Personal risk factors and types of sport associated with drive for thinness and drive for muscularity in NextGen athletes.

Introduction: Professional and student-athletes are at risk of developing symptoms of eating disorders (ED), including drive for thinness and muscularity due to personal risk factors (e.g., low self-esteem) and sport-specific characteristics (e.g., sport requirements). However, limited studies have focused on ED symptoms among NextGen athletes (identified in Canada as élite or relève) who compete at the provincial, national, and international levels but are not yet part of national teams. As such, they have access to fewer financial resources and support from their sport federations, which can create additional stress for these athletes. The present study aimed to identify personal risk factors and types of sports associated with (a) drive for thinness and (b) drive for muscularity in NextGen athletes. Methods: These athletes (n = 254) aged between 14 and 25 years old completed an online questionnaire. Perfectionism, self-esteem in sport, drive for thinness, and drive for muscularity were, respectively, assessed by the Multidimensional Inventory of Perfectionism in Sport, the Sport State Self-Esteem Scale, the Eating Attitude Test-26, and the Drive for Muscularity Scale. Other personal risk factor (e.g., athletic status) were measured using in-house questions. Each personal risk factor was included in two multiple linear regressions, respectively, to determine which factors were most associated with drive for thinness and drive for muscularity. Results: Analyses revealed that perfectionist aspirations during training were linked to a stronger desire for thinness. In addition, not being in school or not having a job were also linked to a stronger desire for thinness. Several variables were found to be associated with a greater desire for muscularity: being a male athlete, playing team sport, weight category sport or endurance sport (as opposed to esthetic sport), having elite status, being less satisfied with one's current sporting performance and having higher perfectionist aspirations during training. Discussion: This study offers initial insights into the factors influencing EDs among NextGen athletes, which provides a foundation for deeper exploration and the creation or modification of targeted interventions. These findings can guide sport organizations in creating guidelines and programs to better support the next generation of national athletes (e.g., create programs to help athletes maintain investments outside).

Alexithymia as a mediator of the associations between child maltreatment and internalizing and externalizing behaviors in adolescence.

Child maltreatment is a global concern that profoundly affects individuals throughout their lives. This study investigated the relationships between various forms of child maltreatment and behavior problems involving internalization and externalization during adolescence. Data obtained from a diverse sample of 1802 Canadians aged 14-18 years was used to examine the mediating role of alexithymia-a difficulty in recognizing and expressing emotions-in these associations. Results indicated that adolescents who experienced sexual abuse, emotional abuse, and exposure to intimate partner violence (IPV) in their childhood exhibited higher levels of alexithymia, which was correlated with elevated levels of both internalizing and externalizing problems. Physical abuse and parental neglect were only associated with externalizing problems. Gender differences also emerged, with gender-diverse adolescents reporting a higher prevalence of maltreatment, alexithymia, and behavior problems compared with their peers. However, alexithymia's mediating role was consistent across genders. Overall, this study highlights the intricate relationships between child maltreatment, alexithymia, and adolescent behavior problems. The findings of this study how different forms of child maltreatment significantly shape behavioral outcomes and indicate the importance of interventions in enhancing emotional awareness and expression in adolescents with a childhood history of maltreatment.

COVID-19-Related distress, body image, and eating behaviors: a cross-sectional explanatory model.

BACKGROUND: The COVID-19 pandemic has been associated with increased body dissatisfaction and disordered eating behaviors in adolescents. To better understand these associations, this study tested an explanatory model in which appearance-focused social media use, internalization of social media pressure, and mindfulness abilities mediated the relationship between COVID-related distress and body dissatisfaction, which in turn was associated with dietary restraint and binge eating episodes. METHODS: Adolescents (N = 493, Mage= 16.7; 47.5% girls) recruited within high schools completed online measures. We conducted model testing through path analysis in MPlus, using modification indices to derive a well-fitting model. RESULTS: The initially hypothesized model was a poor fit for the data. The final well-adjusted model confirmed several significant paths and supported the parallel mediational roles of social media (specifically, the use of appearance-focused social media and internalization of social media pressure) along with mindfulness, on the relationship between COVID-19-related distress and body satisfaction. Model adjustments involved adding three paths, resulting in two additional significant indirect effects, and suppressing one path. CONCLUSIONS: Findings suggest that mindfulness, media use and the internalization of social media pressure are potential key processes explaining body dissatisfaction and eating disorders among adolescents who experienced higher levels of COVID-related distress.

