Concise report: Teenage sexting on the rise? Results of a cohort study using a weighted sample of adolescents.

Background The vast differences in sampling techniques, cultural contexts between international studies, the differences in age groups of the samples and various definitions used to measure sexting make it hard to compare how sexting behaviour has evolved over the past years. This exploratory study aims to address this critical gap in the research by using two datasets of a biennial study on adolescents' media use. The first aim of this study is to compare the sexting prevalence and correlates (i.e. age, gender and smartphone ownership) of youth in 2015 and 2017. The second aim is to investigate the risk mitigation behaviours of youth who engage in sexting and to assess how their behaviours differ between the two time points. METHODS: The data for cohort 1 were collected in October and November 2015 and comprise of 2663 students from 11 secondary schools in the Dutch-speaking community of Belgium. For the second cohort, the data were collected in October and November 2017 and comprise of 2681 students from 10 secondary schools. A weighing factor was implemented on the dataset. RESULTS: The results show sexting behaviour has significantly increased between cohorts, with 8.3% of the respondents having sent a sext in the first cohort, compared with 12.1% in the second cohort. The sexting prevalence rates also significantly increased between cohorts when taking into account students who owned a smartphone. Furthermore, engagement in sexting was associated with being older, and no gender differences were found. In the second cohort, 36.8% of youth who had sent a sext were identifiable in those images. There were no differences between cohorts. CONCLUSION: The results indicate that other factors next to smartphone ownership may be associated with an increase in sexting prevalence. The findings also highlight the need for the development of age-appropriate sexting educational materials.

A first investigation into gender minority adolescents' sexting experiences.

INTRODUCTION: Gender minority adolescents, such as transgender, gender nonconforming, gender diverse and non-binary youth, may face unique challenges with regard to online sexual communication. They may be especially vulnerable for sexting-related risks. The aim of this study is to explore the sexting experiences of gender minority youth among a school-based sample. METHODS: This brief exploratory study reports on a survey that was conducted among 1293 respondents with an average age of 14.79 years old (SD = 1.97) in the Dutch-speaking area of Belgium, and compares engagement in sexting experiences between cisgender and gender minority youth. RESULTS: The results of our exploratory study show that gender minority adolescents were more likely to have ever been pressured to send a sexting image. There were no significant differences with regard to receiving sexts, or receiving forwarded sexts. None of the gender minority youth reported that they had forwarded a sexting image from someone else, as opposed to 9.3% of cisgender youth who had forwarded a sext. CONCLUSIONS: Despite the explorative nature of our study, the results suggest that gender minority youth may be at an increased risk to experience sexting-related pressure. Additional research is needed to investigate the sexting experiences of gender minority adolescents. Gender minority youth may benefit from education about safer sexting, and specifically ways to cope with sexting-related pressure.

Longitudinal associations between sexting, cyberbullying, and bullying among adolescents: Cross-lagged panel analysis.

INTRODUCTION: While adolescent sexting, or the sending of sexually explicit images, has been cross-sectionally associated with bullying and cyberbullying, there is a lack of longitudinal studies in this area. To address this gap in the literature, we examined the longitudinal link between sexting and 1) traditional, in-person, bullying victimization and 2) cyberbullying victimization. METHODS: We used data from a longitudinal study of ethnically diverse adolescents recruited from multiple public high schools in southeast Texas. Three waves of data were used (T2, T3 and T4). Cross-lagged panel analysis was performed in Mplus to analyze the data. RESULTS & CONCLUSIONS: Cross-lagged panel analyses identified autoregressive effects for all three variables, and cross-lagged effects for cyberbullying. Sexting was associated with subsequent cyberbullying victimization across all time points, and T3 cyberbullying victimization was associated with engagement in sexting one year later. Furthermore, T2 cyberbullying victimization indirectly associated with T4 sexting via T3 cyberbullying victimization. For traditional bullying, a cross-lagged effect was found between T3 sexting and T4 offline bullying victimization. Although T2 sexting did not directly link to subsequent traditional bullying victimization, a significant mediation effect was identified such that T3 sexting mediated the effects of T2 sexting on T4 traditional bullying victimization. Results show that sexting adolescents may be at risk for (cyber)bullying victimization and highlight the need to address both sexting and bullying in prevention and intervention efforts.

