The Association Between Pornography Consumption and Perceived Realism in Adolescents: A Meta-analysis

Pornography is more accessible than ever before, which raises questions concerning its influence on adolescent sexual behaviours. Recent research has identified perceived realism of pornography—the extent to which an individual perceives pornographic content as being congruent with reality—to be a potentially significant individual difference variable in this domain. However, the strength of this relationship remains uncertain. Focus is placed on this association for adolescents as sexual curiosity and maturing sexual scripts may be more readily influenced by pornography. The present study addressed this association through a meta-analysis. Database searches identified k = 5 studies (N = 3846) from various countries with relevant associations.The meta-analysis indicated a significant, moderate, and positive relationship between frequency of pornography consumption and perceived realism (r = .39) which was not moderated by the sex of participants. Given these findings, future research may assess behavioural and attitudinal changes associated with pornography use. Findings could also inform novel approaches to sexual education that prioritise recontextualising programs in the context of technology and explore the role of digital sexual socialisation of adolescents.


Introduction
Pornography is any explicit media that is intended to sexually arouse the viewer. The Internet has made pornography more accessible than ever, with online pornography being described as a triple-A engine of sexual content for being highly accessible, anonymous, and affordable (Peter & Valkenburg, 2006). Pornhub, the world's 1 3 The Association Between Pornography Consumption and Perceived… largest pornographic website, received 42 billion visits in 2019, with 150 years worth of newly uploaded content that year (Pornhub Insights, 2019). This content is also highly accessible to adolescents worldwide, despite being legally prohibited from accessing this content. Research reports pornography consumption amongst 44% of Australians aged 9-16 years in the past month (Australian Institute of Family Studies, 2017), 43% of male and 28% of female US middle-schoolers (Brown & L'Engle, 2009). Other US research reported that 29% of males and 16% of female grade 10 students had viewed violent pornography (Rostad et al., 2019). An Italian study reported 99% of males and 67% of females had viewed pornography before the age of 22 (Beltramini & Romito, 2011).
The prevalence of adolescent pornography consumption demands attention as younger audiences may be less able to distinguish between fantasy and reality in depictions of pornography, which may make them more susceptible to any influence of pornography exposure (Wright, 2011;Wright & Štulhofer, 2019. This is concerning given that pornography consumption has been associated with antisocial attitudes and behaviours relating to sexuality and sexual interactions in adolescents (Brown & L'Engle, 2009;Peter & Valkenburg, 2010, 2016Rostad et al., 2019;Wright et al., 2016Wright et al., , 2021Wright et al., , 2022Ybarra et al., 2014).
A potentially important variable in this regard is perceived realism: the extent to which one views pornographic media as reflecting reality (Baams et al., 2015;Hald et al., 2013;Mazandarani, 2016;Miller et al., 2020;Peter & Valkenburg, 2006;Taylor, 2005;Wright & Štulhofer, 2019). The perception of realism is complicated by the nature of pornography, which depicts sexual encounters between actors. Despite the presence of actual sexual intercourse-at least in the case of human actors-the antecedents of the encounter, reactions and attitudes of the actors, and the depicted social reality and norms communicated to the viewer are not necessarily realistic (Wright et al., 2022). Instead, they present the viewer with sensationalised depictions of sex that frequently appeal to male-centric fantasies of dominance that involve verbal and physical aggression against female actors (Bridges et al., 2010), and often without a depiction of consent (Willis et al., 2020). This combination of a real sexual encounter with potentially unrealistic elements may thereby influence the viewer's perceived social norms, attitudes, and behaviours towards sexual behaviour. Therefore, understanding the relationship between consumption of pornography and sexual behaviour requires a considered theoretical approach.