How Does Sexual Subjectivity Vary on the Basis of Gender and Sexual Orientation? Validation of the Short Sexual Subjectivity Inventory (SSSI-11) in Cisgender, Heterosexual and Sexual and Gender Minority Adolescents.

Through sexual exploration, adolescents learn that they are sexual beings with choices, desires, and are deserving of pleasure, which corresponds to sexual subjectivity. However, the two measures of this construct (i.e., Female Sexual Subjectivity Inventory and Male Sexual Subjectivity Inventory) have not been validated with younger adolescents and have different items for boys and girls (with no scale available for gender diverse individuals), limiting gender comparisons. This study examined (1) the factor structure of the adapted Short Sexual Subjectivity Inventory-11 items (SSSI-11) in a large sample of young cisgender, heterosexual and sexual and gender minority adolescents, (2) measurement invariance across language (English and French), gender, and sexual orientation, (3) validity with sexuality-related outcomes, and (4) one-year temporal stability. Results of a confirmatory factor analysis among 2001 adolescents (Mage = 15.5 years, SD = 0.60) revealed a multidimensional factor structure. The SSSI-11, in both English and French, showed adequate reliability and one-year temporal stability, and was invariant across genders, sexual orientations, and languages. Girls had lower scores on the entitlement to self-pleasure and self-efficacy in achieving pleasure factors, and higher scores on the entitlement to pleasure from a partner factor. No significant differences were observed on the basis of language or between heterosexual and sexual minority adolescents. The SSSI-11 correlated positively with sexuality-related variables. Findings support the strong psychometric properties of the SSSI-11, rendering it of considerable use in clinical, education, and research applications.

Recurrent child protection post-investigation services for First Nations children in the province of Quebec.

BACKGROUND: The longitudinal trajectory of Indigenous children within child protection (CP) services, including their recurrent involvement, has yet to be documented. OBJECTIVES: 1) To document whether First Nations children were at increased risk of a first recurrence of post-investigation CP services compared to children from the majority group. 2) To identify the characteristics associated with recurrence for First Nations children, and to compare these results to those for children from the majority group. METHOD: Anonymized CP administrative data (2002-2014; n = 1150) of a region in the province of Quebec were used to conduct Cox proportional hazards modeling, in partnership with an advisory committee. RESULTS: The risk of recurrence of First Nations children did not significantly differ from the risk for children from the majority group (HR: 0.980, n.s.) while controlling for covariates. Among First Nations children (n = 459), being under two at the case closure (HR: 2.718, p < .05), having received short-term intervention (HR: 5.027, p < .001) and coming from a family already known to the CP agency (HR: 2.023, p < .001) were associated with an increased risk of recurrence. CONCLUSIONS: The findings highlight the importance of studying First Nations children's trajectories within CP services as a group deserving full attention and for First Nations to be able to design or demand appropriate services responding to their population's needs. A family-based research perspective is recommended to understand better the full family history leading to and in relation to CP services, which could provide more sound practice recommendations.

Implementing a sexual violence prevention program in two Canadian Indigenous communities: Challenges and lessons learned.

BACKGROUND: The prevalence of child sexual violence remains overwhelming, particularly among Indigenous populations, despite increased awareness. Therefore, implementing efficient initiatives is crucial in preventing and reducing sexual violence rates among these groups. OBJECTIVE: This study aimed to examine the processes involved in the implementation of a sexual violence prevention program in two Indigenous communities in Canada and assess application of culturally safe practices. METHOD: Eight Indigenous and non-Indigenous project managers underwent semi-structured interviews before the program's implementation; five of them also participated in the follow-up interviews. Moreover, thirteen Indigenous service providers from the two communities answered open-ended questions when the included training ended. RESULTS: Thematic analysis revealed the importance of following an ongoing process (not only before implementing a program) to assess the needs of community members and involving them in decision-making. Administrative injunctions were also identified as a significant challenge during implementation. Results showed that participants reported the taboo of sexual violence as a challenge but that constant discussions about the prevention of sexual violence helped defuse the discomfort and foster trust between Indigenous and non-Indigenous professionals. Finally, participants provided recommendations to improve research and intervention practices. CONCLUSIONS: Several takeaways were discussed to improve research practices with, by, and for Indigenous peoples, such as using collaborative communication, developing common understanding relative to work agendas, and increasing cultural competencies to build trust within the partnership.