Cross-sectional and temporal associations between cyber dating abuse victimization and mental health and substance use outcomes.

The purpose of this study was to investigate the cross-sectional and temporal associations between cyber dating abuse victimization (CDAV) and mental health (i.e., anxiety, PTSD, and depression), and substance use (i.e., alcohol, cigarettes, marijuana and hard drugs). We used data from the 5th and 6th waves of an ongoing longitudinal study of ethnically diverse adolescents from seven public high schools in Texas, U.S. Participants were 641 adolescents (63.3% female) with a mean age of 19.1 years (SD = .79) at Wave 5. Analyses suggested that while CDAV was associated with mental health and substance use cross-sectionally, when examining over time, it was only associated with past year hard drug and past month marijuana use. Although long-term mental health effects of CDAV did not emerge in the current study, we identified a temporal link to marijuana and hard drugs, highlighting the need for prevention efforts to incorporate messages about substance use.

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.

The associations of adolescents' dating violence victimization, well-being and engagement in risk behaviors.

This brief report describes dating violence victimization among adolescents in Flanders, Belgium, and focuses on how dating violence is related to adolescents' well-being and engagement in risk behaviors, such as substance use, sexual behaviors, and engagement in vandalism or fighting. A survey was conducted in Flanders, Belgium among 1187 adolescents (61.3% female, n = 728). A total of 466 respondents between 16 and 22 years old (M = 17.82 years, SD = 0.92) were in a relationship (71.0% female, n = 331), and, therefore, formed the subsample of the present study. The results show that adolescents, who consume alcohol at a younger age, have ever used marihuana, or were involved in vandalism have a higher probability to become victim of dating violence than adolescents who are not involved in these behaviors. Dating violence victimization was also linked with symptoms of depression and a lower self-esteem.

Parental Knowledge of Adolescents' Online Content and Contact Risks.

Parental knowledge about adolescents' activities is an identified protective factor in terms of adolescent adjustment. While research on parental knowledge has focused on adolescents' offline behavior, there is little empirical understanding of parental knowledge about adolescents' online behavior. This study investigates parental knowledge about adolescents' online activities and experiences with online risks, as well as the correlates of such knowledge. Building on former research, open communication and knowledge-generating monitoring practices are investigated as potential correlates of parental knowledge. Use is made of triadic data, relying on reports from children aged 13 to 18, mothers and fathers within the same family (N = 357 families; 54.9 % female adolescents). The results showed that parents have little knowledge about the occurrence of online risks and their children's online activities. While mothers did not have more accurate knowledge compared to fathers, they did perceive themselves to be more knowledgeable than fathers. Associations between parental knowledge and hypothesized correlates were tested by means of one-way ANOVA tests and stepwise logistic regression models. Limited evidence was found for associations with parents' accurate knowledge about the occurrence of online risks. Engagement in knowledge-generating monitoring practices was linked to mothers and fathers' self-perceived knowledge about their children's online activities. For mothers, open communication with the child was linked to self-perceived knowledge. The findings suggest that parents need to be more aware of the possibility that online risks might occur and that more research needs to be done in order to understand what parents can do to improve their accurate knowledge.

The Associations Between Substance Use, Sexual Behaviors, Bullying, Deviant Behaviors, Health, and Cyber Dating Abuse Perpetration.

Dating violence is an important public health concern and is considered to be a form of school violence. While digital technologies have enabled perpetrators of dating violence to target their victims online (cyber dating abuse), little is known about how this form of perpetration relates to specific adolescent risk behaviors. This brief research report focuses on the associations between substance use, sexual behaviors, deviant behaviors, self-reported health, and cyber dating abuse perpetration. Participants included 705 ethnically diverse adolescents ( n = 408; 57.9% female) in Southeast Texas. Having had sexual intercourse or using alcohol or drugs before having sex was significantly linked with cyber dating abuse perpetration, as was poor physical health, and substance use. Consistent with limited research, we found a link between cyber dating abuse and engagement in bullying behaviors. The discussion section includes suggestions for school nurse practice and further research.

