative)
moral evaluation of one’s own behavior.
The current study extends the literature con-
necting pornography use to mental health by dem-
onstrating how the link between pornography use
and depressive symptoms in American adults
hinges on the congruence between their moral
beliefs about pornography and consumption prac-
tices. Drawing on data from a nationally represen-
tative panel study of American adults and building
insights from stress process theory, I demonstrate
that viewing pornography in and of itself has vir-
tually no directional influence on the experience
of depressive symptoms unless one is violating
one’s own moral values by doing so. Absent of
one’s moral rejection of pornography, depressive
symptoms are more likely connected to pornogra-
phy use in the opposite causal direction—de-
pressed individuals likely consume more pornog-
raphy as a coping strategy. I also show how this
relationship is highly gendered. American men
view pornography in far larger quantities than
women and more often in isolation (Maddox,
Rhoades, and Markman 2011; Regnerus, Gordon,
and Price 2016), and these consumption patterns
more strongly connect men’s pornography use
and mental health, with causality going in either
direction contingent on their moral views.
EMPIRICAL AND THEORETICAL
BACKGROUND
Pornography Use and Acceptance in
the United States
Determining who uses pornography and how often
has grown increasingly difficult due to advances in
media technology that ensure anonymity (Lykke
and Cohen 2015), compounded by the fact that
porn use is still stigmatized in many circles and
Perry
persons are often reluctant to admit viewing it
(Perry and Hayward 2017; Regnerus 2007). A
recent comparison of three different national data
sets with different measures of pornography con-
sumption (2008–2012 General Social Survey
[GSS], 2012 New Family Structures Survey, and
2014 Relationships in America project) showed
that between 55 percent and 70 percent of men
and roughly 30 percent to 40 percent of women
below age 40 report viewing pornography in the
previous year (Regnerus et al. 2016). These esti-
mates are comparable to those in the 2006 Por-
traits of American Life Study, which indicates
that 67 percent of men and 33 percent of women
below 40 report looking at “pornographic materi-
als” in the past 12 months. Providing a better
idea of viewing frequency, the 2014 Relationships
in America survey, based on a probability sample
of over 15,700 American adults, reveals that 46
percent of men and 16 percent of women under
age 40 report intentionally viewing pornography
in a given week (Perry and Hayward 2017; Regne-
rus et al. 2016). And while pornography use has
increased over time for the adult population of
men and women overall, this increase has been
particularly strong among younger men and
women compared to their older counterparts. Price
et al. (2016) show that men below age 27 who
report viewing porn increased by 16 percent
from the 1973–1980 GSS waves to the 2000–
2008 waves compared to only 6 percent for men
ages 45 to 53 during that same timeframe. So
too, women below age 27 who view porn
increased by 8 percent during that timeframe,
while this percentage actually declined slightly
for women 45 to 53 years old.
Not surprisingly given consumption patterns,
Americans’ attitudes regarding pornography’s dis-
semination and use have been growing more
favorable over time (Carroll et al. 2008; Lykke
and Cohen 2015; Price et al. 2016). Yet Ameri-
cans’ acceptance of pornography has not grown
as drastically as one might suppose given its
greater accessibility or ubiquity in popular culture.
Using aggregated GSS data from 1975 to 2012,
Lykke and Cohen (2015) show that the percentage
of American men and women who believe that the
distribution of pornography should be illegal
regardless of age has declined from about 35 per-
cent of men in 1975 to 23 percent of men in 2012
and from about 50 percent of women to 43 percent
of women during that same timeframe. Moreover,
while one might expect that younger generations
3
of Americans would be more favorable toward
pornography given their higher use patterns (Price
et al. 2016; Regnerus et al. 2016), Price et al.
(2016) found that men and women below age 27
were no less likely to believe porn distribution
should be illegal in the 2000–2008 GSS waves
compared to the 1973–1980 waves. This poten-
tially presents a paradoxical situation, namely,
that Americans (and younger Americans in partic-
ular) are increasingly more likely to view pornog-
raphy compared to previous generations, and yet,
these same Americans are not necessarily becom-
ing more approving of pornography than previous
cohorts, at least not to the point where their
approval is keeping pace with growing use pat-
terns. This suggests that an increasing number of
Americans may find themselves in a situation
where they oppose pornography in principle while
also viewing it, creating a situation where their
moral beliefs and behaviors are incongruent. The
following section reviews the research on pornog-
raphy use and mental health and considers this
moral incongruence as a potential moderating
factor.
Pornography Use and Mental Health
Among the correlates often associated with por-
nography use—along with being younger, male,
less religious, higher socioeconomic status, more
politically liberal, and more sexually permissive
(see Perry 2016, 2017; Peter and Valkenburg
2016; Wright 2013)—persons who use pornogra-
phy more often are consistently found to exhibit
symptoms of poorer mental health and symptoms
of depression in particular. Notably, much of this
finding may be due to the fact that studies are
often drawing on clinical samples (Kafka 2000;
Stein et al. 2001) or samples of individuals who
have otherwise already conceived of their porn
use as problematic (Cooper et al. 2001). Others
are based on samples of adolescents who, due to
common physical and social transitions in their
life course, might already be disposed to experi-
encing bouts of emotional instability (Owens
et al. 2012; Peter and Valkenburg 2006, 2011,
2016; Wolak et al. 2007). Nevertheless, while
researchers have consistently identified an associ-
ation between porn use and depressive symptoms
in these samples, the nature of the relationship is
not well understood. One line of research suggests
that bouts of depression may influence individuals
4 Society and Mental Health XX(X)
to view pornography and masturbate as a way to
relieve stress or cope with feelings. A psychiatrist,
Kafka (2000) described how he was able to suc-
cessfully treat men who compulsively view por-
nography by prescribing antidepressant medica-
tion, suggesting the depression contributed to
frequent pornography use. Cooper et al. (2001),
