The Interplay Between Problematic Online Pornography Use, Psychological Stress, Emotion Dysregulation and Insomnia Symptoms During the COVID-19 Pandemic: A Mediation Analysis

Alessandro Musetti,1,* Alessio Gori,2,* Alessia Alessandra,3 Eleonora Topino,4 Grazia Terrone,5 Giuseppe Plazzi,6,7 Marco Cacioppo,4 Christian Franceschini3 1Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy; 2Department of Health Sciences, University of Florence, Florence, Italy; 3Department of Medicine and Surgery, University of Parma, Parma, Italy; 4Department of Human Sciences, Lumsa University of Rome, Rome, Italy; 5Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, Rome, Italy; 6Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; 7IRCCS Institute of Neurological Sciences of Bologna (ISNB), Bologna, Italy*These authors contributed equally to this workCorrespondence: Alessandro MusettiDepartment of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, Parma, 43121, Italy, Tel +39 0521 034820, Email alessandro.musetti@unipr.itPurpose: Although a link between problematic online pornographic use (POPU) and insomnia symptoms has been established, psychological and psychopathological mechanisms underlying this relationship are still not clear. Psychological stress and emotion dysregulation have been pointed out as relevant in the development and maintenance of insomnia. This study aims to explore the associations between POPU, psychological stress, emotion dysregulation and insomnia symptoms and to understand the mediating role of psychological stress and emotion dysregulation in the relationship between POPU and insomnia symptoms.Participants and Methods: A sample of 776 Italian adults aged 19– 48 years (51.4% female; M age = 28.49; SD = 7.33) completed questionnaires regarding demographics, COVID-19-related variables, POPU, psychological stress, emotion dysregulation, and insomnia symptoms.Results: After controlling for demographic covariates and COVID-19-related variables, multiple mediation model showed that higher psychological stress and emotion dysregulation fully mediated the link between POPU and insomnia.Conclusion: The findings underscore the significance of the negative consequences of POPU and underline the importance of working on this and its effects on psychological stress and emotion dysregulation to limit insomnia.Keywords: addictive behaviors, online pornography, problematic online pornographic use, stress, emotion dysregulation, clinical psychology, insomnia