Sending and Receiving Text Messages with Sexual Content: Relations with Early Sexual Activity and Borderline Personality Features in Late Adolescence

The effect of a tele-educational intervention on modifying dysfunctional sexual beliefs of pregnant women: a randomized controlled trial

BACKGROUND & AIM

Some cultural scenarios in pregnancy and childbirth reinforce dysfunctional sexual beliefs that reverse changes in the couple's sexual life. The present study aimed to investigate the effect of education by sending text messages on modifying dysfunctional sexual beliefs in pregnant women.

METHODS & MATERIALS

This study is a randomized clinical trial, and 82 eligible pregnant women referred to educational-medical centers to receive prenatal care were randomly assigned to intervention or control group. The intervention group received 24 text messages during eight weeks (three text messages per week), and the control group received only routine care. Data was collected through a demographic questionnaire, reproductive profile, Spinner's Dyadic Adjustment Scale (DAS), and dysfunctional sexual beliefs questionnaire. Both groups completed the questionnaires before and one week after the intervention. Independent t-test, paired t-test, and analysis of covariance was used to analyze the data.

RESULTS

The findings revealed no statistically significant difference in the baseline Dyadic Adjustment mean scores of control (132.4 ± 11.01) and intervention (130.10 ± 10.66) groups. Paired t-test analysis showed that the mean score of dysfunctional sexual beliefs was significantly decreased from (29 ± 7.61) at baseline compared to one week after intervention (10.54 ± 6.97) (p < 0.001). Analysis of covariance test to compare the scores of dysfunctional sexual beliefs in the intervention group (10.54 ± 6.97) and control group (26.80 ± 7.80) showed a statistically significant difference (p < 0.01) with an effect size of 0.67.

CONCLUSION

This study showed that sending text messages to mobile phones of pregnant women has corrected their dysfunctional sexual beliefs. Therefore, this approach can be used in pregnancy care to promote women's sexual health.

TRIAL REGISTRATION

Clinical trial registry: IRCT20161230031662N9 .

Associations Between Borderline Personality Disorder Symptoms and Online Self-Disclosure in Clinically Referred Youth

Communicating online via social media has proven to facilitate disclosure of intimate topics and can therefore be helpful in the development of intimate relationships. However, for youth with borderline personality disorder (BPD) symptoms, it may be more difficult to know when, what, and to whom to disclose (i.e., effective disclosure) in online contacts. The authors examine associations between BPD symptoms, online self-disclosure, and ineffective online self-disclosure (e.g., regretting sharing something online). The sample consisted of 235 clinically referred youth (66.4% female), aged 12-25 years (M = 17.82, SD = 2.96). Structural equation modeling revealed that BPD symptoms were related to higher levels of same- and cross-sex online self-disclosure as well as to more ineffective online self-disclosure. There was no moderation by sex or age. This study suggests that youth with BPD symptoms are at risk for oversharing personal information, which could affect forming and maintaining intimate relationships and increases online risks.

Risky Sexual Behavior Profiles in Youth: Associations With Borderline Personality Features

Adolescence and young adulthood are peak periods for risky sexual behaviors (RSB) and borderline personality disorder (BPD) features. RSB is a major public health concern and adolescents with BPD may be particularly vulnerable to RSB, but this is understudied. The aim of this study was to identify distinct RSB profiles in youth and determine whether a specific profile was associated with BPD features. Participants were 220 adolescents and young adults (age 14-21) recruited from the community. To identify groups of adolescents and young adults who engage in similar RSB, a latent profile analysis (LPA) was conducted on sexually active youth (57%). Next ANOVA was used to identify how profiles differed in terms RSB dimensions and BPD features. We identified three distinct RSB profiles: (1) a Low RSB profile that was manifested by the majority (77.7%) of youth; (2) an Unprotected Sex in Relationships profile (13.3%) and; (3) an Impulsive Sex Outside Relationships profile (12%) which was manifested by youth with significantly higher BPD features. The findings shed light on the difficulties youth with BPD manifest around integrating sexuality, intimacy, fidelity, and love. This contrasts with the majority of youth who are sexually active in the context of relationships and engage in little or no RSB. The findings have important clinical implications. Adolescent sexuality is frequently in the blind spot of clinicians. To address the elevated risk of RSB in adolescents with BPD, interventions are needed to help adolescents navigate this period and improve their understanding of the reasons for RSB while addressing difficulties in establishing sexual and attachment relationships.

Importance of Digital Communication in Adolescents' Development: Theoretical and Empirical Advancements in the Last Decade

The past decade saw a sharp increase in the use of smartphones and digital communication platforms. This manuscript reviews advancements in the study of digital communication and adolescent development over the last decade. We highlight theoretical models that seek to explain the power of digital media in adolescents' lives. We then examine research conducted over the last decade on five aspects of digital media: (1) potential to contribute to adolescent development, (2) associations with mental health, (3) differential impact of active versus passive social media use, (4) cyberbullying, and (5) sexting. We conclude with a discussion of potential opportunities and challenges for studying the role of digital communication in adolescents' development during the coming decade.