Can I Love My Body Even if It Doesn't Look Like the Porn Stars'? Longitudinal Associations Between Pornography Use Frequency and Body Appreciation in a Diverse Sample of Adolescents.

Online technologies could play an important role in the sexual development of adolescents as they watch more pornography than before. Pornography may relate to adolescents' perceptions of their bodies, especially among those identifying as a sexual and/or gender minority (SGM) as they have an increased risk of body image concerns compared to their heterosexual, cisgender (HC) peers. The present study examined the cross-sectional and longitudinal associations over 3 years between adolescents' pornography use frequency and body appreciation, considering potential gender and sexual orientation-based differences. Results from linear univariate and parallel processes latent growth curve models with a multi-group approach among 2904 adolescents (MageT1 = 14.5 years, SD = 0.61; 51.4% girls, 16.3% sexual minority) demonstrated that HC and SGM girls' body appreciation slightly decreased over time. Moreover, HC boys, HC girls and SGM girls' pornography use frequency slightly increased over time. Cross-sectionally, greater pornography use frequency was associated with lower levels of body appreciation in HC girls and SGM boys, with a small effect size. However, longitudinally, pornography use frequency and body appreciation were not related to each other in either group. Our findings support that pornography use, in the short term, is negatively associated with adolescents' body appreciation, although these associations might not hold in the long term. Adolescents may be more critical of body ideals represented in pornography as they learn to think with more discernment about the pornographic depictions of bodies and sexuality.

Family Partner: study protocol for a pilot randomised study of a home-visitation intervention in Norway.

AIM: Every year, about 5% of children in Norway experience severe child maltreatment and need support from the child welfare services. However, research-supported interventions for this group are lacking. The current study piloted an intensive home-visitation intervention, Family Partner, which aims to reduce child maltreatment among at-risk parents by improving parental skills, agency and trust in the welfare services, and children's well-being. The randomised controlled trial piloted in this study examines the acceptability of the Family Partner intervention for staff and families and evaluates its feasibility for a full-scale randomised controlled trial. METHODS: This protocol outlines a prospective, parallel, pilot randomised trial of the Family Partner intervention in three Norwegian municipal child welfare services. The participants are families with children under 12 years of age, where the parents are identified as having challenges. Families in the treatment group receive the Family Partner intervention, while families in the control group receive ordinary child welfare services. Data are collected at baseline, and at 3, 6, 12 and 18 months after recruitment. The pilot study monitor retention and adherence to inform the feasibility of a future full-scale randomised study. To assess the acceptability of the trial and intervention, a subsample of the participating families, as well as the family partners and representatives of the child welfare services in each municipality, are invited to complete qualitative interviews. CONCLUSIONS: The results will guide the design of a fully powered randomised controlled trial of the Family Partner intervention compared with ordinary child welfare services. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04957394; Pilot Trial of Family Partner: a Child Maltreatment Prevention Intervention (FAMPART); registered on 12 July 2021.

Romantic Relationships from Adolescence to Established Adulthood.

This 15-year longitudinal study investigated with follow-up data how romantic patterns from ages 16 to 24 are associated with romantic involvement and turnover (ages 25-30), romantic dispositions (age 30) and romantic relationships characteristics (age 30). A sample of 255 individuals (60.8% women) identified all their romantic partners between the ages of 16 and 24. Between ages 25 and 30, participants identified all their romantic partners and the length of each relationship. At age 30, they also completed a series of questionnaires regarding romantic dispositions and if it applied, characteristics of their current romantic relationship. Results indicated continuity in the romantic sphere from adolescence to established adulthood. At age 30, romantic patterns were associated with: avoidance of intimacy, jealousy, global romantic satisfaction, relationship status and the duration of the current romantic relationship. Together, these results bring new information on romantic development from adolescence to established adulthood.

Dating Violence Trajectories in Adolescence: How Do They Relate to Sexual Outcomes in Canada?

