Sexting and Psychological Distress: The Role of Unwanted and Coerced Sexts

Abstract

Sexting (e.g., conveying nude electronic images) is now common among young adults. Despite leading to negative consequences for some (e.g., harassment and unwanted dissemination), findings regarding sexting behaviors and mental health variables have been mixed. We recruited a convenience sample of young adults (N = 444, M age = 20, SD = 1) to test the hypothesis that sexting might be associated with poorer mental health. Our results showed no association between receiving or sending sexts overall. However, receiving unwanted sexts, or sexting under coercion, was associated with higher depression, anxiety, and stress symptoms, and lower self-esteem, and these two sexting experiences were independent predictors of psychological distress. The relationship between these sexting behaviors with poor mental health was moderated by gender, with poorer outcomes for males receiving unwanted sexts. These findings indicate a possible moderating factor in sexting and mental health.

Introduction

“Sexting” is becoming one of the most common forms of online sexual interactions¹ and can be defined as the sending, receiving, or forwarding of sexually explicit messages, images, or photos to others through electronic means. A recent systematic literature review² indicated that sexting behavior is highly prevalent in, predominantly, young adults (48.56 percent for sending and 56.01 percent for receiving image-based sexts), and more so than in adolescents (11.96 percent for sending and 11.85 percent for receiving image-based sexts).

These sexting behaviors might be regarded as a risk-taking behavior in some contexts, given the possibility of adverse outcomes when they involve bullying, nonconsensual dissemination, or take the form of violence against women.³ Given this, researchers have examined the link between sexting behavior and a range of mental health variables; however, findings have been largely mixed. In this article we focus on four of these variables, namely depression, anxiety, and stress symptoms, and self-esteem.

Depressive symptoms may be a risk factor associated with sexting. Individuals reporting elevated depressive symptoms may have an increased need to elicit validation or support from others, and may feel compelled to send sexts or acquiesce to the requests of others due to feelings of powerlessness and low self-esteem. Depressive symptoms may also be a consequence of negative outcomes from sexting, such as in the case of harassment. Several studies have found a relationship between depression and sexting.^4–7 However, other studies reported no such association.^8–10

Another mental health variable associated with sexting behaviors is anxiety. Individuals with high anxiety may engage in sexting as they anticipate that it will improve current or potential relationships,¹¹ or do so to avoid conflict.⁵ Individuals may also feel anxious about receiving sexts, for example, due to pressure to reciprocate, or concerns about negative outcomes such as unwanted dissemination if they reciprocate. Similar to the results observed with depression, findings on anxiety symptoms have been equivocal, with some studies reporting significant correlations,^9,11,12 while other studies have not.^8,10

It might also be possible that stress is a factor associated with sexting, given that higher stress levels are associated with greater sexual risk-taking behaviors in general.¹³ Although one study has linked economic stress with sexting behaviors in adolescents,⁶ the role of stress in sexting behaviors is otherwise unknown.

Relatedly, of the few studies that have investigated self-esteem and sexting, one study examining adolescents found that low self-esteem was related to a high prevalence of sexting,¹⁴ while another study found similar results among adults.¹⁵ However, other studies based on young adult participants^8,16 have found no significant associations between sexting and one's general appraisal of their self-worth.

One potential explanation for the discrepancies in findings on sexting and mental health may be how willingly a person receives or sends the sext. In one study, 52.3 percent of young adults had consensually engaged in sexting behaviors, despite reporting not wanting to do so.⁵ Motivations for this behavior included flirtation, foreplay, to fulfill a partner's needs, or for intimacy reasons. Indeed, peer pressure seems to be an important reason for sexting, with another study reporting that 23 percent of teens felt pressured to sext, and 51 percent of teenage girls saying they felt pressure from a boy to send sexually explicit messages.¹⁷ As already noted, it could be that psychological distress impairs an individual's decision-making processes, and, therefore, they are more inclined to send a sext when they do not want to. Furthermore, those receiving unwanted sexts may worry about receiving more subsequent sexts, or experience stress or low mood through the sense of harassment, or low self-esteem about being objectified. In this study, we aimed to examine whether sexting behavior might be associated with psychological distress in the context of the unwanted receipt of sexts and coerced sending of sexts. Based on previous findings, it was hypothesized that receiving and sending sexts would be associated with higher (+) depression, anxiety, and stress symptoms, and lower (−) self-esteem, but only in the context of when sexts were unwanted or sent under coercion.

