Association of Sexting With Sexual Behaviors and Mental Health Among Adolescents

Abstract

IMPORTANCE Sexting is the exchange of sexual messages, photographs, or videos via technological devices and is common and increasing among youth. Although various studies have examined the association between sexting, sexual behaviors, and mental health, results are mixed. OBJECTIVE To provide a meta-analytic synthesis of studies examining the associations between sexting, sexual behavior, and mental health using sex, age, publication date, and study methodological quality as moderators. DATA SOURCES Electronic searches were conducted in April 2018 in MEDLINE, PsycINFO, Embase, and Web of Science, yielding 1672 nonduplicate records. STUDY SELECTION Studies were included if participants were younger than 18 years and an association between sexting and sexual behaviors or mental health risk factors was examined. DATA EXTRACTION AND SYNTHESIS All relevant data were extracted by 2 independent reviewers. Random-effects meta-analyses were used to derive odds ratios (ORs). MAIN OUTCOMES AND MEASURES Sexual behavior (sexual activity, multiple sexual partners, lack of contraception use) and mental health risk factors (anxiety/depression, delinquent behavior, and alcohol, drug use, and smoking). RESULTS Participants totaled 41 723 from 23 included studies. The mean (range) age was 14.9 (11.9-16.8) years, and 21 717 (52.1%) were female. Significant associations were observed between sexting and sexual activity (16 studies; OR, 3.66; 95% CI, 2.71-4.92), multiple sexual partners (5 studies; OR, 5.37; 95% CI, 2.72-12.67), lack of contraception use (6 studies; OR, 2.16; 95% CI, 1.08-4.32), delinquent behavior (3 studies; OR, 2.50; 95% CI, 1.29-4.86), anxiety/depression (7 studies; OR, 1.79; 95% CI, 1.41-2.28), alcohol use (8 studies; OR, 3.78; 95% CI, 3.11-4.59), drug use (5 studies; OR, 3.48; 95% CI, 2.24-5.40), and smoking behavior (4 studies; OR, 2.66; 95% CI, 1.88-3.76). Moderator analyses revealed that associations between sexting, sexual behavior, and mental health factors were stronger in younger compared to older adolescents. CONCLUSIONS AND RELEVANCE Results of this meta-analysis suggest that sexting is associated with sexual behavior and mental health difficulties, especially in younger adolescents. Longitudinal research is needed to assess directionality of effects and to analyze the mechanisms by which sexting and its correlates are related. Educational campaigns to raise awareness of digital health, safety, and security are needed to help youth navigate their personal, social, and sexual development in a technological world.

Development and Validation of the Adolescent Sexting Scale (A-SextS) with a Spanish Sample

“…Criterion validity was supported by relations between A-SextS and different variables in the available literature. This was the case for age, sexual activity, and pornography consumption, which have consistently been found to positively correlate with sexting [2,18,19]. Nine different subscales of A-SextS were also defined according to sexting action and addressees: sending sexts to a boy/girlfriend (SF), sending sexts to someone known in person (SK), sending sexts to someone known only on internet (SI), posting or live-streaming pictographic content (PS), asking for sexts from a boy/girlfriend (AF), asking for sexts from someone known in person (AK), asking for sexts from someone only known on the internet (AI), receiving sexts (R), and refusing to send sexts (RS).…”

“…In an ongoing meta-analysis it has also been observed that such rates have been progressively increasing over the last ten years (e.g., 7%, 95% CI: 5%, 10% for sending sexts in studies collecting data in 2009, versus 16%, 95% CI: 13%, 20% in 2014, and 29%, 95% CI: 20%, 39% in 2018) [17]. The most supported findings concerning correlates have suggested that sexting is more prevalent with increasing age [2], and is significantly related to adolescent sexual behavior, such as having actual sexual intercourse, and to other online and offline sexual experiences, such as pornography consumption [18,19]. The disparate findings in sexting research may be due to differences in how the practice has been conceptualized and measured among the various studies [2,3,20,21].…”

Is sexting bad for adolescent girls’ psychological well-being? A longitudinal assessment in middle to late adolescence

“…Considering the mixed findings and predominantly cross-sectional nature of the existing research on sexting-which is reflected in a recent call for more longitudinal research (Mori et al, 2019)-and the need for greater focus on outcomes specific to young women, the current study sought to longitudinally explore links between adolescent girls' sexting and psychological well-being.…”

Consensual Sexting among College Students: The Interplay of Coercion and Intimate Partner Aggression in Perceived Consequences of Sexting

“…Because sexting was initially largely conceptualized as a potentially risky behavior among emerging adults, much of the existing research has focused on the association between sexting and a range of risk factors, including unprotected sex, STI diagnosis, substance use, sexual coercion, pornography use, risky internet use, and psychological distress [ 1 , 3 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. An additional area of concern related to sexting is the potential for coercion and aggression in interpersonal relationships that this behavior may afford.…”