Patterns of sexting and sexual behaviors in youth: A Latent Class Analysis.

INTRODUCTION: A sizable minority of youth are sexting; however there are likely large individual differences in sexting and sexual behaviors, yet to be captured. A Latent Class Analysis was used to identify subgroups of youth characterized by differential engagement in sexting and sexual behaviors. METHODS: Participants were an ethnically diverse sample of 894 youth (55.8% female; Mage = 17.04, SD = 0.77) from a longitudinal survey study in southeast Texas. Latent classes were identified through participants' responses to the following indicator variables: sending, receiving, and requesting sexts, sexual activity, contraception use, ≥ three partners, and substance use prior to sexual activity. Gender, ethnicity, impulsivity, and living situation were analyzed as predictors, and depressive symptoms as an outcome, of class membership. RESULTS: The analysis revealed four distinct classes: No sexting-Low sex (42.2%), Sexting-Low sex (4.5%), No sexting-Moderately risky sex (28.3%), and Sexting-Moderately risky sex (24.9%). Gender and ethnicity predicted class membership wherein females and ethnic minority youth were less likely to be in groups displaying higher rates of sexting. Impulsivity and living situation predicted class membership, such that youth reporting higher impulsivity and living in a situation other than with two biological parents were less likely to be in classes displaying low sexting and sexual behaviors. Group membership predicted depressive symptoms. CONCLUSIONS: Results suggest that not all youth who are sexting are having sex, and not all youth who are having sex are sexting. Evidence of individual differences in youth sexual behaviors should inform educational initiatives aimed at teaching youth about sexual and online health.

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.

Conflict between Family Caregivers and Staff in Nursing Homes: Feasibility of the Daily Diary Method.

OBJECTIVE: The purpose of this study was to investigate the daily diary method (DDM) for assessing family-staff conflicts in nursing homes, to provide descriptive information on conflict, and to examine the relationship between conflict and mood among family caregivers. METHODS: Participants were nine caregivers that experienced conflict with staff on an ongoing basis. They were contacted daily by telephone for 14 days and were asked (1) whether a conflict had occurred, (2) to describe the severity and type of conflict, and (3) to rate their positive and negative affect. RESULTS: Compliance was excellent with no attrition, and there were only 2 missing data points over 126 potential observations. Conflicts occurred on 22% of the days, were rated as moderately severe, and were related to poor resident care, lack of information, and staff attitudes. Participants reported significantly lower positive affect (p < .05) and higher negative affect (p < .001) on conflict versus no-conflict days. Exit interviews indicated positive attitudes towards the DDM. CONCLUSIONS: These results support the feasibility of the DDM for providing an in-depth understanding of family-staff conflict and its relationship to caregivers' mood. CLINICAL IMPLICATIONS: The DDM would ideally be used as an outcome measure in studies that assess interventions that target high-conflict family-staff relationships.

Exposure to sexual content and problematic sexual behaviors in children and adolescents: A systematic review and meta-analysis.

BACKGROUND: Exposure to sexual content, such as online pornography or live sexual content, has been posited in the literature as a risk factor for problematic sexual behaviors (PSBs) in children and adolescents, and has been identified as an important avenue for research and intervention, particularly given the ubiquitous access to technology among children. OBJECTIVE: To examine the association between live/violent and non-violent sexual content exposure and PSB among children and adolescents. Objectives also include informing future research on sexual content exposure as a risk factor for PSB, and providing clinical recommendations related to prevention and intervention. PARTICIPANTS AND SETTING: Results are based on 16,200 participants (28.65 % female; Mage = 14.26; range = 4.74-17.92) and 27 studies conducted in North America, Europe, Asia, and Africa. METHODS: A systematic review was conducted of available literature published up to September 2021. Abstract and full-text review were conducted to assess whether studies met inclusion criteria. Random-effects meta-analyses were conducted on included studies. RESULTS: Significant associations were found between exposure to non-violent sexual content and likelihood of engaging in PSB (OR = 1.82; p < .001; 95 % CI: 1.50-2.21), and between exposure to violent/live sexual content and PSB (OR = 2.52; p < .001; 95 % CI: 1.75-3.61). Sex emerged as a moderator of the association between exposure to non-violent sexual content and PSB, such that the association was stronger in studies with a greater proportion of females. CONCLUSIONS: Results support the need for future research on risk factors and mechanisms implicated in PSB. Prevention and intervention programs for children with PSB and their families could benefit from incorporating education on sexual content exposure.

