Full Name
Email
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Instructions:
For each statement below, select how often it applies to you.
Questions (0–4 scale: Never = 0, Rarely = 1, Sometimes = 2, Often = 3, Very Often = 4):
1. I spend more time viewing adult content than I intend to.
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Never
Rarely
Sometimes
Often
Very Often
2. I tell myself I will stop, but end up returning to it anyway.
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Never
Rarely
Sometimes
Often
Very Often
3. Thoughts about viewing adult content interrupt my focus during the day.
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Never
Rarely
Sometimes
Often
Very Often
4. I use adult content to cope with stress, loneliness, boredom, anxiety, or difficult emotions.
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Never
Rarely
Sometimes
Often
Very Often
5. I feel a strong urge to view adult content even when I do not want to.
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Never
Rarely
Sometimes
Often
Very Often
6. I have tried to cut back or stop, but struggled to maintain the change.
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Never
Rarely
Sometimes
Often
Very Often
7. I need more time, more frequent viewing, or more intense material to get the same effect as before.
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Never
Rarely
Sometimes
Often
Very Often
8. Viewing adult content leaves me feeling drained, ashamed, distracted, or emotionally disconnected afterward.
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Never
Rarely
Sometimes
Often
Very Often
9. My viewing has interfered with sleep, work, school, motivation, or responsibilities.
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Never
Rarely
Sometimes
Often
Very Often
10. My viewing has affected my real-life relationships, intimacy, or ability to connect with others.
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Never
Rarely
Sometimes
Often
Very Often
11. I return to adult content quickly after deciding to take a break.
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Never
Rarely
Sometimes
Often
Very Often
12. I hide, minimize, or feel secretive about how often I view.
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Never
Rarely
Sometimes
Often
Very Often
13. I feel restless, irritable, or uncomfortable when I try not to view.
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Never
Rarely
Sometimes
Often
Very Often
14. I use adult content even when it goes against my values or goals.
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Never
Rarely
Sometimes
Often
Very Often
15. I feel like adult content has become a repeated cycle rather than a conscious choice.
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Never
Rarely
Sometimes
Often
Very Often