Dating violence during adolescence is a major public health issue: it is highly prevalent and extensive research has documented its physical and psychological consequences, yet very little has focused on its sexual consequences. The present study investigated the longitudinal associations between dating violence victimization (psychological, sexual or physical) and sexual well-being (sexual satisfaction and sexual distress) among 1442 sexually active adolescents aged between 14 and 17 years who completed at least one of three data waves (51.1% girls; 45.7% boys; 0.3% non-binary; 3.0% varying gender identity). The study also examined whether these associations differed by gender identity and sexual minority status. Adolescents completed online questionnaires on electronic tablets during class. The results indicated that psychological, physical (except for boys), and sexual dating violence victimization were all associated with lower sexual satisfaction and greater sexual distress over time. Moreover, the between-level associations between dating violence and poorer sexual outcomes were stronger among girls and gender varying adolescents than among boys. The within-level association between physical dating violence and sexual satisfaction was significant among adolescents with a nonvarying sexual minority status, but not among those with a nonvarying heterosexual status or that varied in sexual minority status. Findings offer cues for dating violence prevention and intervention programs by suggesting the need to examine sexual well-being over time.

Childhood Sexual Abuse, Intellectual Disability, and Subsequent Physical and Mental Health Disorders: A Matched Cohort Study.

This study assesses whether children with intellectual disability (ID) are more at risk of sexual abuse and whether they have similar consultation rates for physical and mental health disorders than children without ID. The matched-cohort design study uses administrative databases of children who had a sexual abuse report corroborated by a child protection agency and a matched group from the general population. Children with ID were 3.5 times more likely to have a corroborated sexual abuse report when compared to their peers without ID and a higher post-abuse number of medical consultations for physical and mental health disorders. Children with ID are more at risk of sexual abuse and physical and mental health disorders and may also be more vulnerable to the effects of abuse.

Stressed and distressed: how is the COVID-19 pandemic associated with sexual frequency, sexual satisfaction, and relationship satisfaction?

BACKGROUND: The Canadian government's response to the ongoing COVID-19 pandemic included the implementation of several restrictive measures since March 2020. These actions sought to decrease social contact and increase physical distancing, including that within universities. Such constraints were required to impede the transmission of the virus; however, concerns remain about their impact on the sexual and intimate relationships of university employees and students. AIM: This study examined the associations between COVID-19-related stress and sexual frequency, sexual satisfaction, and relationship satisfaction, also testing the mediating role of psychological distress. METHODS: The models were tested with Canadian data collected from university employees and students in 2 phases: the first wave in April-May 2020 (T1; n = 2754) and the second wave in November-December 2021 (T2; n = 1430), 18 months afterward. Participants completed self-report questionnaires online. Path analyses were performed to test the associations of the mediation models. OUTCOMES: The principal outcomes included psychological distress determined via the Patient Health Questionnaire-4, relationship satisfaction measured via the Dyadic Adjustment Scale, and sexual satisfaction and sexual frequency ascertained through a single item each. RESULTS: Overall, COVID-19-related stress was associated with higher psychological distress, which in turn was related to lower sexual frequency, sexual satisfaction, and relationship satisfaction. Similar results were obtained with T1 and T2 data, indicating the mediating effect of psychological distress. CLINICAL IMPLICATIONS: These findings increase scholarly comprehension of the negative associations between stress/distress and sexual and romantic relationships. Sexuality and close relationships are vital to the quality of human life; thus, targeted interventions should be developed to reduce COVID-19-related stress and its impact on sexual and romantic relationships to mitigate the long-term influences of this unique global challenge. STRENGTHS AND LIMITATIONS: To our knowledge, this study is the first to use a large sample size and replicate findings in 2 waves. Nonetheless, it is limited by the use of cross-sectional data. Longitudinal studies with the same participants are mandated to better understand the evolution of these outcomes. CONCLUSION: COVID-19-related stress and psychological distress were found among participating university students and employees and were associated with lower sexual satisfaction, sexual frequency, and intimate relationship satisfaction. These results were observed at the early onset of the pandemic and 18 months afterward, suggesting that the stress generated by the pandemic were not mere reactions to the onset of the pandemic but persisted over time.

A Validation Study of the Global Measure of Sexual Satisfaction in Sexually Active Adolescents.