A Factorial Validation of Parental Mediation Strategies with Regard to Internet Use.

This study investigated the strategies which parents employ in order to mediate their adolescent child's internet use, thereby including the perspectives from the mother, the father and an adolescent child aged 13 to 18. Data from 357 families (n = 1071) were analyzed. Parental mediation strategies were inductively derived from a wide range of concrete mediation practices. Factor analysis yielded the same six factor solution for each informant, resulting in the identification of six distinct parental mediation strategies. Differences occurred between the three informants in terms of the quantity of mediation taking place. Parental mediation was predicted by the child's age, but less by the parents' age and the child's gender.

Predicting students' intention to use stimulants for academic performance enhancement.

BACKGROUND: The non-medical use of stimulants for academic performance enhancement is becoming a more common practice among college and university students. OBJECTIVE: The objective of this study is to gain a better understanding of students' intention to use stimulant medication for the purpose of enhancing their academic performance. Based on an extended model of Ajzen's theory of planned behavior, we examined the predictive value of attitude, subjective norm, perceived behavioral control, psychological distress, procrastination, substance use, and alcohol use on students' intention to use stimulants to improve their academic performance. METHODS: The sample consisted of 3,589 Flemish university and college students (mean age: 21.59, SD: 4.09), who participated anonymously in an online survey conducted in March and April 2013. Structural equation modeling was used to investigate the relationships among the study variables. RESULTS: Our results indicate that subjective norm is the strongest predictor of students' intention to use stimulant medication, followed by attitude and perceived behavioral control. To a lesser extent, procrastinating tendencies, psychological distress, and substance abuse contribute to students' intention. Conclusions/ Importance: Based on these findings, we provide several recommendations on how to curtail students' intention to use stimulant medication for the purpose of improving their academic performance. In addition, we urge researchers to identify other psychological variables that might be related to students' intention.

The association between adolescent sexting, psychosocial difficulties, and risk behavior: integrative review.

When a sexting message spreads to an unintended audience, it can adversely affect the victim's reputation. Sexting incidents constitute a potential school safety risk. Just as with other types of adolescent risk behavior, school nurses might have to initiate the first response when a sexting episode arises, but a school nurse's role goes beyond intervention. They can also play an important role in the prevention of sexting and its related risks. This article reviews the links between adolescent sexting, other types of risk behavior, and its emotional and psychosocial conditions. Seven databases were examined and nine studies remained for further review. The review of the literature shows that adolescent sexting is cross sectionally associated with a range of health-risk behaviors. Youth who engage in sexting are also found to experience peer pressure and a range of emotional difficulties. The results can guide school nurse education and practice.

Brief report: The association between adolescents' characteristics and engagement in sexting.

The potential emotional and legal consequences of adolescents' engagement in sending sexually explicit pictures through the internet or the mobile phone (i.e., sexting) have caused significant concern about the behavior among practitioners and academics. The present study compares the characteristics of students who engage in sexting to those who do not. A survey among 1028 adolescents of 11 secondary schools in Belgium was administered. Logistic regression analyses suggest that sexting is significantly linked with sensation seeking, experiential thinking styles and depression, while controlling for gender, age, family status and students' response to economic stress. The results are of importance to practitioners who could adapt their prevention and intervention campaigns to better reach this complex youth. Differences with the findings of previous studies highlight the importance of continuing research on sexting and the need to pay attention to the specific context in which adolescent sexting takes place.

Determinants of physicians' prescribing behaviour of methylphenidate for cognitive enhancement.