Are Youth Sexting Rates Still on the Rise? A Meta-analytic Update.

A meta-analysis of 39 studies (110,380 participants) from 2009 to 2015 indicated that youth sexting increased over time. To inform current practice and policy initiatives, this meta-analytic update of studies since 2016 examined if rates of youth sexting have continued to rise and whether youth sexting differs by age, sex, sexting methods, and geographical location. Electronic searches were conducted in March 2020 in Embase, PsycINFO, MEDLINE, and Web of Science, yielding 1,101 nonduplicate records. Studies were included if they provided prevalence of youth sexting and data collection occurred ≥2016. Literature review and data extraction were conducted by following established PRISMA guidelines. All relevant data were extracted by two independent reviewers. To calculate mean prevalence rates, random-effects meta-analyses were conducted. Twenty-eight studies (N = 48,024) met inclusion criteria. The estimated pooled prevalence rates were as follows: (1) sending (19.3%), (2) receiving (34.8%), and (3) forwarding sexts without consent (14.5%). These prevalence rates are statistically similar to studies with data collected before 2016. In recent studies, females receive sexts at a higher rate than males, older youth are more likely to send sexts, and younger and older adolescents receive sexts at similar rates. Youth sexting rates have likely plateaued. Sexting education initiatives should begin early and encourage safe, ethical, and respectful online behavior.

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.

Association Between Screen Time and Children's Performance on a Developmental Screening Test.

Importance: Excessive screen time is associated with delays in development; however, it is unclear if greater screen time predicts lower performance scores on developmental screening tests or if children with poor developmental performance receive added screen time as a way to modulate challenging behavior. Objective: To assess the directional association between screen time and child development in a population of mothers and children. Design, Setting, and Participants: This longitudinal cohort study used a 3-wave, cross-lagged panel model in 2441 mothers and children in Calgary, Alberta, Canada, drawn from the All Our Families study. Data were available when children were aged 24, 36, and 60 months. Data were collected between October 20, 2011, and October 6, 2016. Statistical analyses were conducted from July 31 to November 15, 2018. Exposures: Media. Main Outcomes and Measures: At age 24, 36, and 60 months, children's screen-time behavior (total hours per week) and developmental outcomes (Ages and Stages Questionnaire, Third Edition) were assessed via maternal report. Results: Of the 2441 children included in the analysis, 1227 (50.2%) were boys. A random-intercepts, cross-lagged panel model revealed that higher levels of screen time at 24 and 36 months were significantly associated with poorer performance on developmental screening tests at 36 months (ß, -0.06; 95% CI, -0.10 to -0.01) and 60 months (ß, -0.08; 95% CI, -0.13 to -0.02), respectively. These within-person (time-varying) associations statistically controlled for between-person (stable) differences. Conclusions and Relevance: The results of this study support the directional association between screen time and child development. Recommendations include encouraging family media plans, as well as managing screen time, to offset the potential consequences of excess use.

Adolescent Sexting Involvement Over 4 Years and Associations With Sexual Activity.

PURPOSE: To investigate how demographic factors, dating, and sexual behaviors are related to both initial and changing rates of sexting over time, we examined sexting involvement among ethnically diverse adolescents over a 4-year period. METHODS: A total of 1,042 participants from seven public high schools throughout southeast Texas (Dating it Safe study) were asked yearly about sexting involvement, as well as sexual and dating behaviors. RESULTS: Using latent growth curve modeling, results revealed that males and white participants had greater initial involvement in sexting compared with females and Hispanic and other ethnicities, respectively. In addition, we found that sexting significantly increased over the 4-year period. Finally, participants who had sex and who had more dating partners at each wave were significantly more likely to be involved in sexting than their counterparts, even after controlling for their initial sexting involvement. CONCLUSIONS: Involvement in sexting increases steadily from adolescence into emerging adulthood. The present study extends prior research by identifying a longitudinal association between sexting and sexual activity.