Methods

Participants

Participants were 444 young adults aged 18–21 years (M = 20, SD = 1) of whom 219 were male (49.3 percent) and 225 were female (50.7 percent). Approximately 97 percent of the participants were Australian, and 91 percent of the sample identified as heterosexual, 4 percent homosexual, 3 percent bisexual, and 2 percent not wanting to say. Most of the participants (86.5 percent) reported being currently sexually active, and 16.4 years (SD = 2.1) was the average age of first sexual intercourse.

Materials

Sexting behavior

Sexting behavior was assessed through questions about participant engagement in and frequency of receiving or sending text messages containing sexually explicit images. We chose this particular definition of sexting as we were interested in focusing on message content that would be generally considered highly sexualized and as having a stronger potential for negative outcomes. Unwanted receipt of sexts was assessed with the question, “Have you ever received sexually explicit images of another person via text message that were unwanted/unwelcome?” (Yes/No). Participants were then asked what action they took if this occurred, and could respond: ignored it (no action taken); told a friend; told a parent; told a teacher; told the person directly to not do it; reported it to the police. To assess the coerced, but consensual, sending of sexts, we used the question, “Have you ever consented to sexting when you actually did not want to sext” (Yes/No).

Depression, anxiety, and stress

Depression, anxiety, and stress symptoms were measured using the short form of the Depression, Anxiety, and Stress Scale (DASS-21).¹⁸ This is a 21-item self-report instrument that includes three 7-item subscales. Participants respond to the items in reference to the past week using a 4-point Likert scale ranging from 0 (did not apply to me at all) to 3 (applied to me very much, or most of the time). Responses to items on each subscale are summed, with higher scores indicating greater levels of psychological distress. The DASS-21 has demonstrated good psychometric properties,¹⁹ and internal reliability in this sample was good (Cronbach's α's for the depression, anxiety, and stress subscales were 0.91, 0.88, and 0.87, respectively).

Self-esteem

Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES²⁰), a brief self-report inventory assessing global self-esteem. It consists of 10 statements, in response to which respondents indicate their level of agreement using a 4-point Likert scale ranging from 0 (strongly disagree) to 3 (strongly agree). Once five reverse-worded items are recoded, the total scale score is produced from the sum of responses to the 10 items. Scale scores can range from 0 to 30 with higher scores indicating higher self-esteem. The RSES has been found to have high internal reliability and good construct validity.^21–23 Internal reliability in this study was good (Cronbach's α = 0.92).

Procedure

After obtaining ethical approval for the study from the Deakin University Human Research Ethics Committee, participants were recruited through online Facebook advertisements, e-mail distribution, advertisements posted on the university campus, and through subsequent snowball recruiting. Potential participants were invited to review a brief description of the study online and, if interested in participating, to indicate their consent by commencing the survey, which took around 15–20 minutes to complete. Participation was voluntary and confidential, and no incentive was offered for participants to partake in the study.

Results

Responses to the DASS variables were found to be positively skewed. Logarithmic transformation for the depression and anxiety subscales, and square root transformation for the stress subscale and total DASS scale, produced a normal distribution for conducting parametric analyses. Table 1 shows descriptive statistics for the study variables, for the total sample, and for males and females separately. Three-quarters of the sample had received sexts, while around half had sent them. Over a third of participants had received unwanted sexts, and >10 percent had sent them under coercion from someone else.

Table 1.

