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This study explored the lived experiences of individuals with PPU in China and examined how multi\u2010layered stigma processes might have shaped PPU\u2010related experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A qualitative study using reflexive thematic analysis of semi\u2010structured interview data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Online recruitment and data collection conducted in mainland China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Thirty\u2010one adults who self\u2010identified as experiencing PPU participated in online semi\u2010structured interviews (26 males and 5 females; mean age\u2009=\u200931.32\u2009\u00b1\u20097.77\u2009years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>In\u2010depth interviews explored pornography use experiences, motivations, perceived consequences, stigma and coping strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Five themes were identified: multi\u2010layered stigma processes; motivations for pornography use; manifestations of PPU; negative consequences of PPU; and personal coping strategies. Participants' motivations broadly aligned with motivations reported in prior PPU research conducted in WEIRD contexts, but also reflected sociocultural factors emphasized within participants' local context, including limited opportunities for open sexual communication, perceived gaps in sex education and concerns related to social and interpersonal risks. Participants described impaired control, psychological distress, shame, secrecy and self\u2010blame, experiences that have also been documented in WEIRD contexts. However, participants described these experiences within a context of legal, familial and sociocultural regulation surrounding sexuality. Coping strategies were predominantly individualized and short\u2010term, frequently accompanied by distress, intrusive sexual thoughts and recurring difficulties regulating use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although many experiences associated with problematic pornography use may be shared across cultures, sociocultural environments may shape how pornography use is morally interpreted, socially regulated and experienced as problematic, as well as how individuals cope with related distress and stigma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70587","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:24:52Z","timestamp":1787984692000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Contradictory experiences of problematic pornography use in China: A qualitative study of multi\u2010layered stigma within a morally restrictive socio\u2010cultural context"],"prefix":"10.1111","author":[{"given":"Feng","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of China Medical University  Shenyang Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenwen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Health Statistics, School of Public Health China Medical University  Shenyang Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengshuo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry The First Affiliated Hospital of China Medical University  Shenyang Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2642-1351","authenticated-orcid":false,"given":"Joshua B.","family":"Grubbs","sequence":"additional","affiliation":[{"name":"Department of Psychology, Center on Alcohol, Substance Use, And Addictions (CASAA) The University of New Mexico  Albuquerque NM USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2718-4703","authenticated-orcid":false,"given":"Be\u00e1ta","family":"B\u0151the","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Psychologie Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Qu\u00e9bec Canada"},{"name":"Centre de recherche interdisciplinaire sur les probl\u00e8mes conjugaux et les agressions sexuelles (CRIPCAS)  Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7324-5808","authenticated-orcid":false,"given":"Ziqi","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Health Professions Education Assessment and Reform China Medical University  Shenyang Liaoning Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8010091"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2021.106774"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/466029a"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2020.01.013"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/15546128.2020.1831676"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/00224499.2016.1191597"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41443-020-00380-w"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-007-9212-1"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13178-012-0103-4"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2019.03.265"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH21220"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.abrep.2021.100345"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.encep.2023.12.004"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1556\/2006.8.2019.22"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2020.01.007"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/jsxmed\/qdae101"},{"key":"e_1_2_10_18_1","unstructured":"World Health Organization.International classification of diseases eleventh revision (ICD\u201011).2022.https:\/\/icd.who.int\/dev11\/l-m\/en. 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