Sexual script theory describes a social learning process whereby sexual behaviour is guided by cognitive scripts, which are informed by messages embedded in culture (Simon & Gagnon, 1986). These sexual scripts guide an individual's perception, expectations, and responses to stimuli in sexual situations. Wright's (2011Wright's ( , 2014 3AM theory builds on sexual script theory by defining various stages of the process of assimilating or adopting novel scripts. The three elements that contribute to media content being incorporated into one's sexual script involve sexual information being retained in memory (acquisition), retrieved or primed (activation), and then enacted (application). Further, 3AM theory posits that media factors (i.e., plausibility, prevalence) situational factors (i.e., sexual arousal), and individual factors (i.e., gender, age, perceived realism) influence the strength of media effects (Wright, 2014;Wright et al., 2021Wright et al., , 2022. Consistent with this notion, Valkenburg and Peter's 1 3 (2013) differential susceptibility to media effects model (DSMM) conceptualises how dispositional, developmental, and social factors influence the potential effects of media and, similarly, how cognitive, emotional, and excitative response states mediate media use and subsequent media effects. The emerging quality of sexuality in adolescence may lead to youth seeking out sexual information more frequently and one's sexual illiteracy may strengthen their disposition to altering sexual script according to information embedded in pornographic content (Wright, 2011;Wright & Štulhofer, 2019). These theories provide a framework for how PC affects cognitive structures and subsequently behaviour, and how specific variables such as perceived realism may influence the degree to which one is affected by media.
Given the perspective of sexual script theory, the degree of exposure to pornography should predict real-world behaviour. Pornography consumption has been linked to increased sexual victimisation (Ybarra et al., 2014), sexual aggression (Wright et al., 2021) and erroneous sexual beliefs (Wright et al., 2022) in participants younger than 21 years of age, sexual risk-taking in young adults (Sinković et al., 2013), and sexual aggression in adults (Malamuth et al., 2021). Wright et al. (2016) meta-analysed 22 studies and found significant weak associations between pornography consumption and sexual aggression, and a moderate association between violent pornography consumption and sexual aggression. Furthermore, as the hierarchical confluence model of sexual aggression (Malamuth et al., 1986(Malamuth et al., , 1991(Malamuth et al., , 1996(Malamuth et al., , 2003 was expanded to include pornography consumption, its incremental validity improved in college samples (Malamuth et al., 2021;Vega & Malamuth, 2007). This was replicated in Brazilian samples (D'Abreu & Krahé, 2014;Marshall et al., 2017) and community samples (Bouffard & Goodson, 2017). The contribution of pornography consumption to predictions of sexual aggression may, in part, be due to the relationship between pornography consumption and sexist attitudes. Brown and L'Engle (2009) found that middle-school children (12-14 year-olds) with more frequent pornography consumption had more permissive sexual norms, sexist attitudes, and perpetration of sexual harassment. This finding extends to young adults (18-30 year-olds) with higher PC being associated with higher hostile and benevolent sexism (Hald et al., 2013;Malamuth et al., 2012). These findings highlight the accessibility of pornography and the association between pornography consumption and sexism.
Perceived realism is particularly important to understanding adolescents as their sociosexual knowledge, captured by sexual scripts, is underdeveloped, making them less critical regarding depictions of sex and subject to greater influence (Wright, 2011;Wright & Štulhofer, 2019). Pornography may also be perceived as a viable means of acquiring sexual knowledge and information, but which endorses erroneous or unrealistic sexual beliefs (Wright et al., 2022). Baams et al. (2015) tracked the development of pornography consumption, impersonal sexual attitudes, and perceived realism in adolescents longitudinally, reporting that perceived realism moderated the relationship between pornography consumption and impersonal sexual attitudes. Thus, the greater the level of perceived realism, the stronger the association between pornography consumption and impersonal sexual attitudes. Similarly, those who sought sexual information primarily from pornography were more likely to endorse erroneous sexual beliefs relating to physiological responses to sexual 1 3 The Association Between Pornography Consumption and Perceived… pleasure and sexual ability (Wright et al., 2022). These findings suggest that individuals who perceive realism and utility in pornography are more likely to develop sexual attitudes and beliefs that reflect pornographic themes and content.
Moreover, Peter and Valkenburg (2010) conducted a three-wave longitudinal study assessing pornography consumption, impersonal sexual attitudes, perceived social realism, and perceived utility of pornography. In a sample of 956 Dutch adolescents, perceived realism and perceived utility mediated the relationship between pornography consumption and impersonal sexual attitudes. This relationship was explained as follows: the more an individual views pornography, the more pornographic scripts they incorporate into memory. Subsequent viewings of pornography may appear more realistic due to congruence with these acquired scripts, and the depicted behaviours appear more normative and rewarding, increasing the likelihood of re-enacting these behaviours (Peter & Valkenburg, 2006. Other longitudinal research suggests that one's level of perceived realism may stabilise at around 17 years of age when many adolescents have their first sexual experience (Wright & Štulhofer, 2019). This was explained as an indirect effect, whereby sexual experiences are discussed amongst peers and experiences are compared. In this way, sexual experiences may decrease the effect of pornography as sexual scripts have assimilated with sexual experience. Conversely, Wright et al. (2022) reported that sexual experience did not preclude erroneous sexual beliefs, but rather these beliefs were greater amongst those with sexual experience. It was explained that sexual experiences may have acted as opportunities to enact sexual scripts with pornography-congruent erroneous sexual beliefs, thus reinforcing rather than decreasing them. Further research is required to elaborate on the role of sexual experience and perceived realism, although other factors may also play a role in these relationships, such as the specific content that is being viewed.