Descriptive Statistics for the Study Variables

Variable	Full sample	Males	Females
Have received sexts (%)	72.1	78.1^**	66.2^**
Have sent sexts (%)	56.5	57.5	55.6
Have received unwanted sexts (%)	35.6	24.6^***	48.3^***
Have sent sexts under coercion (%)	22.6	22.7	22.4
Mean no. of sexts received (SD)	3.1 (1.1)	3.2 (1.1)^*	2.9 (1.1)^*
Mean no. of sexts sent (SD)	2.8 (1.2)	2.9 (1.1)	2.7 (1.2)
Mean DASS-depression (SD)	4.8 (4.7)	5.0 (5.0)^**	4.2 (4.3)^**
Mean DASS-anxiety (SD)	4.1 (4.4)	4.3 (4.7)	3.9 (4.1)
Mean DASS-stress (SD)	6.0 (4.8)	5.6 (4.8)^*	6.5 (4.8)^*
Mean DASS-total (SD)	14.9 (12.4)	15.3 (12.9)	14.5 (12.0)
Mean self-esteem (SD)	16.6 (5.5)	16.7 (6.0)	16.5 (5.2)

Note: Differences between genders are indicated with asterisks, ^*p < 0.05, ^**p < 0.01, ^***p < 0.001. Percentages refer to participants who answered in the affirmative.

DASS, Depression, Anxiety, and Stress Scale; SD, standard deviation.

A series of chi-square tests on the dichotomous sexting variables indicated that more males than females endorsed having ever received sexts, χ²(1) = 7.8, p = 0.005. However, almost twice as many females than males endorsed having ever received unwanted sexts, χ²(1) = 19.6, p < 0.001. No other differences were found (p > 0.05). For the participants who received unwanted sexts, 69 percent reported ignoring them and taking no action, 38 percent told the person directly not to do it, 25 percent told a friend, 4 percent told a parent, 0.8 percent (one person) told the police, and none told a teacher. There were no gender differences in these responses (all p > 0.05).

Independent samples t-tests indicated that males received more sexts on average relative to females, t(322) = 2.26, p = 0.024, d = 0.27, and reported higher levels of depressive symptoms, t(422) = 2.8, p = 0.006, d = 0.17. Females reported higher levels of stress symptoms, t(442) = 2.0, p = 0.046, d = 0.19. No differences were found on the remaining variables (all p > 0.31).

Table 2 shows the results of independent samples t-tests to investigate differences on the mental health variables between those who had ever sexted or not sexted, and between those who had received sexts and those who had not. There was no difference between those who had sent or received sexts relative to those who had not. However, there were moderate significant differences, on all the mental health variables, between participants who had received unwanted sexts or had sent sexts under coercion and those who had not. This indicates that sexting behaviors per se were not associated with poorer mental health, but were associated when they involved unsolicited receipt of sexts or pressure to send sexts.

Table 2.

Means (and Standard Deviations) and Results of T-Tests for Sexting and Mental Health Variables

Variable	DASS-depression				DASS-anxiety				DASS-stress				DASS-total				Self-esteem
Variable	Y	N	t	d	Y	N	t	d	Y	N	t	d	Y	N	t	d	Y	N	t	d
Received sexts	4.7 (4.7)	4.9 (4.8)	0.1	—	4.1 (4.1)	4 (4.3)	0.5	—	6 (4.9)	6.1 (4.6)	0.1	—	14.8 (12.7)	14.9 (11.6)	0.1	—	16.7 (5.5)	16.3 (5.6)	0.7	—
Sent sexts	4.5 (4.3)	5.1 (5)	1	—	4.3 (4.5)	3.7 (4.2)	1.7	—	6.2 (4.8)	5.7 (4.7)	1	—	15.1 (12.4)	14.5 (12.4)	0.6		16.9 (5.1)	16.2 (6.1)	1.4	—
Received unwanted sexts	6 (4.6)	4.1 (4.5)	4^*	0.47	5.7 (4.8)	3.1 (4)	5^*	0.59	7.8 (4.8)	5 (4.5)	5.3^*	0.62	19.5 (12.8)	12.2 (11.9)	5.4^*	0.69	14.7 (5)	17.8 (5.5)	4.9^*	0.58
Sent sexts under coercion	7.2 (5)	3.7 (3.9)	5.1^*	0.77	6.5 (5.5)	3.5 (3.9)	4.2^*	0.62	8.3 (5.5)	5.5 (4.3)	2.9^*	0.44	22.1 (14.4)	12.8 (10.9)	4.6^*	0.68	14.1 (4.5)	17.9 (5)	5.2^*	0.78

Note: Untransformed means and standard deviations for DASS variables reported here.

p < 0.001.