A Longitudinal Investigation of Observed Adolescent Text-Based Sexting and Adjustment

Despite strong concerns that sexting poses risks for adolescents' well-being, previous research finds mixed results. Moreover, these studies rely heavily on self-report measures and cross-sectional designs. This study utilizes observational methods to examine longitudinal relations between text-based sexting and both negative and positive indicators of psychosocial adjustment. An ethnically diverse sample of 197 adolescents was provided smartphones that captured their text messages across high school, from 2008-2012. Two, two-day samples of text messages from grades 9-12 were content-coded (468,201 total observations). Sexting was defined as sending and receiving text-based statements about past, present, or hypothetical sexual behaviors occurring between dyadic texting partners. Each year, adolescents reported on negative (internalizing, externalizing, and social problems; borderline personality features) and positive (life satisfaction, group belongingness, and positive self-perceptions) indicators of their psychosocial adjustment. Using concurrent and longitudinal multilevel models, greater sexting at one time point than one's average (within-person) was only associated with lower levels of group belongingness within the same year. For girls only, text-based sexting more than others on average (between-person) was related to increased externalizing symptoms and borderline personality disorder features, as well as decreased life satisfaction, group belongingness, self-perceived social competence, and global self-worth. No within-person differences by gender emerged, nor did longitudinal associations. Future studies and intervention efforts should examine when and why higher sexting might be related to psychosocial problems among girls.

The outcomes of sexting for children and adolescents: A systematic review of the literature

INTRODUCTION

Given associated risks, sexting among children and adolescents has yielded significant interest in recent years. Several previous reviews have examined data on the prevalence, determinants, and correlates of sexting behaviour, however, in an ever-changing digital media context, a comprehensive overview of findings regarding its outcomes is warranted. This novel review aimed to systematically identify and conduct a narrative synthesis of empirical evidence regarding the outcomes of sexting involvement for children and adolescents.

METHODS

Four databases were searched for peer-reviewed literature on sexting, and 54 articles were identified for inclusion in the review. The quality of included studies was appraised using Dixon-Woods et al. (2006) five question prompts.

RESULTS

Four 'outcomes' categories were derived, namely, psychological (victimisation; sexual abuse/victimisation; mental health and quality of life; and emotional outcomes), behavioural (sexual activity, risk behaviours, and perpetration of abuse and harassment), relational (personal connections with others & reputational outcomes), and systems-level (distribution/public exposure of sexting content).

CONCLUSIONS

Findings indicate that the outcomes of sexting for children and adolescents (aged ≤19 years) are wide-ranging, some positive and desirable, others negative and unwanted. Furthermore, identified outcomes were located along a continuum spanning benefits for adolescents' well-being and relationships, stigma and associated difficulties, and serious harm or trauma. Limitations (e.g., methodological constraints of studies) and implications (e.g., informing harm prevention/intervention initiatives; further large-scale and replication studies) are discussed within.

Multiple Forms of Sexting and Associations with Psychosocial Health in Early Adolescents

Despite the recent surge of sexting research, the link between sexting and psychosocial health remains inconclusive. To address this gap in the literature, we examined the link between multiple forms of sexting and a range of psychosocial health problems. Data were from a randomized controlled trial of a school-based dating violence prevention program. Participants were 2199 early adolescents (49.8% female) aged 14 years and under (mean age = 13.53, SD = 0.50) enrolled in middle-schools in southeast Texas. Participants self-reported to be 35.4% Hispanic, 7.9% Non-Hispanic White, 26.2% Non-Hispanic Black, 18.6% Asian, and 11.9% other. Multilevel multivariate regressions found that pressured sexting was associated with hostility and aggressive temperament. Receiving unsolicited sexts was associated with depression, impulsivity, hostility, emotion dysregulation, and aggressive temperament. Forwarding sexts without permission was linked to hostility. Asking someone for sexts was linked to impulsivity and aggressive temperament, while being asked to send a sext was associated with depression, anxiety, impulsivity, hostility, emotion dysregulation, and aggressive temperament. Finally, consensual sexting was not significantly associated with poor psychosocial health of any type. Interventions should focus on preventing pressured sexting and teaching early adolescents on how to respond to being pressured to sext.