Considering the variety of pornography readily available, these different genres may be associated with different outcomes. Currently, assessment of perceived realism evaluates the degree to which "Sex on the internet" is similar to "Sex in real life" (Peter & Valkenburg, 2006). The more realistic one considers pornography to be, the greater the degree of perceived realism. However, it must be considered that these items enquire about pornography broadly and specific contents or themes are uncertain to the researchers. This becomes a methodological issue because the relationship between pornography consumption and other variables may be influenced by the depicted content. The meta-analysis by Wright et al. (2016) found that violent pornography associated more strongly with sexually aggressive behaviour than with pornography without overt violence. Alternatively, most popular pornography depicts violence against female actors and reflect distorted views of sexual consent (Bridges et al., 2010;Willis et al., 2020). It is argued that the most prevalent themes in pornography may be the most profitable and thus emulated in the mainstream, acknowledging pornography as an industry and associated market pressures of profit (Wright et al., 2022). From this perspective, it would be less imperative to separate pornography by genre and types.
Nevertheless, initial research indicates that perceived realism is a significant feature of one's relationship to pornography (Wright, 2011) and associated attitudinal and behavioural changes. In adolescents, perceived realism mediates pornography consumption and outcomes including impersonal and instrumental sexual attitudes (Peter & Valkenburg, 2006 and sexual promiscuity (Vandenbosch et al., 2018). In young adults, perceived realism mediates pornography consumption and sexual risk-taking behaviours, such as condomless sex (Wright et al., 2022). Other research reported that the strength of association between PC and permissive sexual attitudes was moderated by perceived realism (Baams et al., 2015). Thus, although little research has assessed perceived realism, it appears to be significant in one's relationship with pornography. However, the strength of this association remains uncertain, with reported estimates ranging from weak (Miller et al., 2020;Vandenbosch et al., 2018;Wright & Štulhofer, 2019) to moderate (Baams et al., 2015;Peter & Valkenburg, 2006. This relationship may also be influenced by sex. Most pornography is male-centric, depicting male fantasy and male dominance, with females being subordinated sexual objects for males, which may lead to different effects of viewing pornography for males and females. Wright (2014) identifies gender as an audience factor in the 3AM model that may influence the process from pornography consumption to sexual script enactment. Male adolescents typically reported greater pornography (Baams et al., 2015;Brown & L'Engle, 2009;Peter & Valkenburg, 2006) and perceived realism (Baams et al., 2015;Peter & Valkenburg, 2006) than females, and reported earlier exposure to pornography (Beltramini & Romito, 2011;Brown & L'Engle, 2009). Differential effects by sex have also been reported for the process of sexual socialisation. Wright and Štulhofer (2019) found that males and females both reported increased pornography consumption and decreased perceived realism over time, with more pronounced effects in males. However, early exposure linked with later pornography consumption only in males. Other research found that the mediational relationship between PC and recreational sexual attitudes is influenced by gender and the degree of perceived realism (Peter & Valkenburg, 2006). Therefore, considering these findings, gender (reported as sex in the primary studies) is assessed as a moderator in this meta-analysis.
Given these considerations, the aim of the present study was to assess the association between frequency of pornography consumption and perceived realism using meta-analysis. Two research questions were asked: (1) How strong is the association between perceived realism and PC in adolescents? And (2) Is this association moderated by sex? Answering these questions may provide a more detailed understanding of these complex issues, and inform future theory and research.