Hierarchical multiple regressions determined whether receiving and sending unwanted sexts might independently predict variance in the mental health variables. As DASS variables were highly correlated with one another (r = 0.66–0.71) and did not differ in their association with the sexting variables, the DASS total score comprised the dependent variable (note: analyses for each DASS subscale showed the same results). For the regression on the DASS total score, the model was significant, F(2, 243) = 18.8, R² = 0.13, adjusted R² = 0.13, p < 0.001. Both receiving unwanted sexts, b = −0.86, SE = 0.22, β = −0.24, t = −3.9, p < 0.001, and sending sexts under coercion, b = −0.89, SE = 0.24, β = −0.22, t = −3.6, p < 0.001, were found to be independent predictors.

Similar results were found for the multiple regression on self-esteem, with a significant overall model, F(2, 243) = 18.9, R² = 0.14, adjusted R² = 0.13, p < 0.001, and both variables uniquely predicting lower self-esteem: receiving unwanted sexts, b = 2.1, SE = 0.68, β = 0.19, t = 3.2, p = 0.002, and sending sexts under coercion, b = 3.2, SE = 0.76, β = 0.27, t = 4.3, p < 0.001.

To examine whether the relationship between unwanted or coerced sexting and poorer mental health differs dependent on gender, moderated regression models using an SPSS macro by Hayes (PROCESS²⁴) were used. A bootstrapping approach was used, which is a nonparametric approach to estimating effect sizes and testing hypotheses. Bootstrapping was conducted with 5,000 samples, and bias-corrected 95 percent confidence intervals were generated. The results are reported for the DASS total scale only for receiving and sending as the results did not differ across the subscales. The full regression results are reported in Table 3.

Table 3.

Results of Moderation Analyses: Testing the Association Between Sexting and Depression, Anxiety, and Stress Scale Total and Self-Esteem as Dependent Variables

	b	SE	t	p	Lower confidence interval	Upper confidence interval
DASS-total
Constant	8.9	0.97	9.4	<0.001	7.1	10.9
Gender	−2.3	0.61	−3.8	<0.001	−3.6	−1.1
Receiving unwanted sexts	−3.1	0.58	−5.3	<0.001	−4.2	−1.9
Gender × receiving unwanted sexts	1.25	0.38	3.3	0.001	0.51	2
F (df)	18.9 (3, 316)
R²	0.17
Self-esteem
Constant	5.5	3.5	1.6	0.114	−1.4	12.5
Gender	3.7	2.1	1.8	0.076	−0.4	7.9
Receiving unwanted sexts	6.1	2	3	0.003	2.1	10.1
Gender × receiving unwanted sexts	−1.8	1.2	−1.5	0.141	−4.3	0.61
F (df)	9.7 (3, 316)
R²	0.08
DASS-total
Constant	7.7	1.6	4.9	<0.001	4.6	10.8
Gender	−1.5	0.98	−1.5	0.129	−3.5	0.44
Sending sexts under coercion	−2.4	0.85	−2.8	0.005	−4.1	−0.71
Gender × sending sexts under coercion	0.84	0.53	1.6	0.115	−0.2	1.9
F (df)	6.6 (3, 253)
R²	0.09
Self-esteem
Constant	9.6	4.1	2.3	0.020	1.5	17.7
Gender	0.42	2.5	0.16	0.869	−4.6	5.4
Sending sexts under coercion	4.6	2.3	2	0.047	0.05	9
Gender × sending sexts under coercion	−0.49	1.4	−0.34	0.732	−3.3	2.3
F (df)	9.9 (3, 253)
R²	0.1

The first model significantly predicted scores on the DASS total scale, and receiving unwanted sexts and gender were both unique predictors. Importantly, the interaction term was also a significant predictor, indicating that receiving unwanted sexts was more strongly related to psychological distress for males, relative to females (Fig. 1). For self-esteem, the model was again significant; however, only receiving unwanted sexts was a unique predictor of the DASS total scale, while gender and the interaction term were not.