in a cross-sectional study of over 7,000 respond-
ents, reported that persons who had previously
experienced symptoms associated with depression
and severe anxiety were more likely to view
higher levels of pornography as a form of distrac-
tion and stress release. Other studies find that ado-
lescents who score higher on indicators of depres-
sion are more likely to seek out porn (Wolak et al.
2007; Ybarra and Mitchell 2005). And in both
cross-sectional and longitudinal surveys with
Dutch adolescents and adults, Peter and Valken-
burg (2006, 2011) reported that lower life satisfac-
tion predicted more frequent use of online pornog-
raphy later on.
Another line of research, however, suggests
that habitual pornography use may be a contribut-
ing factor to depression itself, possibly due to
attendant self-isolation (Owens et al. 2012). Yoder
et al.’s (2005) study of 400 Internet porn users
found that higher porn viewing frequency pre-
dicted higher levels of isolation and loneliness.
And in their longitudinal study of Dutch adoles-
cents, van den Eijnden et al. (2008) found that
viewing Internet pornography predicted later feel-
ings of depression and loneliness through its con-
nection to compulsive Internet use. And still other
studies suggest that the relationship between
depression and pornography is complex and bidi-
rectional. In their psychiatric case study, Stein
et al. (2001) described “Mr. A,” who was experi-
encing significant depression associated with
habitual pornography use and masturbation. On
the one hand, the psychiatrists observed that Mr.
A would view pornography and masturbate during
times of stress and loneliness as a way to seek
relief. Notably, however, they also observed that
Mr. A used pornography habitually even when
his depression had been medically controlled and
reduced. The patient also articulated distress at
his lack of self-control and feared that his pornog-
raphy use had become unmanageable, which led
him to seek treatment. The doctors theorized the
connection between the patient’s compulsive
porn use and depression “does not simply involve
one-directional causality but, rather, is likely to be
complex” (Stein et al. 2001:1591). Other research
has pointed to this ambiguous and likely bidirec-
tional association between pornography use and
depressive symptoms. In their study of 751 college
students at a Christian university, for example, Bal-
tazar et al. (2010) reported that 23 percent of men
expressed that their pornography use increased
when they were experiencing negative emotions,
including anger, depression, stress, boredom, or
loneliness. And yet, they also found that 26 percent
of men and 12 percent of women indicated that their
pornography use itself actually increased negative
emotions like guilt, shame, and low self-esteem.
Rather than viewing pornography use and men-
tal health as directly related, recent research has
considered the importance of how porn users inter-
pret or understand their behavior, drawing largely
on notions of cognitive dissonance—the psycho-
logical distress actors tend to feel when their stated
values or beliefs do not align with their actions or
experiences. Festinger’s (1957) original conceptu-
alization of cognitive dissonance involved mental
distress from failing to succeed in domains that
one considers personally relevant and important.
Employing this perspective, Mannheimer and
Hill (2015) showed that conservative Protestants
who failed to meet religious norms for faithful prac-
tice were more likely to experience psychological
distress and depression. Going beyond the cognitive
dissonance concept, stress process theory provides
a more distinctively sociological framework through
which to consider how a “failure” (in one’s own
self-evaluation) could contribute to depressive
symptoms (Bierman 2010; Schieman, Bierman,
and Ellison 2013). Pearlin’s (1989) early work
argued that socially constituted values (i.e., what is
defined as good or bad) were influential in the pro-
cess of stress formation because they defined how
actors interpreted their behavior and experiences.
Extending this idea, Bierman (2010) proposed the
concept of “stress valuation” to argue that certain
experiences may be particularly stressful and ulti-
mately contribute to poorer mental health if they
clash with actors’ inculcated moral values.
Research that considers the moderating role of
religion in the link between pornography use and
psychological well-being lends itself to this view
that the incongruence between moral values and
behavior is at the heart of the relationship. Patter-
son and Price (2012) analyze aggregated GSS data
and found that porn users who attended church
more often reported lower life satisfaction than
porn users who rarely attended church, suggesting
that the lower life satisfaction was connected to
Perry
violating the moral values of oneself and one’s
faith community rather than porn use per se (see
also Nelson et al. 2010; Short, Kasper, and Wetter-
neck 2015). Focusing more specifically on the
issue of how one interprets pornography use,
Grubbs and colleagues (Grubbs, Stauner, et al.
2015; Grubbs, Volk, et al. 2015) found in their
nonrandom samples of undergrads and adults
that those who considered themselves addicted to
Internet pornography—who are also more likely
to be religious persons (Grubbs, Exline, et al.
2015)—were more likely to experience psycho-
logical distress (symptoms for depression, anxiety,
and stress). Importantly, this association remained
regardless of how often someone viewed pornog-
raphy, suggesting that the critical factor connect-
ing pornography use to mental health and psycho-
logical well-being is how porn users interpret that
behavior in light of their own moral values.
Hypotheses
The current study is the first to directly examine
how the connection between pornography use
and depressive symptoms may be moderated by
whether actors’ moral beliefs regarding pornogra-
phy use are congruent with their viewing patterns.
Based on previous research establishing a connec-
tion between pornography use and depressive
symptoms, I first generally expect that:
Hypothesis 1: On the whole, Americans who
view pornography, either at all or in greater
frequencies, will be more likely to report
experiencing depressive symptoms.
Conversely, there would be no reason to expect
that Americans who oppose pornography morally
would be more likely to experience depressive
symptoms compared to those who are more
accepting of it. In other words, there is nothing
about the moral conviction against pornography
per se that would be connected with depressive
symptoms. Thus, I predict that:
Hypothesis 2: On the whole, Americans who
believe pornography is morally wrong will
be no more likely to report experiencing