The non-medical use of methylphenidate for cognitive enhancement becomes a more and more common practice among college and university students. Although physicians are a source of access, little is known about the underlying mechanisms that might lead to physicians' intention and behaviour of prescribing methylphenidate to improve students' academic performance. Applying Ajzen's theory of planned behaviour (TPB), we tested whether attitudes, subjective norms (controllability and self-efficacy) and perceived behavioural control predicted the intention and the prescribing behaviour of physicians. Participants were 130 physicians (62.3% males). Structural equation modelling was used to test the ability of TPB to predict physicians' behaviour. Overall, the present study provides support for the TPB in predicting physicians' prescribing behaviour of methylphenidate for cognitive enhancement. Subjective norms, followed by attitudes, are the strongest predictors of physicians' intention to prescribe methylphenidate. To a lesser extent, controllability predicts the intention of physicians, and self-efficacy predicts the self-reported behaviour. Compared to their male colleagues, female physicians seem to have more negative attitudes towards prescribing methylphenidate for cognitive enhancement, feel less social pressure and perceive more control over their behaviour. Intervention programmes that want to decrease physicians' intention to prescribe methylphenidate for improving academic performance should primarily focus on alleviating the perceived social pressure to prescribe methylphenidate and on converting physician neutral or positive attitudes towards prescribing methylphenidate into negative attitudes.

Mindful sharenting: how millennial parents balance between sharing and protecting.

Background: Sharenting, parents' sharing of personal information about children on social media is becoming increasingly controversial. Its potential risks have drawn some parents to engage in mindful sharenting: parents' application of strategies to reduce the potentially negative effects of sharenting, as they are aware of the impact sharenting can have on the child's privacy. Objective: This study aims to investigate parents' motives for engaging in mindful sharenting, the strategies they implement and how relatives and acquaintances react. Methods: In-depth interviews were conducted with eight mother-father dyads in Belgium. At least one of both respondents had to be born between 1980 and 2000 (i.e., millennial parents), having a child aged between 0 and 6 years. Conversations were transcribed ad verbatim, coded in Nvivo, and were analyzed thematically. Results: The reasons leading parents to engage in mindful sharenting were previous negative experiences they encountered or heard of from acquaintances. In addition, parents aimed to safeguard their child's privacy and prevent any misuse of their identity or any other forms of aggression. Furthermore, certain parents wish to grant their children the freedom to choose which media content about them is shared online at a later stage in life. As parents are aware of potential benefits of sharenting, they employ strategies to ensure their child's privacy, while still enjoying the benefits sharenting offers them. These strategies include photographing the child from a distance, the child looking away from the camera, focusing only on a body part, covering the face with an emoticon, blurring the face, or cutting recognizable parts from the photo. However, parents engaging in mindful sharenting are also confronted with questions and negative comments from family members and acquaintances. This makes them feel like they must justify their decision. Moreover, they are sometimes confronted with family members posting identifiable pictures of their child, which leads to privacy turbulence, and parents having to clarify and renegotiate the privacy boundaries concerning image sharing. Conclusion: Parents deciding to engage in mindful sharenting engage in several strategies to balance between the opportunities sharenting can offer them, the social pressure they experience to post child-related updates, and their objective to protect their child's privacy. However, some parents face criticism, making them feel pressured to justify their decision and having to clearly explain to family members not to make identifiable pictures of their child available online.

Reasons for Nonuse, Discontinuation of Use, and Acceptance of Additional Functionalities of a COVID-19 Contact Tracing App: Cross-sectional Survey Study.

