Toward a theoretically grounded preventive framework for Problematic Pornography Use: The PPU-PrevFrame

A small proportion of pornography users experience problems to control this sexual behavior (i.e., "Problematic Pornography Use" PPU), leading to significant distress and functional impairment. Although several therapeutic interventions for PPU exist and have shown promising results, only a small proportion of affected individuals seek or access treatment. In this context, prevention of PPU (i.e., interventions designed to reduce the risk of PPU "before" the clinical picture emerges and leads to clinically significant impairment) is provided as a sound alternative. This paper introduces the "PPU-PrevFrame", a theoretically grounded, multi-component framework designed to guide universal, selective, and indicated prevention of PPU. This framework integrates strategies drawn from research on other addictive behaviors, tailoring them to the mechanisms underlying PPU. Universal prevention, as proposed by the "PPU-PrevFrame", focuses on comprehensive sexual education and pornography literacy delivered in sex-positive, developmentally appropriate formats. For individuals at elevated risk or displaying subthreshold symptoms, the "PPU-PrevFrame" incorporates additional components aimed at reducing vulnerability factors and interrupting escalation processes. These include increasing awareness of pornography use patterns and social norm interventions, educating about the "addictive-by-design" features of online pornography, strengthening internal regulation (self-control and self-regulation), implementing external control strategies, and promoting adaptive coping and emotion-regulation skills. The model also recommends periodic short-term abstinence periods, as well as other components that may be added when specific risk profiles require further support. In conclusion, the "PPU-PrevFrame" offers a theoretically grounded, flexible structure to guide the development of prevention programs that reduce PPU risk while respecting individuals' sexual agency.