depressive symptoms compared to those
who do not believe it is morally wrong.
However, building on insights from stress process
theory, that the link between behavior and poorer
5
mental health may depend largely on how individ-
uals interpret their behavior in light of their
socially constituted moral values and expectations
(Bierman 2010; Mannheimer and Hill 2015), I
expect that the association between pornography
use and depressive symptoms will only apply to
those who are violating their own moral values
in porn use. Stated more formally:
Hypothesis 3: Only Americans who report an
incongruence between their moral beliefs
about pornography and viewing practices
(i.e., believing porn use is morally wrong
but viewing it anyway) will report experi-
encing depressive symptoms.
Previous studies on the potential connection
between pornography use and depressive symp-
toms have largely ignored the moderating role of
gender. This is a significant oversight given that
pornography viewing motivations and practices
are highly gendered. Men are considerably more
likely to view pornography, view it more fre-
quently, and view it in isolation for masturbation
compared to women who are more likely to
view pornography within the context of a romantic
relationship as a part of love-making (Bridges and
Morokoff 2011; Maddox et al. 2011; Perry 2016,
2017; Poulsen et al. 2013; Price et al. 2016;
Regnerus et al. 2016; Wright 2013; Wright et al.
2013). The fact that male porn use is more fre-
quent and isolated than for women suggests that
any connection pornography use has with psycho-
logical well-being (in either direction, as a way to
relieve stress or contributor to guilt and disso-
nance) will be stronger among men. Supporting
this theory, dyadic studies of romantic couples
have found that depression is significantly associ-
ated with porn use for men but not women
(Bridges and Morokoff 2011; Poulsen et al.
2013). Thus, I predict that:
Hypothesis 4: The observed associations
between pornography use, depression, and
moral incongruence will be stronger for
men than women.
Lastly, in considering how the frequency of por-
nography use might relate to both moral incongru-
ence and depressive symptoms, research suggests
that porn users who morally object to pornography
use are more likely to consider themselves
addicted to pornography regardless of how often
6 Society and Mental Health XX(X)
they view it (Grubbs, Exline, et al. 2015). Moreover,
this belief that one is addicted to porn also predicts
depressive symptoms regardless of use frequency
(Grubbs, Stauner, et al. 2015; Grubbs, Volk, et al.
2015). Thus, it is not necessarily the frequency of
pornography use that contributes to depression for
those who morally reject it but merely the fact that
they violate their moral convictions at all. Stated
more formally, I expect that:
Hypothesis 5: Levels of depression associated
with morally conflicted pornography use
will not be influenced greatly by viewing
frequency.
DATA AND METHODS
Data
This study incorporates both cross-sectional and
longitudinal data from the 2006 Portraits of Amer-
ican Life Study (PALS) and the 2006–2012 PALS
data set in which the 2006 respondents were rein-
terviewed six years later. PALS is a nationally rep-
resentative panel survey with questions focusing
on a variety of topics, including social networks,
moral and political attitudes, and religious life.
The original 2006 PALS sampling frame includes
the civilian, noninstitutionalized household popu-
lation in the continental United States who were
18 years of age or older at the time the survey
was conducted. Surveys were administered in
English or Spanish. From April to October 2006,
face-to-face interviews were conducted with
2,610 respondents in their homes. Interviewers
used audio computer-assisted self-interviewing
(ACASI) for more sensitive questions (i.e., por-
nography usage). The response rate was 58 per-
cent. The 2006 PALS data include sampling
weights that, once applied, bring the PALS sample
in line with the U.S. Census Bureau’s American
Community Survey (ACS) three-year average esti-
mates for 2005–2007 (Emerson, Sikkink, and
James 2010). These weights are used in all analy-
ses using the 2006 data. The full models that use
the cross-sectional data from the 2006 PALS ulti-
mately include 2,292 respondents who provided
valid responses to measures used in this study.
The second wave of PALS was conducted from
March to September 2012, with 1,314 participants
successfully reinterviewed. After accounting for
participants from 2006 who died or were mentally
incapacitated, the Wave 2 response rate is 53 per-
cent. The second wave was administered through
self-administered web survey, computer-assisted
telephone interviewing, and face-to-face inter-
viewing. The longitudinal 2006–2012 PALS data
include sampling weights that bring the PALS
sample in line with the U.S. Census Bureau’s
American Community Survey, 2005 and 2011.
Weights also adjust for nonresponse in Wave 2.
These weights were used in all analyses using
the 2006–2012 data. The full models that use the
longitudinal data from the 2006–2012 PALS
include 912 respondents who provided valid
response to measures used.1
Measures
Depressive Symptoms. The outcome variable
for this study is an index made from three indica-
tors for symptoms of depression commonly used
in studies of mental health using other data (Elli-
son et al. 2001; Hopcroft and Bradley 2007;
Krause 2010) and PALS (Chou and Hofer 2014;
Schafer 2013). Both the 2006 and 2012 PALS
waves asked respondents whether in the past 12
months they ever had two weeks or longer when
“nearly every day you felt sad, empty, or
depressed for most of the day;” “nearly every
day you felt hopeless;” or “nearly every day you
felt worthless.” For each question, respondents
could answer yes (=1) or no (=0). The three meas-
ures were summed together to create a depressive
symptoms index with strong reliability at both
waves (Cronbach’s alpha = .83 in 2006; .84 = in
2012) with four values ranging from 0 to 3.2 It
should be kept in mind that this measure is not
intended to fully meet the diagnostic criteria for
clinical depression outlined in the DSM-V (Amer-
ican Psychiatric Association 2013). Rather, this
measure assesses what may be considered subclin-
ical or preclinical symptomotology (cf. Hopcroft
and Bradley 2007; Krause 2010; Simon and
Lively 2010). Thus, rather than indicating a binary
diagnosis (depression is either present or absent),
the depressive symptoms index measures self-
reported symptoms on a continuum similar to
the frequently used Center for Epidemiologic
Studies Depression (CES-D) Scale (George and
Lynch 2003; Krause 2010; Radloff 1977; Schie-
man, van Gundy, and Taylor 2002).
Perry 7