BACKGROUND: In several countries, contact tracing apps (CTAs) have been introduced to warn users if they have had high-risk contacts that could expose them to SARS-CoV-2 and could, therefore, develop COVID-19 or further transmit the virus. For CTAs to be effective, a sufficient critical mass of users is needed. Until now, adoption of these apps in several countries has been limited, resulting in questions on which factors prevent app uptake or stimulate discontinuation of app use. OBJECTIVE: The aim of this study was to investigate individuals' reasons for not using, or stopping use of, a CTA, in particular, the Coronalert app. Users' and nonusers' attitudes toward the app's potential impact was assessed in Belgium. To further stimulate interest and potential use of a CTA, the study also investigated the population's interest in new functionalities. METHODS: An online survey was administered in Belgium to a sample of 1850 respondents aged 18 to 64 years. Data were collected between October 30 and November 2, 2020. Sociodemographic differences were assessed between users and nonusers. We analyzed both groups' attitudes toward the potential impact of CTAs and their acceptance of new app functionalities. RESULTS: Our data showed that 64.9% (1201/1850) of our respondents were nonusers of the CTA under study; this included individuals who did not install the app, those who downloaded but did not activate the app, and those who uninstalled the app. While we did not find any sociodemographic differences between users and nonusers, attitudes toward the app and its functionalities seemed to differ. The main reasons for not downloading and using the app were a perceived lack of advantages (308/991, 31.1%), worries about privacy (290/991, 29.3%), and, to a lesser extent, not having a smartphone (183/991, 18.5%). Users of the CTA agreed more with the potential of such apps to mitigate the consequences of the pandemic. Overall, nonusers found the possibility of extending the CTA with future functionalities to be less acceptable than users. However, among users, acceptability also tended to differ. Among users, functionalities relating to access and control, such as digital certificates or "green cards" for events, were less accepted (358/649, 55.2%) than functionalities focusing on informing citizens about the spread of the virus (453/649, 69.8%) or making an appointment to get tested (525/649, 80.9%). CONCLUSIONS: Our results show that app users were more convinced of the CTA's utility and more inclined to accept new app features than nonusers. Moreover, nonusers had more CTA-related privacy concerns. Therefore, to further stimulate app adoption and use, its potential advantages and privacy-preserving mechanisms need to be stressed. Building further knowledge on the forms of resistance among nonusers is important for responding to these barriers through the app's further development and communication campaigns.

Ready or Not for Contact Tracing? Investigating the Adoption Intention of COVID-19 Contact-Tracing Technology Using an Extended Unified Theory of Acceptance and Use of Technology Model.

To diminish the risk of spreading COVID-19 as society exits the lockdowns, several apps have been developed for contact tracing. These apps register which users have been in proximity of each other. If a user is diagnosed with COVID-19, app users who have been recently in proximity to this person are notified. The effectiveness of these apps highly depends on public support. Therefore, this study investigated the factors that influence app use intention, based on an extended unified theory of acceptance and use of technology model. A survey was administered in Belgium (Flanders) to 1,500 participants aged 18 to 64 years old. Structural equation modeling was used to test the relationships among the model's constructs. Our results indicated that 48.70 percent of the respondents wanted to use the app. The model explained 39 percent of the variance in app use intention. The most important predictor was performance expectancy, followed by facilitating conditions and social influence. Effort expectancy was not related to intention. Moreover, individuals' innovativeness was positively related with app use intention, whereas app-related privacy concerns negatively influenced intention. Based on the results, suggestions are made for policy makers and developers.

The Moderating Role of Parenting Dimensions in the Association between Traditional or Cyberbullying Victimization and Mental Health among Adolescents of Different Sexual Orientation.

Cyberbullying victimization is associated with mental health problems and reported to occur more in nonheterosexual orientation youth (lesbian, gay, bisexual, and questioning (LGBQ)) than among heterosexual youth. Parental support may protect against mental health problems after being victimized, but nonsupportive parental influences may also exacerbate harm. This study investigated whether parenting dimensions (autonomy support, psychological control) moderated the associations between bullying victimization and mental health problems among heterosexual and LGBQ adolescents. An anonymous survey was completed by 1037 adolescents (M age = 15.2 ± 1.9, 50% female). Regression analyses examined associations between victimization, sexual orientation, and mental health problems, and investigated the moderating role of parenting. Both forms of victimization were associated with higher mental health problems. LGBQ youth experienced more depressive symptoms and suicidal ideation than heterosexual youth. Lower levels of parental psychological control and higher levels of autonomy support were related to having fewer mental health problems. However, perceived autonomy support appeared less protective when adolescents experienced more frequent victimization. Moreover, parental psychological control was related to heightened risk for suicidal plans specifically among LGBQ youth and also exacerbated the association between cyberbullying victimization and stress among LGBQ youth. These findings underscore the need to address parenting in whole-school antibullying and mental health promotion programs.

