Abstract
Abstract
Sexting is widely prevalent among young adults; however, the impact of sexting on mental health is not fully understood. This study aimed to investigate sexting behavior among young adults (18–30 years) attending an Australian music festival and the impact of sexting on mental health. A paper survey was completed by 776 respondents. Psychological distress (Kessler 6) was classified as “distressed” or “not distressed.” Univariate and logistic regressions were used to test the associations between sexting and distress. In the past 12 months, 53.1 percent of respondents had sent a sexually explicit message, 43.1 percent had sent a sexually explicit image, 61.2 percent had received a sexually explicit message, and 55.1 percent had received a sexually explicit image. Three quarters of respondents (73.1 percent) felt that sexting could have a positive impact. No association was found between the frequency of sending and receiving sexually explicit images or messages in univariate analyses. However, the more unwanted messages/images were received in the past year, the more likely respondents were to be distressed as seen in univariate analyses. After adjusting for gender, sexual orientation, and alcohol, people who received 5 or more unsolicited messages were 2.4 times more likely to be distressed (odds ratio = 2.42, 95% confidence interval = 1.33–4.40, p = 0.004). In conclusion, this study showed that sexting is common and that the more unsolicited sexts that were received, the higher the distress level. Policymakers and program developers should be aware of the positive and negative impact of sexting.
Background
Given the rise of technology, the changing nature of sexual practices and behavior of young people has received increased attention. 1 There has been particular focus on young adults, as sexual development is a key stage where sexual expression and exploration is important. 2 Sexually risky behavior among youth has been linked to adverse mental health outcomes. 3
The sexual practice of “sexting” is sending or receiving messages, photographs or videos of a sexual nature on any platform, for example, text, Facebook, Snapchat, or Tinder, is prevalent among young adults. 4 Yeung et al. investigated the prevalence and attitudes toward sexting among Australian young people at a music festival. 4 They found ∼40 percent of participants, 16–29 years of age, were engaged in the sending or receiving sexually explicit material in their lifetime. Similarly, among Australians 13 years and older, Lee et al. found that in the participants' entire lifetime 49 percent had sent a sexually explicit image/video and 67 percent had received a sexual image. 5
Previous studies into effects of sexting on mental wellbeing have returned mixed results. A 2014 systematic review by Klettke et al. of sexting 6 and its correlates included four studies addressing psychological distress. Two of the four studies,7,8 both from the United States, found no correlation between sexting and depression, self-esteem, or anxiety; or was sexting a marker of poor mental health. One study by Dake et al. found a correlation between previous sexting and feelings of sadness, hopelessness, suicidal thoughts, and attempts in a population of middle and high schoolers in the United States. 9 Conversely, Englander 10 found college students who sexted were less likely to have experienced depression. Several studies have also found an association between sexting and increased risk of risky sexual behaviors, such as the use of alcohol and/or illicit drugs before sexual intercourse.2,11 However, the implications of this risk on physical and/or mental health was not examined.
Music festivals attract a large number of attendees less than the age of 30, and attendees are an at risk population for substance abuse and risky sexual behavior,12,13 making it an ideal context to study the relationship between sexting and mental health.
In summary, sexting is widely prevalent among young adults; however, the impact of sexting on mental health is not yet fully understood. In addition, the positive impact of sexting has not been researched widely. Therefore, this study aimed to investigate sexting behavior among young adults attending an Australian music festival and the impact of sexting on mental health.
Methods
Survey development
The survey content and design were guided by previous research,14,15 using validated tools and members of the research team who had expertise in the areas of sexual and mental health. The survey was piloted twice with groups representative of the target demographic (n = 20) and the survey content was refined. The study was approved by Western Sydney University Human Research Ethics Committee (H11327).