Positive views of adolescents' sexuality have only begun to garner interest in the last two decades. Despite great strides in this emerging area, progress is limited by the paucity of valid and reliable measures among this population. The goal of this study was to validate the widely used adult five-item Global Measure of Sexual Satisfaction (GMSEX) in a large sample of sexually active adolescents. A total of 1,036 adolescents (516 girls, 49.8%) aged between 14 and 17 years (Mage = 14.62; SD = 0.66) were recruited to investigate the reliability and validity of the GMSEX. The GMSEX yielded strong psychometric properties in adolescents, including factor structure, measurement invariance, and reliability. Results showed that the scale works similarly for boys and girls as well as for heterosexual, cisgender, and sexual minority adolescents. The GMSEX is a short, reliable, and valid measure of sexual satisfaction that can be used in future studies focusing on adolescents' sexuality and relationships.

A survey of eating styles in eight countries: Examining restrained, emotional, intuitive eating and their correlates.

INTRODUCTION: Restrained, emotional and intuitive eating were examined in relation to each other and as correlates of participants' weight status, body image and self-esteem. In some past research, restrained and emotional eating have been associated with higher weight status and poorer mental health, while intuitive eating is more frequently linked to lower weight status and more positive well-being. However, these eating styles have rarely been examined together and never in a large cross-country sample. METHOD: Six-thousand two-hundred and seventy-two (6272) emerging adults (M age = 21.54 years, SD = 3.13) completed scales from the Three-Factor Eating Questionnaire, the Eating Disorders Examination Questionnaire, the Intuitive Eating Scale-2, the Multidimensional Body Self Relations Questionnaire, the Rosenberg Self-Esteem Scale, and provided weight and height information that was used to calculate body mass index (BMI). Participants resided in Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States and provided information using an online survey. RESULTS: Path analyses for the entire sample revealed significant pathways between higher intuitive eating and higher body satisfaction and self-esteem, and lower BMIs among participants. Higher levels of restrained and emotional eating were associated with lower body satisfaction and self-esteem, and higher BMIs among participants. Minor cross-country differences were evident in these patterns of relations, but intuitive eating emerged as a consistent predictor across countries. CONCLUSION: Overall, findings suggest that efforts should be made to increase intuitive eating among emerging adults and to support individual and macrolevel interventions to decrease restrained and emotional eating behaviours.

Self-determination, restrictive eating, and psychological needs: Challenges for young athletes.

OBJECTIVE: The purpose of this study was to examine the mediating role of self-determination for sport in the relationship between psychological needs in a sport context, and restrictive eating behaviors among adolescent athletes, while controlling for confounding variables. METHOD: Self-report online surveys were completed by 983 adolescent athletes (41.3% identified as girls, M = 14.63 years, SD = 0.765). Structural equation modeling was conducted to investigate the hypothesized associations between basic psychological need satisfaction and frustration in sport, self-determination for sport, and restrictive eating behaviors, controlling for the level of competition and the type of sport practiced. Gender differences between the associations were assessed using moderation analysis. RESULTS: Girls reported significantly more restrictive eating behaviors (Mgirls = 0.85; SD = 1.39 vs. Mboys = 0.62; SD = 1.31). Both associations between basic psychological need frustration and satisfaction and restrictive eating behaviors were mediated by self-determination for sport (ß = 0.054, 95% bootstrap IC = 0.027-0.089; ß = -0.045, 95% bootstrap IC = -0.079 to -0.021). Further, gender moderated an association so that frustration of basic psychological in sport more strongly predicted restrictive eating behaviors in girls (ß = 0.256; p = 0.008), compared with boys. DISCUSSION: Our study reveals considerable gender differences in the mechanism underlying the adoption of restrictive eating in adolescent athletes. The research also fills a gap in the literature by supporting the assumptions of the Hierarchical Model of Intrinsic and Extrinsic Motivation in eating behaviors, specifically in the sport context.

Validation of the Body Appreciation Scale-2 in cisgender, heterosexual and sexual and gender minority adolescents and sexuality-related correlates.