Method
Five inclusion criteria were used. Studies were required to (1) include a measure of frequency of internet pornography consumption, regardless of assessment interval (i.e., past week, past month etc.); (2) measure perceived realism using social realism, the degree to which pornographic content reflects reality; (3) sample individuals no older than 20 years; (4) report zero-order correlations between PC and perceived realism, with data from longitudinal designs being extracted only from T1 to T2; and (5) be sourced from peer-reviewed, academic journals. Studies were sourced 1 3 The Association Between Pornography Consumption and Perceived… from electronic research databases (i.e., PsycINFO, ScienceDirect, Web of Science, and ProQuest). The following search terms were applied: '(("perceived realism" OR "social realism" OR "realism") AND ("pornography" OR "sexually explicit material" OR "sexualised media" OR "sexualized media") AND ("adolescence" OR "adolescent"))'. Searches were conducted in August 2020 and reconducted in February 2023. Correlations between perceived realism and PC were adjusted for scale reliability using Spearman's correction for scale unreliability (Spearman, 1904) before meta-analysis was undertaken using the Meta-Essentials Spreadsheets (Suurmond et al., 2017). Overall effect sizes were presented using correlation coefficients with 95% confidence intervals, generated using a random-effects model. Heterogeneity was evaluated using Q and I 2 statistics. Sex was assessed as a moderator using a sex ratio calculated from the publication's descriptive statistics or obtained from the corresponding authors. Table 1 presents the five studies that met the inclusion criteria which yielded a total sample size of 3846 participants, comprised of 1569 males and 2066 females, and Fig. 1 presents the data collection method. Three studies were longitudinal and two were cross-sectional. Thirty-eight studies were excluded for not meeting inclusion criteria. Pornography consumption was not measured by 26 studies. Of those that did measure pornography consumption, eight sampled individuals older than 20. The remaining studies were excluded as two did not measure perceived realism or did not report zero-order correlations. The full dataset is available from the first author.

Results
The mean effect size for the relationship between frequency of pornography consumption and perceived realism was r = 0.39 (95% CI 0.18-0.57; k = 5) indicating a moderate, statistically significant relationship ( Table 2) with means of four of the five included studies falling within the 95% CI (Fig. 2). There was significant heterogeneity among the studies, with the I 2 statistic indicating that the variation observed in the sample was overwhelmingly due to real variation between original correlations (Table 2). Sex was also assessed as a moderator between pornography consumption and perceived realism, with no statistically significant difference being found (R 2 = 0.25), F(1,3) = 0.98, p = 0.40.

Discussion
The first research question of this meta-analysis concerned the strength of the association between pornography consumption and perceived realism in adolescents, which was found to be moderate, positive, and significant. This finding supports previous research that has assessed perceived realism as a relevant variable in seeking to understand pornography consumption, by demonstrating that these variables are robustly related in research. The second research question concerned whether this relationship was moderated by sex, which was found not to be the case. Overall, Table 1 Overview of analysed studies The Association Between Pornography Consumption and Perceived… these findings provide a basis for further exploring the salience of perceived realism for understanding pornography consumption. Previous approaches have utilised perceived realism as mediator between PC and other variables, as theorised by Wright's 3AM model (2014) and the DSMM (Valkenburg & Peter, 2013), and present findings do not contradict these approaches.
A potential explanation for this association involves the effect of perceived realism on the degree to which one evaluates pornographic content critically. Previous explanations reason that the more pornographic scripts an individual acquires through consumption, the more congruent pornography becomes with their sexual scripts, thus increasing the perception of realism in pornographic content (Peter & Valkenburg, 2006. An individual with a higher level of perceived realism may be less critical of pornographic content, and thereby more readily encode and assimilate the pornographic content into their sexual scripts (Wright, 2011;Wright & Štulhofer, 2019). Wright's 3AM stage of application provides a theoretical framework of how consumption of mainstream pornography, with prevalent depictions of verbal and physical aggression towards females (Bridges et al., 2010), may lead to enacting content and themes depicted in this pornography. In the context of adolescent social sexualisation this may produce related outcomes in adult life, such as increased sexist attitudes (Brown & L'Engle, 2009;Miller et al., 2020), sexual risk-taking behaviours (Lim et al., 2017;Sinković et al., 2013;Wright et al., 2022) and sexually aggressive behaviour (Vega & Malamuth, 2007;Wright et al., 2016). Further, previous longitudinal research has indicated that adolescents who reported  greater initial pornography consumption had greater perceived realism in subsequent measurements, but without evidence of reciprocal effects (Peter & Valkenburg, 2010). However, because the current findings cannot be used to evaluate such causal relationships, future research should assess whether these exist between perceived realism and PC. Furthermore, despite variation in terms used to refer to pornography between studies, most studies fell within the confidence intervals for the combined effect size. Although the present study was ostensibly assessing 'pornography', studies included in the meta-analysis referred to 'sexually explicit internet materials' (Nguyen et al., 2021;Peter & Valkenburg, 2010), 'sexualised media' (Baams et al., 2015), 'pornography' (Wright et al., 2022), and 'sexually explicit online materials' (Peter & Valkenburg, 2006). Kohut et al. (2020) suggested lack of uniformity in how researchers refer to "pornography" creates ambiguity in what is actually being referred to (i.e., depictions of nudity, hardcore pornography, erotica etc.). However, whether the similar strength of association between variables in these studies and pornography consumption indicates that they measure the same construct or different constructs that relate to similar degrees with pornography consumption remains unclear and a topic for future research.