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Figure 1. Breakdown of moral beliefs about pornography and usage in the past year.
Source. 2006 Portraits of American Life Study; N = 2,292.
Pornography Beliefs and Use. The focal
predictors for this study are a combination of var-
iables constructed from responses to two PALS
questions in 2006 concerning (1) the morality of
viewing3 pornography and (2) respondents’ por-
nography viewing history in the past year. Regard-
ing the morality of viewing pornography, respond-
ents could indicate they felt it was: (1) always
morally wrong, (2) usually morally wrong, (3)
sometimes morally wrong, (4) never morally
wrong, (5) not a moral issue, and (6) case by
case. Because the theoretical expectations of this
study hinge on actors’ moral rejection of some-
thing they willingly participate in, this measure
is dichotomized into 1 = always morally wrong
(about 55 percent of the sample) and 0 = not
always morally wrong. PALS also asked partici-
pants, “In the past 12 months, how often have
you viewed pornographic materials?” Responses
ranged from 1 = once a day or more to 8 = never.4
This measure was recoded in two ways for the
analysis. First, a dichotomous measure was con-
structed indicating that someone either did or
did not view pornography in the previous year
with 1 = yes (about 38 percent of the sample)
and 0 = no. Second, the full measure was
reverse-coded so that higher scores indicate
greater pornography viewing frequency. This
measure is used in analyses to determine the
potential effects of pornography viewing fre-
quency on depressive symptoms either for all
Americans or those who already admit to viewing
pornography at all.
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From the dichotomized morality and usage
measures, four dummy categories of respondents
were constructed, represented in Figure 1. In the
top two quadrants are “uninterested porn
abstainers,” or those who do not believe viewing
pornography is always morally wrong but do not
view it anyway (17 percent of the sample), and
“principled porn abstainers,” or those who believe
pornography is always morally wrong and do not
view it (45 percent of the sample). In the bottom
two quadrants are “unconflicted porn viewers,”
or those who do not believe viewing pornography
is always morally wrong and view it (28 percent of
the sample), and “conflicted porn viewers,” or
those who believe viewing pornography is always
morally wrong but still view it (10 percent of the
sample). While each category will be used as a ref-
erence in the analysis, the primary reference cate-
gory will be unconflicted porn viewers to highlight
the comparison with conflicted porn viewers.
Controls. Analyses also included a variety of
sociodemographic controls that were selected
both for theoretical reasons and their association
with key predictors. Depressive symptoms tend
to be higher among those who are younger,5
female, unmarried, nonwhite, and lower socioeco-
nomic status (Akhtar-Danesh and Landeen 2007;
George and Lynch 2003; Hopcroft and Bradley
2007; Schieman et al. 2002; Simon and Lively
2010), and thus controls were included for age
(in years, 18–80 in 2006; 24–80 in 2012), gender
(male = 1), marital status (married = 1), race
8 Society and Mental Health XX(X)
(white = reference), education (bachelor’s degree
or higher = 1), and household income (from 1 =
less than $5,000 to 19 = $200,000 or more). Having
children in the home can also be associated with
depressive symptoms (Evanson and Simon 2005;
McLanahan and Adams 1987), so a measure is
also included for this (children in home = 1). A con-
trol was also included for region of the country,
which was found to be associated with depressive
symptoms in ancillary analyses (South = reference).
Religious factors were important to consider
for a variety of reasons. Religiously committed
and theologically conservative Americans are
both more likely to reject pornography use on
moral grounds (Carroll et al. 2008; Lykke and
Cohen 2015) and less likely to view it compared
to other Americans (Perry 2016, 2017; but see
Whitehead and Perry 2017), and experiencing
depressive symptoms is negatively associated
with religious participation (Ellison et al. 2001;
Krause 2010; Schieman et al. 2006, 2013), though
not necessarily religious tradition or conservatism
(Wesselmann and Graziano 2010; but see Scheitle
and Adamczyk 2010). The analyses thus include
controls for religious commitment, tradition, and
conservatism. Religious commitment was mea-
sured with religious service attendance, which
ranged from 1 = never to 8 = more than three times
a week. Religious tradition was measured with
a modified version of the RELTRAD classifica-
tion scheme (Steensland et al. 2000).6 Categories
included conservative Protestant, mainline Protes-
tant, other Protestant, other religious tradition, and
the unaffiliated. The unaffiliated serves as the ref-
erence category. Lastly, theological conservatism
was measured with whether respondents believed
their sacred text was fully inspired by God.
Responses ranged from 1 = fully inspired by
God to 4 = I have never heard of the religious
text. The measure was dichotomized so that 1 =
fully inspired by God, 0 = other. Participants
with a 1 for this measure would be more likely
to view the moral teachings of their sacred text
as authoritative. In analyses that use the cross-sec-
tional 2006 data, all controls are from 2006. For
analyses using the longitudinal 2006–2012 data,
all controls are from 2012.7 For descriptive statis-
tics of all variables in the analyses, see Table 1.
Analytic Strategy
Table 1 presents descriptive statistics for all vari-
ables from the 2006 and 2006–2012 PALS data
sets to provide an overview of the outcome varia-
bles and focal predictors. Table 1 also presents
zero-order correlation coefficients for all predictor
variables and outcome variables to establish the
bivariate relationships.
For the multivariate analyses, I draw primarily
on the cross-sectional 2006 PALS data and use the
2006–2012 data to establish temporal precedence.
While the 2006–2012 data are helpful for the pur-
poses of establishing that pornography use pre-
ceded depressive symptoms, I draw on the cross-
sectional 2006 data primarily because several of
the restrictions used in some of the models reduce
the 2006–2012 panel data to small sample sizes
(e.g., \260) and cause the models to violate the
proportional odds assumption. Thus, the 2006–
2012 data are used primarily as a supplement.
The outcome variable measuring the experience
of depressive symptoms is ordinal, with four
ordered response categories (0–3), and thus I use
ordinal logistic regression. A Brandt test indicated
that all reported models met the proportional odds
assumption, which assumes that the slopes are
identical across all response categories.
Tables 2 through 4 present ordinal logistic
regression coefficients predicting higher scores on
the depressive symptoms index. Table 2 uses the
2006 cross-sectional PALS data. Models 1 through
3 establish the net association between viewing por-
nography, either at all or in higher frequencies, and
depressive symptoms. These models also take moral
rejection of pornography into account to provide
context for potential influence of moral incongru-
ence. Model 4 predicts depressive symptoms using
the four constructed categories of pornography
beliefs and usage. And Model 5 includes an interac-
tion term to test whether significant differences are
moderated by gender. To establish temporal prece-
dence, Table 3 uses the 2006–2012 data and predicts
depressive symptoms in 2012 on earlier porn catego-
ries while controlling for depressive symptoms in
2006. Lastly, Table 4 uses the 2006 cross-sectional
data to predict depressive symptoms for American
men who report using pornography to test whether
the frequency of pornography use moderates the
link between moral incongruence and depressive
symptoms. Models in Tables 2 through 4 present
odds ratios (OR) and standard errors (SE).
RESULTS
Correlations in Table 1 indicate that viewing por-
nography at all is not associated with experiencing
 Table 1. Descriptive Statistics.