Análise da produção científica sobre a violência digital no namoro entre adolescentes

A violência no namoro entre adolescentes é considerada um problema de saúde pública e preditor de violência conjugal. O objetivo deste estudo foi produzir uma revisão sistemática acerca da violência digital no namoro entre adolescentes. A busca foi realizada nas bases de dados SciELO, LILACS, Scopus, PubMed e o buscador Google Acadêmico, nos idiomas Português, Inglês e Espanhol. A amostra final resultou em 34 artigos internacionais. A violência digital no namoro ocorre de duas formas: os comportamentos de controle e monitoramento e a violência sexual digital, ambos mediados pela Internet. Aponta-se a potência silenciosa da violência, naturalizada e quiçá tomada como parte integrante do relacionamento. Constatou-se necessidade de incremento na realização de pesquisas brasileiras para maior aprofundamento acerca do fenômeno, com vistas à prevenção deste tipo de violência, bem como o uso mais responsável e positivo das tecnologias de informação e comunicação pelos adolescentes nas relações de namoro.

Developmental Trajectories of Adolescent Girls' Borderline Personality Symptoms and Sexual Risk Behaviors

Adolescence is a developmental period during which youth tend to initiate sexual behavior, which may include sexual risk behavior. Symptoms of borderline personality disorder (BPD) are associated with increased rates of risky behaviors. However, little is known about longitudinal associations between BPD symptoms and sexual risk behaviors during adolescence. This study examines developmental trajectories of adolescent girls' BPD symptoms and sexual risk behaviors in a community sample of Black and White girls from the Pittsburgh Girls Study (n = 1620). Dual trajectory modeling provided insights into the temporal precedence and co-development of BPD symptoms and sexual risk behaviors from ages 14 to 18. In order to examine the unique association between BPD symptoms and sexual risk behaviors, analyses controlled for symptoms of depression and conduct disorder, as well as race, sexual orientation, and pubertal development. Girls with more BPD symptoms at age 14 showed steeper growth over time in sexual risk behaviors from ages 14 to 18. Additionally, adolescents who showed steeper increases in BPD symptoms over time also showed steeper increases in sexual risk behaviors across adolescence. Notably, however, sexual risk behavior at age 14 was not significantly associated with longitudinal trajectories of BPD symptoms. Results suggest that adolescent girls with early symptoms of BPD are at heightened risk for the development of sexual risk behaviors during adolescence, while the reverse association does not hold. Implications for adolescent development and sexual risk behavior are discussed.

How Adolescents Use Text Messaging Through their High School Years

Co-construction theory suggests adolescents use digital communication to address developmental challenges. For a sample of 214 ethnically diverse adolescents, this research used direct observation to investigate the frequency, content, and timing of texting with parents, peers, and romantic partners through grades 9-12. Analyses showed that texting frequency follows a curvilinear trajectory, peaking in eleventh grade. Adolescents discussed a range of topics, predominantly with peers. Communication with parents was less frequent, but consistent over time. Approximately 45-65% of adolescents communicated with romantic partners, texting heavily and about topics similar to those discussed with peers. Texting may help adolescents navigate key developmental challenges of adolescence-the establishment of autonomy, intimate peer relationships, romantic relationships, and self-identity.

The Prevalence of Sexting Behaviors Among Emerging Adults: A Meta-Analysis

Sexting is the sharing of sexually explicit images, videos, and/or messages via electronic devices. Prevalence estimates of sexting have varied substantially, potentially due to broad age ranges being examined. The current study sought to synthesize relevant findings examining the prevalence of consensual and non-consensual sexting in a specific developmental period, emerging adulthood (≥ 18-< 29), to try to explain discrepancies in the literature. Searches were conducted in electronic databases for articles published up to April 2018. Relevant data from 50 studies with 18,122 emerging adults were extracted. The prevalence of sexting behaviors were: sending 38.3% (k = 41; CI 32.0-44.6), receiving 41.5% (k = 19; CI 31.9-51.2), and reciprocal sexting 47.7% (k = 16; CI 37.6-57.8). Thus, sexting is a common behavior among emerging adults. The prevalence of non-consensual forwarding of sexts was also frequent in emerging adults at 15.0% (k = 7; CI 6.9-23.2). Educational awareness initiatives on digital citizenship and psychological consequences of the non-consensual forwarding of sexts should be targeted to youth and emerging adults with the hopes of mitigating this potentially damaging and illegal behavior.

