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| 1. How old were you when you were first introduced to pornography (magazines, Internet pornography, x-rated videos)? |
before age 10
age 11-13
age 14-17
age 18-21
over age 22
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| 2. After my first exposure to pornography, my curiosity led me back to it _________. |
a few days later
months later
a year later
more than a year later
only one or two times since then
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| 3. How many times did you see pornographic material before age 20? |
one time
2-5 times
6-10 times
11-20 times
21-40 times
41-60 times
61 or more times
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| 4. When you first started viewing pornographic images did it start with |
swimsuit issues/catalogues
magazines (i.e. Playboy, Penthouse, etc.)
R-rated videos
educational books or videos
Internet (pictures)
xxx-rated videos
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| 5. What type of pornographic images are you looking at now? |
swimsuit/catalogues
magazines (Playboy, Penthouse, etc.)
R-rated videos
educational books or videos
Internet (images or pop-ups)
xxx-rated videos or downloaded clips via the Internet
all of the above
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| 6. When viewing pornography (magazines, Internet, or video), how much time will you spend during one episode? |
5-15 minutes
more than 15 minutes but less than 30 minutes
30 minutes to 1 hour
1-3 hours
3-5 hours at a time
5-6 hours at a time
6 or more hours at a time (sometimes all day and/or all night)
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| 7. In the last year, what is the frequency with which you have viewed pornography? |
1-2 times
every two or three months
once a month
every two weeks
once a week
3-5 times a week
almost every day, if not daily
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| 8. Once you start looking at pornography do you? |
view it briefly, but don't look again for weeks or months
view it 3 or 4 times within a short period of time and then stop for weeks or months
view it and then repeatedly look at it for a few days before trying to stop
view it daily for a few weeks before trying to stop
view it multiple times a day for weeks at a time and then stop for a few days before you go at it again
view it as often as I can, every day all day if I could
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| 9. How much money have you spent on pornography in the last year? |
I don't spend money on pornography
between $1 to $25 dollars
$26-$100 dollars
$101-$500 dollars
$501-$1000 dollars
$1001-$5000 dollars
$5001-10,000 dollars
over 10,000 dollars
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| 10. How often do you think about or fantasize about viewing pornography? |
multiple times a day
once a day
three to five times a week
once a week
every other week
once a month
every two or three months
very rarely to never
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| 11. How often to you act upon your fantasies and view pornography or act out? |
multiple times a day
once a day
three to five times a week
once a week
every other week
once a month
every two or three months
very rarely to never
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| 12. What is the longest period of time that you have gone without pornography in the last year? |
8 months to a year
6-8 months
4-6 months
2-4 months
1-2 months
two weeks to a month
one week
one or two days
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