2006 Data Set 2006–2012 Data Set

Variables
Range Mean SD Correlationa Range Mean SD Correlationa

Outcome measures
Depressive symptoms index 2006 0–3 .58 0–3 .59
Depressive symptoms index 2012 0–3 .54 .39***
Focal predictors
Viewed porn at all 0–1 .38 .01 0–1 .38 2.05
Pornography viewing frequency 1–8 1.97 1.7 .05* 1–8 1.99 1.7 2.04
Pornography viewing frequencyb 1–7 2.60 1.9 .11*** 1–7
Viewing pornography “always morally wrong” 0–1 .55 .02 0–1 .55 .04
Unconflicted porn viewer 0–1 .28 2.03 0–1 .30 2.06
Conflicted porn viewer 0–1 .10 .05* 0–1 .09 .02
Principled porn abstainer 0–1 .45 2.01 0–1 .46 .03
Uninterested porn abstainer 0–1 .17 .01 0–1 .16 .03
Controls
Male 0–1 .49 2.11*** 0–1 .48 2.09**
Age 18–80 44.97 16.1 2.08*** 24–80 49.8 15.6 2.03
Bachelor’s 0–1 .27 2.11*** 0–1 .34 2.014***
Household income 1–19 9.29 4.6 2.20*** 1–19 9.41 4.8 2.23***
Married 0–1 .58 2.14*** 0–1 .57 2.16***
Lives with children 0–1 .46 2.01
Any children (2012) 0–1 .76 2.03
South 0–1 .33 .04* 0–1 .34 .03
West 0–1 .26 2.02 0–1 .26 2.06
Midwest 0–1 .24 2.01 0–1 .23 2.04
Northeast 0–1 .17 2.02 0–1 .17 .07*
White 0–1 .71 2.05* 0–1 .69 .02
Black 0–1 .11 .04 0–1 .12 .01
Hispanic 0–1 .12 .04 0–1 .14 .00
Asian 0–1 .05 2.04* 0–1 .04 2.08*
Native American 0–1 .01 .09*** 0–1 .01 .06
Religious service attendance 1–8 3.58 2.2 2.08*** 1–8 3.68 2.4 2.03
Scriptural fully inspired 0–1 .59 .02 0–1 .60 .01

9
(continued)
10 Society and Mental Health XX(X)

Correlationa
depressive symptoms in either 2006 or 2012 at the
bivariate level. However, pornography viewing

2.03
.02
2.06
.06
.03
2.04
frequency is positively associated with experienc-
ing depressive symptoms in 2006, and when only
those who report viewing pornography are
2006–2012 Data Set

included, viewing frequency is more strongly

and positively associated with experiencing
SD

depressive symptoms. Looking at the four catego-

ries of pornography belief and usage, only being in
the conflicted porn viewer group is positively
.19
.31
.09
.11
.24
.07
Mean

associated with experiencing depressive symp-

toms in 2006. The other groups by comparison
show virtually no correlation whatsoever with
the outcome. While this association does not
0–1
0–1
0–1
0–1
0–1
0–1
Range

hold between these 2006 categories and 2012

depressive symptoms, multivariate findings indi-
cate that this non-association is due largely to stark
gender differences.
Turning to the multivariate analyses, in Model
a
Correlation

.07***

1 of Table 2, the odds that Americans who view

2.07**
.02

2.01
2.01
2.03

pornography experience depressive symptoms

Source. 2006 Portraits of American Life Study, N = 2,292; 2012 Portraits of American Life Study, N = 912.

are 36 percent higher than those who abstain

This measure only includes those who reported viewing pornography in the previous year (N = 859).

from pornography net of relevant controls. By

contrast, one’s moral view of pornography is unre-
2006 Data Set

lated to depressive symptoms. Model 2 uses the

SD

expanded measure and finds that the odds of expe-

riencing depressive symptoms increase roughly 15
percent for every increase in the 8-value use mea-
sure. Though, one’s moral view about pornogra-
.16
.32
.14
.04
.27
.07
Mean

phy is still not significantly related to the outcome.

These results affirm the first two hypotheses: (1)
On the whole, Americans who view pornography
(either at all or more often) are more likely to
0–1
0–1
0–1
0–1
0–1
0–1
Range

experience depressive symptoms, but (2) Ameri-

cans who reject pornography morally are not
more likely to experience depressive symptoms.
Things change when the sample is restricted to
porn viewers in Model 3, however. Among Amer-
*p \ .05. **p \ .01. ***p \ .001 (two-tailed test).

icans who report viewing pornography in the pre-

vious year, both viewing frequency and believing
that viewing pornography is always morally
Correlation with the outcome variable.

wrong are significantly and positively associated

with higher log odds of experiencing depressive
symptoms. This indicates that while believing por-
Conservative Protestant

nography use to be morally wrong is generally

unassociated with depressive symptoms for all
Mainline Protestant
Table 1. (continued)

Other Protestant

Americans, among those who use pornography,

Other religion

it is highly predictive of depressive symptoms.

This finding points to the potential influence of
Unaffiliated

Catholic

moral incongruence on experiencing depressive

Variables

symptoms.
Isolating this incongruence more directly,
Model 4 predicts depressive symptoms with the
b
a
Perry 11

Table 2. Ordinal Logistic Regression Predicting Depressive Symptoms.

Model 1 Model 2 Model 3a Model 4 Model 5

Predictor OR SE OR SE OR SE OR SE OR SE

Viewed porn at all 1.36** .116

Pornography viewing frequency 1.15*** .032 1.20*** .045
Viewing porn “always 1.20 .113 1.24 .111 1.83*** .187
morally wrong”
Unconflicted porn
viewer (reference)
Conflicted porn viewer 1.59** .171 .99 .264
Principled porn abstainer .92 .134 .87 .151
Uninterested porn abstainer .91 .150 .88 .135
Conflicted porn 2.14* .310
viewer 3 male
Male 57*** .101 .52*** .105 .51*** .182 .58*** .101 .52*** .109
Age .99 .003 .99 .003 1.00 .006 .99 .003 .99* .003
Bachelor’s .83 .121 .84 .122 1.12 .186 .83 .121 .83 .121
Household income .93*** .012 .93*** .012 .92*** .020 .93*** .012 .93*** .012
Married .75** .107 .76** .107 .46*** .189 .74** .107 .75** .107
Lives with children 1.05 .100 1.06 .101 1.27 .174 1.06 .100 1.05 .101
South (reference)
West .80 .123 .80 .124 .83 .191 .80 .123 .80 .124
Midwest .73* .125 .73* .125 .85 .218 .74* .125 .74* .125
Northeast .85 .141 .86 .141 .84 .234 .85 .141 .84 .141
White (reference)
Black .91 .152 .89 .152 1.30 .242 .91 .152 .90 .152
Hispanic .89 .155 .90 .154 .84 .256 .89 .155 .89 .155
Asian .87 .248 .91 .249 .64 .457 1.66 .249 .87 .249
Native American 4.24** .473 3.84** .471 5.77** .601 4.29** .474 4.23** .475
Religious service attendance .93** .025 .93** .025 .98 .047 .93** .025 .92*** .025
Scriptural fully inspired 1.14 .108 1.17 .109 1.13 .174 1.15 .108 1.16 .108
Unaffiliated (reference)
Conservative Protestant .83 .156 .86 .157 .93 .245 .83 .156 .84 .156
Mainline Protestant .71 .181 .74 .182 1.12 .286 .71 .181 .71 .181
Other Protestant .71 .265 .75 .266 1.28 .380 1.45 .266 .72 .266
Catholic .94 .156 .99 .157 .90 .248 .94 .156 .96 .156
Other religion .82 .221 .81 .221 1.24 .300 .83 .221 .83 .221
Nagelkerke pseudo R2 .090 .096 .144 .093 .096