Body dissatisfaction has received considerable scientific attention, while research about positive body image has been neglected, particularly among adolescents. The aims of the present study were to examine (1) the factor structure of the Body Appreciation Scale-2 (BAS-2) in a large sample of cisgender, heterosexual and sexual and gender minority adolescents, (2) measurement invariance across language, gender and sexual orientation-based groups, (3) convergent validity with sexuality-related outcomes and (4) one-year temporal stability. Results of a confirmatory analysis among 2419 adolescents (Mage=14.6 years, SD=0.62; 52.6% girls) corroborated the proposed one-dimensional factor structure of the scale. The BAS-2 demonstrated adequate reliability and one-year temporal stability. The scale was partially invariant across gender and fully invariant across language and cisgender heterosexual and sexual and gender minority adolescents. Boys (cis and trans) had higher levels of body appreciation than girls (cis and trans), while no significant differences were observed between heterosexual and sexual minority adolescents. The BAS-2 correlated positively with sexual satisfaction and sexual body-esteem as well as negatively with sexual distress. Our findings support the validity and reliability of the BAS-2 in French and English for measuring body appreciation in adolescents.

Changes in Canadian Adolescent Well-Being since the COVID-19 Pandemic: The Role of Prior Child Maltreatment.

Adolescents may be particularly vulnerable to the negative impact of the coronavirus disease 2019 (COVID-19) pandemic, given their increased socialization needs during this developmental period. This prospective study examined the potential changes in adolescents' well-being from before to during the pandemic, and the moderating role of a history of child maltreatment (CM), COVID-19-related distress, and gender among 1,802 adolescents (55.5% participants identified as boy, 42.2% as girl, and 1.5% as nonbinary; Mage 14.74 years). Another aim was to determine whether COVID-19-related distress mediated the relationship between CM and well-being. Results revealed that COVID-19-related distress was associated with lower well-being (i.e., higher levels of internalized and externalized behaviors, and lower levels of self-esteem and life satisfaction). Boys experienced a greater decrease in life satisfaction and self-esteem than girls. A history of CM had a moderation effect, with the pandemic having a lesser impact on the outcomes of adolescents with such a history. However, it was also associated with more COVID-19-related distress, which in turn was associated with lower levels of internalized and externalized behaviors, self-esteem, and life satisfaction. These unexpected results with regard to CM might indicate that the social restrictions during the pandemic could have had a relieving effect on adolescents with particular challenges associated with CM.

Testing of a model for risk factors for eating disorders and higher weight among emerging adults: Baseline evaluation.

Although a range of risk factors have been identified for disordered eating and weight status, the breadth of risk factors have been rarely considered within a single, comprehensive model. The robustness of these findings across countries also remains an open question. The present study sampled 6272 participants aged 18-30 years from eight countries in an attempt to evaluate combined and unique predictors for these two conditions, and to explore possible cross-country differences in these models. Participants completed a range of demographic, biological, behavioral, psychological, and sociocultural measures to test a comprehensive model of the contributions of these predictors for disordered eating and weight-related constructs (binge eating, body mass index, compensatory behaviors, dietary restraint, drive for muscularity, and drive for leanness). Structural invariance testing within a multigroup path analysis framework revealed that a single model across the eight countries provided poor model fit. Freeing of 22% of parameters across countries provided excellent fit and a satisfactory compromise for country-invariant and country-variant parameters in the model. Overall, predictors accounted for between 15% and 60% of variance in the outcome measures, with lowest explained variance for the disordered eating outcomes. Significant unique contributions to prediction were observed for each of the five risk factor variable types and across the eight countries. Thus, the findings show strong support for this model as an explanatory framework of both disordered eating and weight status.

Heterosexual, Cisgender and Gender and Sexually Diverse Adolescents' Sexting Behaviors: The Role of Body Appreciation.

Sexting has become part of the repertoire of adolescents' sexual behaviors, especially among those who identify as gender and sexually diverse. Whereas body dissatisfaction increases during adolescence and is associated with negative sexuality outcomes, little research has examined how body appreciation may contribute to adolescents' sexting. The present study examined associations between body appreciation and sexting behaviors, and whether these differed by gender and sexual orientation, using path analysis in a sample of 2904 adolescents (Mage = 14.53; SD = 0.61) comprised of five groups: heterosexual cisgender and gender and sexually diverse boys (heterosexual cisgender = 1193; gender and sexually diverse = 157), heterosexual cisgender and gender and sexually diverse girls (heterosexual cisgender = 1152; gender and sexually diverse = 320), and non-binary adolescents (n = 18). Lower levels of body appreciation were associated with higher sexting frequency in heterosexual cisgender girls and gender and sexually diverse boys. Adolescents preoccupied with their appearance may use sexting for body image-related validation.