Sexting, Online Sexual Victimization, and Psychopathology Correlates by Sex: Depression, Anxiety, and Global Psychopathology

Recent research on sexting highlighted a relationship between this new technology-mediated behavior and psychopathology correlates, although up to date results are mixed, and so far, studies have often used simple and not clinically validated measures of mental health. This study aimed to investigate sexting behaviors, online sexual victimization, and related mental health correlates using clinically validated measures for global psychopathology, anxiety, and depression; and doing so separately for men and women. The sample consisted of 1370 Spanish college students (73.6% female; 21.4 mean age; SD = 4.85) who took part in an online survey about their engagement in sexting behaviors, online sexual victimization behaviors, and psychopathological symptomatology, measured by a sexting scale and the Listado de Síntomas Breve (brief symptom checklist) (LSB-50), respectively. Out of our total sample, 37.1% of participants had created and sent their own sexual content (active sexting), 60.3% had received sexual content (passive sexting), and 35.5% had both sent and received sexual content, with significant differences between male and female engagement in passive sexting. No differences were found between men and women in the prevalence of their victimization by nonconsensual dissemination of sexual content; however, women were more pressured and threatened into sexting than men. Sex differences in psychopathology were found only for depression prevalence rates but not for global psychopathology or anxiety. Furthermore, for male participants, our results showed a significant association only between online sexual victimization and psychopathology but not for consensual active and passive sexting. However, for the female participants, active sexting, passive sexting, and online sexual victimization were all associated with poorer mental health. Implications for prevention and intervention are discussed.

Social media and children: what is the paediatrician's role?

Social media use has become an integral part of children's and adolescents' lives. It has become a novel way of interaction among people and influences people's social lives and public opinion as well as people's purchasing decisions and businesses. Any website or platform that allows social interaction is considered to be a social media site. Social media use among children in 25 European countries has been reported to be 38% among 9-12 year olds and 77% among those aged 13-16 years. All these children report having their own profile on at least one social network site. While social networking provides children and adolescents with many opportunities and benefits, it also carries many risks. Among the benefits are socialization and communication enhancement, improving learning skills, positive impact on education and getting health information. Potential risks of social media use include falsifying age and identity, cyberbullying, sexting, Facebook depression, gamification, glamourization, cyberostracism and sleep disturbances.Conclusion: Paediatricians play a vital role in promoting the physical, mental and social welfare of all children. There is a critical need for paediatricians to play an active role, guiding children and families appropriately through the impact of social networking, in order to become a real driver of children's development.

Association of Sexting With Sexual Behaviors and Mental Health Among Adolescents: A Systematic Review and Meta-analysis

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.

Sexting, Mental Health, and Victimization Among Adolescents: A Literature Review

The practice of creating and sharing sexual images via technological devices, known as sexting, has received crescent attention in the past years, especially due to the increase of adolescent engagement in this behavior. Although consensual sexting is not prima facie a crime, as some research has shown, it has the potential to be a risky behavior, and a threshold to get exposure to dangerous kinds of victimization as sextortion, online grooming or cyberbullying. In this context, teenagers represent a vulnerable group due to their limited ability of self-regulation, their high susceptibility to peer pressure, their technophilia, and their growing sexual curiosity. The present paper aims to review the scientific literature to analyze the relationship between mental health and sexting as a potentially risky behavior and its association with online victimization. The results and implications will be discussed.

"Sex Pics?": Longitudinal Predictors of Sexting Among Adolescents

PURPOSE

To analyze the longitudinal relationships of demographic characteristics (i.e., sex, age, and sexual orientation), personality traits according to the Big Five model, and several indicators of psychological adjustment (i.e., depression symptoms, self-esteem, and problematic Internet use) with sexting behavior among adolescents over 1 year.

METHOD

A total of 1,208 adolescents (638 girls; mean age = 13.57, SD = 1.09) completed measures at baseline and after 1 year of follow-up. The relationships among variables were examined using structural equation modeling.

RESULTS

Out of the sample, 10.7% and 19.2% of adolescents reported producing and sending sexual content at time 1 (T1) and time 2 (T2), respectively. Higher ages at T1 predicted more engagement in sexting at T2. Less conscientiousness and more extraversion at T1 increased T2 sexting. Finally, more depressive symptoms at T1 predicted more sexting at T2.

CONCLUSIONS

Sexting increases significantly over the course of adolescence. Educational efforts should pay attention to demographic and psychological characteristics of adolescents to tailor preventive programs and prevent possible negative outcomes of engaging in sexting.

The Associations between Substance Use, Sexual Behavior, Deviant Behaviors and Adolescents' Engagement in Sexting: Does Relationship Context Matter?

While prior research has identified multiple associations between engagement in sexting and risky behaviors, most existing studies do not take into account the contexts in which sexting occurs. The present study extends prior research by examining whether the associations between adolescents' sexting behavior and engagement in substance use, sexual behaviors, and deviant behaviors differ depending on the relational context (within or outside of a romantic relationship) in which young people engage in sexting. Results from a survey of 1187 secondary school students (61.3% girls, n = 728) between 16 and 22 years old (M = 17.82 years; SD = 0.88) revealed that sexting with a romantic partner is not a significant marker of engagement in risk behaviors. However, single youth who engage in sexting outside of a romantic relationship are more likely to report substance use, relative to their non-sexting counterparts. These findings underscore the need to use more nuanced measures to investigate sexting and for sexual education initiatives to integrate messages about substance use.