FIG. 1.

Graph showing the moderating effect of gender on the association between receiving unwanted sexts and psychological distress (shown as square root-transformed total DASS score). DASS, Depression, Anxiety, and Stress Scale.

For sending sexts under coercion, the overall model was significant for the DASS total scale, but the gender and interaction term were not significant predictors. This pattern was also found for self-esteem, with a significant overall model, but no significant interaction.

Discussion

In this study, we explored the relationships between sending and receiving sexts and mental health, and whether these might differ dependent on the context of sexting, that is, whether they were unwanted or coercive in nature. Consistent with some previous studies, males were more likely to have received sexts than females. However, females were more likely than males to have received unwanted sexts. As the source of these sexts is unknown, it is unclear whether the sexts originated from same or other-sex senders. There was no difference between males and females with regard to the sending of sexts; similar proportions of each gender had sent sexts, and with similar frequency.

Overall, having sent or received sexts was not associated with any of the psychological variables, which supports previous research that has found no difference.^8–10,16 However, as predicted, receiving unwanted sexts and sending sexts under coercion were associated with poorer mental health. Specifically, when receiving or sending unwanted but consensual sexts, respondents reported higher depression, anxiety, and stress, and lower self-esteem. Another significant finding was that receiving unwanted sexts and sending sexts under pressure were independent predictors of poorer mental health. This suggests that they affect mental health in unique ways, and that there is an additive impact for these two sexting phenomena on mental health. Moreover, this finding is important as the nature of this sexting behavior has been likened to intimate partner violence. That is, the findings of our study may shed light on why some researchers conceptualize sexting as simply a normative sexual behavior,²⁵ while others see it as a potential risk behavior, including for sexual violence.²⁶ Indeed, our findings indicate that both can be true. Sexting behaviors can range from consensual sexting as a normative behavior exploring one's sexuality to non-consensual sexting which is associated with negative mental health outcomes and more closely resembles a form of intimate partner violence.

Interestingly, the analyses testing whether gender moderated the relationship between receiving sexts and psychological functioning indicated that receiving unwanted sexts was more strongly related to psychological distress for males than for females. This is contrary to popular belief that females are more adversely impacted than males by sexting activity. However, it is important to note that both genders were adversely affected with regard to depression, anxiety, stress, and self-esteem when sending a sext under coercion.

Limitations

While our study produced some important findings, our data were obtained via convenience sampling. The sample size is moderate and has good gender balance; however, higher rates of depression observed in males suggest it is unlikely to be representative of the general population of young adults. As such, small subgroup populations present challenges in data analysis, particularly with reference to less common behaviors such as sexting under coercion.

The limited nature of the questions asked reduced the detail of our findings. For example, participants did not specify the source of sexts received, or the recipients of sexts sent. These factors may moderate the relationships investigated, especially those related to coercion and unwanted sexts. This may be particularly relevant in the case of the moderating factor of gender in receiving unwanted sexts, whereby some characteristics of the sext content or sender may explain this finding (e.g., a male sending an explicit photo of themselves to a heterosexual male).

Despite these limitations, we have identified a possible moderating factor linking sexting behaviors to psychological distress. Indeed, sexting is not an inherently pernicious behavior; however, our findings highlight particular circumstances where it may be. Importantly, we focused on sexts with sexually explicit sexual photos. It may be that in the context of unsolicited or coerced sexting, such content is more strongly related to mental health. Future research may clarify whether content moderates these associations.

Conclusion

As previous research has indicated mixed findings with regard to sexting behaviors and mental health, this study may offer a potential explanation for this discrepancy in the context of young adults. Specifically, while there was no links between sexting and psychological well-being or self-esteem, this was the case when there was receipt of unwanted sexts or coercive sending of sexts. While these associations hold for both males and females, psychological distress is more likely to be associated with the receiving of unwanted sexts among males than among females. Further research to explore the moderating role of consent in sexting is warranted.

Footnotes

Author Disclosure Statement

No competing financial interests exist.

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