Note. The proportional odds assumption is met for each model. Ancillary analyses rotated the porn beliefs/usage
reference category and only conflicted porn viewer was significantly different from any other category. Interactions
between conflicted porn viewer 3 male were significant with any porn beliefs/usage group as the reference category.
Full models available on request. OR = odds ratio; SE = standard error.
Source. 2006 Portraits of American Life Study; N = 2,292.
a
Model only includes those who reported viewing pornography at some point in the previous year (N = 859).
*p \ .05. **p \ .01. ***p \ .001 (two-tailed test).

four categories of porn belief and usage net of all
controls. With those who are unconflicted porn
viewers as the reference category, only those
who are conflicted porn viewers show higher
odds of experiencing depressive symptoms. Those
in the principled porn abstainer or uninterested
porn abstainer categories are not more likely
than unconflicted porn viewers to experience
depressive symptoms. In ancillary analyses (avail-
able on request), I rotated the reference categories,
12 Society and Mental Health XX(X)

Table 3. Ordinal Logistic Regression Predicting Depressive Symptoms in 2012.

Model 1 Model 2
Predictor
OR SE OR SE

Unconflicted porn viewer (reference) — —

Conflicted porn viewer 1.46 .309 .53 .519
Principled porn abstainer 1.05 .237 .98 .239
Uninterested porn abstainer .95 .270 .88 .273
Conflicted porn viewer 3 male 4.64** .591
Depressive symptoms in 2006 2.01*** .071 2.02*** .071
Male 1.53* .182 1.29 .193
Age .98** .006 .98** .006
Bachelor’s 1.04 .196 1.09 .198
Household income .93*** .021 .92*** .022
Married .84 .200 .86 .201
Any children .88 .216 .88 .216
South (reference)
West .69 .223 .70 .224
Midwest .64* .227 .63* .228
Northeast .87 .238 1.16 .238
White (reference)
Black .58* .280 .55* .282
Hispanic .53* .276 .51* .278
Asian .87 .416 1.14 .416
Native American .09 1.555 .08 1.559
Religious service attendance .85*** .043 .85*** .043
Scriptural fully inspired .93 .197 .93 .197
Unaffiliated (reference)
Conservative Protestant 1.70 .274 1.78* .276
Mainline Protestant .74 .395 .67 .402
Other Protestant .1.55 .323 1.63 .324
Catholic .1.73* .274 1.72* .275
Other religion .1.60 .381 1.66 .382
Nagelkerke pseudo R2 .235 .243

Note. The proportional odds assumption is met for each model. OR = odds ratio; SE = standard error.
Source. 2006–2012 Portraits of American Life Study; N = 912.
*p \ .05. **p \ .01. ***p \ .001 (two-tailed test).

and those who are conflicted porn viewers are sig-
nificantly more likely than each of the other cate-
gories to experience depressive symptoms. More-
over, none of the three categories besides the
conflicted porn viewers are different from one
another in their likelihood of experiencing depres-
sive symptoms. In other words, it is not the act of
viewing pornography per se that is associated with
depressive symptoms, nor is it believing that por-
nography use is immoral. Rather, it is the moral
incongruence—the contradiction of believing por-
nography to be always morally wrong but still
viewing it anyway—that is predictive of depres-
sive symptoms.
But is this true regardless of gender? Model 5
includes the interaction term for being a conflicted
porn viewer 3 being male to test for this. The term
is positive and statistically significant, indicating
that men who are conflicted porn viewers are
more likely to report experiencing depressive
symptoms compared to their female counterparts.
The analyses in Table 3 essentially replicate
Models 4 and 5 in Table 2 but predicting depres-
sive symptoms at the 2012 wave of PALS and
controlling for earlier depressive symptoms in
2006. In Model 1, those who were conflicted
porn viewers in 2006 are not significantly different
from unconflicted porn viewers in their likelihood
Perry 13

Table 4. Ordinal Logistic Regression Predicting Depressive Symptoms among Male Respondents Who
Reported Using Pornography in the Previous Year.

Model 1 Model 2
Predictor
OR SE OR SE

Pornography viewing frequency 1.24*** .051 1.33*** .059

Viewing pornography “always morally wrong” 2.65*** .238 9.37*** .508
Porn frequency 3 pornography always wrong .71** .123
Age 1.00 .007 1.00 .007
Bachelor’s 1.34 .244 1.37 .245
Household income .90*** .026 .89*** .026
Married .50** .253 .48** .255
Lives with children 1.29 .233 1.39 .236
South (reference)
West 1.02 .238 1.00 .239
Midwest .99 .272 .96 .274
Northeast .89 .306 .90 .308
White (reference)
Black 1.43 .293 1.41 .295
Hispanic .65 .333 .65 .335
Asian .43 .617 .43 .627
Native American 3.24 .694 3.56 .691
Religious service attendance 1.02 .062 1.01 .062
Scriptural fully inspired 1.37 .221 1.40 .224
Unaffiliated (reference)
Conservative Protestant .73 .298 .74 .301
Mainline Protestant .91 .344 .95 .346
Other Protestant .87 .537 .78 .545
Catholic .76 .312 .84 .316
Other religion 1.84 .357 1.89 .359
Nagelkerke pseudo R2 .186 .198

Note. The proportional odds assumption is met for each model. OR = odds ratio; SE = standard error.
Source. 2006 Portraits of American Life Study; N = 617.
**p \ .01. ***p \ .001 (two-tailed test).