Cultural aspects are also likely to be relevant in the development of sexual perspectives. Nguyen et al. (2021) described Vietnamese cultural aspects whereby intra-familial discussion about sex and sexual education are considered taboo, and thus peers and the internet may become sources of sexual information. Additionally, cultural factors may influence the rate at which adolescents report pornography consumption or are willing to take part in sex-related research (Grubbs et al., 2019;Peter & Valkenburg, 2016). A greater reliance on pornography as a source of sexual knowledge may make distinguishing between safe and unsafe content more challenging, and contribute to impersonal sexual attitudes (Peter & Valkenburg, 2010;Vandenbosch et al., 2018;Wright & Štulhofer, 2019). The current study was unable to assess culture as a moderator because three of the five samples were from the Netherlands, and the other two (Croatia and Vietnam) could not comprise a meaningful subgroup. Therefore, future research should address cultural aspects that influence pornography consumption.
This study was limited in several ways. First, being correlational means its findings cannot be used to infer causality in the relationship between perceived realism and pornography consumption. Second, it did not measure the motivation, genre, and platform associated with pornography consumption, which may influence relationships between pornography consumption and other variables (Grubbs et al., 2019;Nguyen et al., 2021;Wright et al., 2016). Similarly, understanding specific cultural differences that influence relationships would elucidate the relationship between perceived realism and pornography consumption. Third, only five studies were included in the analysis, limiting both statistical power and the ability to subdivide studies into subgroups for moderation analysis. Nevertheless, despite these limitations, the major strength of the current study was that it is-to our knowledge-the first attempt to quantitatively assess the literature reporting the relationship between perceived realism and pornography consumption, which these preliminary results indicate is significant, moderate, and robust.
Several future directions for pornography research are worth pursuing. First, research should further assess whether various types of content are differentially associated with behavioural outcomes (Wright et al., 2016). This would have several theoretical implications for 3AM theory which has identified aspects of the media that may influence the process of sexual socialisation. Furthermore, although much research focuses on the negative predictors of higher pornography consumption, it remains plausible that higher pornography consumption and individual factors, such as perceived realism, may predict positive outcomes depending on the content being viewed (Peter & Valkenburg, 2016;Vertongen et al., 2022), such as sexual flexibility and sexual functioning (Komlenac & Hochleitner, 2022). This is an avenue for future research. Second, a uniform measure of pornography consumption should be developed and validated to make future research more consistent (Kohut et al., 2020). Similarly, a standardised measure of perceived realism should also be developed which would assess this broad domain more comprehensively beyond the existing factors: content details, typologies of pornography, and social contexts of use. Third, future research should evaluate the role of perceived realism in attitudinal outcomes (i.e., motivations to use pornography, genre-preferences) and behavioural outcomes (i.e., sexual risk-taking behaviours in adulthood), as it may explain or nuance these relationships. Fourth, psychological perspectives could contribute to population-health interventions aimed at reducing negative sexual-health related behaviour through focus on integrating pornography literacy modules into sexual education programs. These programs may become more effective if they acknowledge the presence, purpose, and role of pornography in the sexual socialisation of adolescents (Willis et al., 2020) orientated at students and teachers alike (Maas et al., 2022).

Conclusion
Several studies have indicated that perceived realism is related to pornography consumption. The present meta-analysis found a significant overall relationship between perceived realism and pornography consumption, that was consistent between males and females, and thus highlights the existence of an individual factor that relates to one's frequency of pornography consumption in adolescents. Given the proliferation