Students' stimulant use for cognitive enhancement: A deliberate choice rather than an emotional response to a given situation.

BACKGROUND: Prescription stimulants such as methylphenidate are usually prescribed to treat attention deficit (and hyperactivity) disorders (ADHD). Recently, these drugs have gained popularity among college students, because of the belief that they can help improve academic performance. OBJECTIVES: This study assessed whether engaging in nonmedical use of prescription stimulants for cognitive enhancement is a rational or a more spontaneous decision-making process. METHOD: A survey was conducted among 661 students (63.5 % females, n = 420, Mage = 21.40). Data were analyzed using structural equation modeling. RESULTS: A total of 15.9 % (n = 105) of the students had previously taken stimulants to improve their academic performance. The use of stimulants was significantly higher among males (22.4 %) than females (12.1 %). Positive attitudes toward stimulant use for cognitive enhancement were strongest related to students' intention to take stimulants for increasing their academic performance, followed by the norm of parents. Additionally, the more the students identified themselves with the prototype of a student using stimulants for cognitive enhancement, the more likely they were to be willing to misuse stimulants. CONCLUSIONS: The findings suggest that using stimulants for cognitive enhancement is a rational choice rather than an unplanned one.

The Relationship between Dark Triad Personality Traits and Sexting Behaviors among Adolescents and Young Adults across 11 Countries.

BACKGROUND: Sexting is an increasingly common phenomenon among adolescents and young adults. Some studies have investigated the role of personality traits in different sexting behaviors within mainstream personality taxonomies like Big Five and HEXACO. However, very few studies have investigated the role of maladaptive personality factors in sexting. Therefore, the present study investigated the relationship between Dark Triad Personality Traits and experimental (i.e., sharing own sexts), risky (i.e., sexting under substance use and with strangers), and aggravated sexting (i.e., non-consensual sexting and sexting under pressure) across 11 countries. METHODS: An online survey was completed by 6093 participants (Mage = 20.35; SDage = 3.63) from 11 different countries which covered four continents (Europe, Asia, Africa, and America). Participants completed the Sexting Behaviors Questionnaire and the 12-item Dark Triad Dirty Dozen scale. RESULTS: Hierarchical regression analyses showed that sharing own sexts was positively predicted by Machiavellianism and Narcissism. Both risky and aggravated sexting were positively predicted by Machiavellianism and Psychopathy. CONCLUSIONS: The present study provided empirical evidence that different sexting behaviors were predicted by Dark Triad Personality Traits, showing a relevant role of Machiavellianism in all kinds of investigated sexting behaviors. Research, clinical, and education implications for prevention programs are discussed.

Adoption of a Contact Tracing App for Containing COVID-19: A Health Belief Model Approach.

BACKGROUND: To track and reduce the spread of COVID-19, apps have been developed to identify contact with individuals infected with SARS-CoV-2 and warn those who are at risk of having contracted the virus. However, the effectiveness of these apps depends highly on their uptake by the general population. OBJECTIVE: The present study investigated factors influencing app use intention, based on the health belief model. In addition, associations with respondents' level of news consumption and their health condition were investigated. METHODS: A survey was administered in Flanders, Belgium, to 1500 respondents, aged 18 to 64 years. Structural equation modeling was used to investigate relationships across the model's constructs. RESULTS: In total, 48.70% (n=730) of respondents indicated that they intend to use a COVID-19 tracing app. The most important predictor was the perceived benefits of the app, followed by self-efficacy and perceived barriers. Perceived severity and perceived susceptibility were not related to app uptake intention. Moreover, cues to action (ie, individuals' exposure to [digital] media content) were positively associated with app use intention. As the respondents' age increased, their perceived benefits and self-efficacy for app usage decreased. CONCLUSIONS: Initiatives to stimulate the uptake of contact tracing apps should enhance perceived benefits and self-efficacy. A perceived barrier for some potential users is privacy concerns. Therefore, when developing and launching an app, clarification on how individuals' privacy will be protected is needed. To sustain perceived benefits in the long run, supplementary options could be integrated to inform and assist users.