of reporting depressive symptoms in 2012. The
results of Model 2, however, suggest that this
non-effect is due to the large gender differences.
Model 2 includes the interaction term for being
a conflicted porn viewer 3 being male, and the
term is strongly significant and positive, with the
odds ratio indicating that men who are conflicted
porn viewers in 2006 show odds of experiencing
depressive symptoms in 2012 (even after control-
ling for earlier depressive symptoms) that are over
4.5 times that of women.
Figure 2 presents predicted probabilities to
illustrate the moderating effect of gender on the
association between moral incongruence regarding
porn use and depressive symptoms. The top panel
predicts depressive symptoms in 2006, while the
bottom panel predicts depressive symptoms in
2012 (controlling for earlier depressive symp-
toms). While women who are conflicted porn
viewers do not differ greatly in terms of experienc-
ing depressive symptoms from those who are
unconflicted porn viewers, there is a great deal
of difference between these groups for men. Men
who are conflicted porn viewers are considerably
more likely to report depressive symptoms in
2006 and 2012 compared to men who are uncon-
flicted porn viewers. The association between
moral incongruence—at least in the area of porn
use—and depressive symptoms thus only appears
to apply to men. Hypotheses 3 and 4 are thus
supported.
But how does one’s frequency of pornography
use potentially interact with their moral rejection
of pornography to predict depressive symptoms?
14
Figure 2. Predicted probability of experiencing depressive symptoms by incongruence between porn
beliefs and use across gender.
Table 4 predicts depressive symptoms with the
sample restricted only to men who report viewing
pornography during the previous year. In Model 1,
porn viewing frequency is a positive predictor of
experiencing depressive symptoms, as is believing
pornography is always morally wrong (similar to
findings in Table 2, Model 3). This again suggests
that men who view pornography and morally
reject it show higher odds of experiencing depres-
sive symptoms. Model 2 includes an interaction
term for porn viewing frequency 3 believing
porn use is always morally wrong, and the term
is significant and negative, indicating that the
slopes differ and invert. This relationship is illus-
trated clearly in the predicted probabilities pre-
sented in Figure 3. At the lowest frequencies of
pornography use (where the majority of porn users
in the survey are), those who believe viewing por-
nography is always morally wrong are more likely
to experience depressive symptoms compared to
those who do not believe it is always morally
wrong. However, for porn users who believe view-
ing pornography is always immoral, depressive
symptoms do not increase greatly as their porn
Society and Mental Health XX(X)
viewing frequency increases. This supports the
fifth hypothesis. By contrast, for those who do
not believe pornography is always morally wrong,
their likelihood of reporting depressive symptoms
increases sharply as their viewing frequency
increases. Put another way, higher depressive
symptoms are linked with higher frequencies of
porn use but only among men who do not morally
reject pornography. I interpret these different pat-
terns in the discussion section.
DISCUSSION
As pornography use continues to increase in the
United States, a growing body of research has
sought to better understand its observed connec-
tion to poorer mental health. Though studies
have consistently found a link between pornogra-
phy use and symptoms of depression, data limita-
tions have precluded understanding the nature of
this relationship, including causal direction and
mechanisms or whether the associations general-
ize to the broader population. Drawing on data
from a nationally representative panel survey of
Perry
Figure 3. Predicted probability of experiencing depressive symptoms by porn viewing frequency and
believing pornography is always morally wrong (men only).
Americans and incorporating insights from stress
process theory, this study demonstrated that the
association between viewing pornography and
depressive symptoms hinges largely on (1) the
(in)congruence between Americans’ moral beliefs
about viewing pornography and their use patterns
and (2) gender.
Both cross-sectional and longitudinal analyses
affirmed that American men (but not women)
who were conflicted porn viewers (those who
believe viewing porn is always wrong but viewed
it anyway) were more likely to experience depres-
sive symptoms compared to other Americans who
did not report an incongruence between their porn
beliefs and usage. It is also important to recall that
unconflicted porn viewers (those who viewed porn
and did not view it as always wrong) were not
more likely to experience depressive symptoms
either in 2006 or 2012 compared to Americans
who did not view pornography at all. Thus, while
Americans who view porn, either at all or in
greater frequencies, are generally more likely to
report experiencing depressive symptoms, this
only appears to be true for American men who
are violating their own moral views about pornog-
raphy use. The important issue, therefore, is not
pornography use per se but likely the dissonance
and distress one feels for violating one’s own val-
ues (Bierman 2010; Pearlin 1989). It is the moral
incongruence that predicts depressive symptoms.
Another key finding highlighting the impor-
tance of moral incongruence helps us understand
15
the bidirectionality of the relationship between
pornography use and depressive symptoms
(among men). Interacting porn viewing frequency
with moral opposition to porn use showed that for
American men who view pornography and believe
it is always wrong, viewing porn predicts depres-
sive symptoms even at relatively low frequencies,
and this association does not increase much as
viewing frequency increases. By comparison, for
male porn users who do not morally reject pornog-
raphy, only viewing porn at the highest frequen-
cies is associated with higher reported depressive
symptoms. These paradoxical findings suggest
the association between porn use and depressive
symptoms is both bidirectional and contingent on
one’s moral beliefs about viewing pornography.
Male porn users who feel morally conflicted about
their use may experience cognitive dissonance or
distress, leading to depressive symptoms, even
when they do not view pornography that often.
This finding supports preliminary work by
Grubbs, Exline, et al. (2015), who find that under-
graduates who are more religious and morally
opposed to porn use are more likely to consider
themselves addicted to pornography even though
their usage is no more frequent than others. Else-
where, Grubbs and colleagues (Grubbs, Stauner,
et al., 2015; Grubbs, Volk, et al. 2015) show the
belief that one is addicted to pornography—which,
I contend, is really a proxy for moral incongruence
between beliefs about pornography and viewing
practices—is associated with experiencing higher
16
levels of psychological distress regardless of view-
ing frequency. On the other hand, for those who do
not morally reject porn, it is likely the depressive
symptomology itself that leads to higher porn
use frequency. In other words, depressed men
who do not morally reject pornography are more
likely to view large amounts of porn as a coping
strategy. This finding is consistent with clinical
research suggesting that men experiencing high
levels of depression often view pornography and
masturbate rather compulsively (Cooper et al.
2001; Kafka 2000; Stein et al. 2001).
Ultimately, the bidirectionality of the relation-
ship between pornography use and depressive
symptoms suggests that the experience of porn
use and depressive symptoms among conflicted
porn users is cyclical. Though the data used for
this study cannot unpack this possibility, it is
likely that conflicted porn users feel guilty and
experience depressive symptoms due to their
porn use (likely accompanied by greater isolation
and loneliness), and this in turn contributes to
these individuals returning to pornography to
relieve bad feelings, thus repeating this cycle.
This pattern would help explain why clinicians
and other researchers often find participants indi-
cating pornography is both a consequence and
cause of negative emotional states (e.g., Baltazar
et al. 2010; Stein et al. 2001).
Why do these effects only hold true among
American men but not women? Men are consider-
ably more likely to view pornography in isolation
compared to women, who are more likely to view
porn within the context of a relationship (Bridges
and Morokoff 2011; Maddox et al. 2011; Poulsen
et al. 2013). It could be that regular, isolated pornog-
raphy use feels more deviant for men who morally
reject it and thus is more strongly associated with
cognitive dissonance and depressive symptoms later
on. By contrast, women (even those who believe
pornography to be wrong) may rationalize coupled
porn use as strengthening the intimacy of a relation-
ship (Bridges and Morokoff 2011). Because the
causal relationship goes in the opposite direction
as well, it could be that depressed men are also
more likely to turn to porn as a coping strategy,
whereas women are more likely to turn to other rela-
tionships or activities. Unfortunately, because PALS
does not ask individuals about their reasons for
viewing pornography, the moderating role of gender
cannot be explored more fully.
Several additional data limitations should be
acknowledged to chart a course for future
Society and Mental Health XX(X)
research. First, the pornography use measure
does not specify what sort of pornography is being
viewed. Respondents can have different ideas of
what constitutes “pornography” (Willoughby and
Busby 2016), and it is possible that persons who
morally reject sexually explicit media have
a more expansive view of what constitutes pornog-
raphy while those who do not morally reject it may
reserve the term for more graphic material. Alter-
natively, Americans generally understand what the
term pornography means (Regnerus et al. 2016;
Whitehead and Perry 2017), and definitions would
likely not vary so widely as to drastically influence
the outcomes observed here. Nevertheless, future
studies would ideally use more specific questions
regarding the explicit content being viewed. Another
possible limitation is that because the question about
pornography use was only asked in the 2006 wave of
PALS, participants would not yet have been exposed
to smartphone technology, which was introduced in
2007 and has become a common medium for view-
ing pornography (Griffith 2016). Even so, Internet
pornography was very much available at the time
of PALS, and the reported use frequencies for men
and women in PALS are very similar to those of
other surveys fielded since 2012 (Perry and Hay-
ward 2017; Regnerus et al. 2016; Wright 2013;
Wright et al. 2013).
Beyond helping us understand the connection
between pornography use and mental health, find-
ings from this study also provide further evidence
that moral incongruence itself can hold conse-
quences for mental health. While Mannheimer
and Hill’s (2015) study of conservative Protestants
showed a rather oblique connection between
values-behavior incongruence and depressive
symptoms, by explicitly isolating incongruence
between porn beliefs and use patterns, this study
not only affirms an association between this incon-
gruence and depressive symptoms but shows that
this incongruence can precede depressive symp-
toms and predict them years later, though notably
only in men. Future studies on this topic could
profitably examine whether moral incongruence
regarding other behaviors traditionally thought of
as “deviant” could also predict depressive symp-
toms in both men and women.8 Such behaviors
might include drug use, binge drinking, or unmar-
ried sexual behavior, all of which are linked with
cognitive dissonance for (religious) adolescents
and emerging adults and thus might also contrib-
ute to depressive symptoms (along with being
a consequence of depression) (e.g., Regnerus
Perry
2007). Another example would be religious apos-
tasy or backsliding. Mannheimer and Hill (2015),
for example, showed that conservative Protestants
who failed to meet their communities’ expecta-
tions for religious practice were more likely to
experience depression and psychological distress.
Future studies should thus explore the connection
between depressive symptoms and other violations
of internalized community expectations.
NOTES
1. For both the cross-sectional and longitudinal compo-
nents, the majority of missing cases came from the
household income measure. Models were tested
with various imputation techniques to replace miss-
ing values as well as without the income measure,
and none changed the key findings substantively or
in terms of statistical significance (results available
on request). Ultimately, the decision was made to
use listwise deletion to make replication as straight-
forward as possible.
2. Ancillary analyses (available on request) showed that
final results were substantively the same if the three
depressive symptom measures were separated and
models were estimated predicting each individually
with binary logistic regression.
3. It is important to point out the question specifically
asks about the morality of “viewing” pornography.
Respondents are not necessarily being asked about
the legality or distribution of pornography (as in the
General Social Survey; see Lykke and Cohen 2015;
Price et al. 2016), or even the idea of pornography
in general, but actually viewing it. This underscores
the potential moral contradiction for those who claim
that viewing pornography is always morally wrong
even as they report viewing it themselves.
4. These two measures were asked at different times in
the interview, so it is unlikely that participants were
primed for either question. Moreover, Emerson, Sik-
kink, and James (2010) explain that to mitigate social
desirability bias for sensitive questions like one’s
pornography viewing habits, each Portraits of Amer-
ican Life Study (PALS) participant wore earphones
to hear the questions prerecorded and then entered
their responses directly into the computer apart
from the knowledge or help of the interviewer.
5. To qualify this claim, the relationship between age
and depressive symptoms is often curvilinear in cor-
respondence to significant changes across the life
course. Depressive symptoms are high among adoles-
cents and young adults, decrease with age until the
later years of life when health starts to decline, and
then depressive symptoms increase (Krause 2010;
Mirowsky and Ross 1992; Schieman, van Gundy,
and Taylor 2002).
17
6. I include evangelical and black Protestants together
in one category (conservative Protestant) because
the two are highly similar on most outcomes and
because including black Protestant as a separate cat-
egory creates potential collinearity issues with the
racial category “black” also included in the analysis.
Ultimately, including evangelicals and black Protes-
tants together or separately made virtually no differ-
ence in the outcomes.
7. The only difference in the controls variables included
in the models using 2006 and 2006–2012 data are that
the models using 2006–2012 data include a control
for “any children” as opposed to having children in
the home, which PALS did not ask about in the
2012 wave. This change does not alter the results
either in substance or statistical significance.
8. Research among lesbian, gay, and bisexual (LGB)
individuals finds small to moderate associations
between internalized homophobia and depressive
symptoms (for a review, see Newcomb and Mustanski
2010), but sexual orientation is not an ideal parallel to
porn use since sexual orientation is so closely con-
nected with personal identity, the depression LGB
individuals experience may also be indirectly or
directly due to the outright hostility they experience,
and there is little possibility for reverse causation since
depressed heterosexuals do not tend to seek out same-
sex partners to cope with stress or sadness.
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