Outcome measures
Respondents were asked about gender, age, rurality, relationship status, sexual orientation, study status, employment status, and sexting behaviors over the past 12 months. Sexting behaviors were categorized into four groups: sending sexually explicit messages, receiving sexually explicit messages, sending sexually explicit images, and receiving sexually explicit images. Further questions included impact of sextings on their mental health. The audit-C was used to measure alcohol intake. 16 Other risky sexual behaviors were assessed based on findings in previous surveys of a similar population.14,15
The Kessler 6 (K6), a validated psychological distress scale, was used to measure psychological distress, 17 allowing for comparison with similar studies.18–20 K6 is widely recognized, and has been used by the Australian Bureau of Statistics in the Australian National Survey of Mental Health and Wellbeing, 21 and the U.S. National Health Interview Survey. 22 Furukawa et al. 21 evaluated K6 against other screening scales and found K6 preferable because of its brevity and consistency. Our cutoff score for psychological distress was based on data of Furukawa et al., which showed an increased chance of having or developing a serious mental health disorder for scores ≥12. Hence, we classified scores of 6–11 as “Not Distressed,” and 12–30 as “Distressed” (see Supplementary Data).
Data collection
The data collection for this study was undertaken over 4 days at a major music festival in New South Wales. Attendees within the target age group were approached, invited to complete the survey, and given a participant information sheet. The data collection was convenience sampling because of the location and time constraints of the music festival. Completion of the survey was considered as providing consent. Surveys were completed anonymously with private areas available for completion, and placed into a closed box to ensure confidentiality. No identifying data were collected. No visibly intoxicated person was invited to complete the study. No incentives were provided.
Data analysis
Data were analyzed using SPSS version 22. Pearson χ2 tests were run to compare categorical variables. A value of p < 0.05 was considered statistically significant. Cronbach's alpha was calculated to determine internal consistency for the K6. Crude and adjusted odds ratios (ORs) were calculated with binary logistic regression to determine which demographic factors and sexting behaviors were associated with psychological distress, and to determine which groups received more unwanted sexts. Variables that were significant in the univariate analysis were entered into the logistic regression model.
Results
Demographics and sexting prevalence
A total of 776 respondents completed the survey. Females comprised 63.7 percent of respondents. The highest proportion (49.4 percent) of respondents were 21–24 years of age, 85.3 percent lived in urban areas, 49.0 percent were in a relationship, 89.4 percent identified as heterosexual. Of the respondents, 56.6 percent reported studying part-time or full-time, and 91.9 percent reported some level of employment.
A slight majority (53.1 percent) had sent a sexually explicit message in the past 12 months and 43.1 percent had sent a sexually explicit image. Of respondents, 61.2 percent had received a sexually explicit message and 55.1 percent had received a sexually explicit image in the past 12 months.
Sexting and demographics
Sexting behaviors were not significantly different between men and women, except that men were more likely to have received an image in the past 12 months (p = 0.004). Lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) respondents were more likely to have sent a message (p = 0.026) or image (p ≤ 0.001) but were not more likely to receive messages or images. Respondents who were in a relationship were more likely to have sent an image (p = 0.010), with no difference in other sexting behaviors. Age, rurality, study, and employment status were not significantly correlated with sexting behaviors (Table 1).
Prevalence of Sexting Behaviors in the Last 12 Months by Demographics
All p-values calculated by Pearson χ2 test.
Bold values indicate that p-value is significant at p < 0.05.
LGBTIQ+, lesbian, gay, bisexual, transgender/gender diverse, intersex and queer.
Distress prevalence and demographics
Of total respondents, 55.3 percent reported a K6 score of 12 and above and categorized as distressed. Women and LGBTQI respondents were more likely to be distressed (p = 0.003 and p = 0.009, respectively). Cronbach's alpha was 86 percent. Age, relationship status, rurality, study, and employment status had no significant correlation with distress (Table 2).
Demographics Versus Distress
All p-values calculated by Pearson χ2 test.
Bold values indicate that p-value is significant at p < 0.05.
LGBTQI, Lesbian, gay, bisexual, transgender, queer, and intersex.
Distress versus sexting and alcohol
An association between receiving unsolicited or unwanted sexts and distress was found, but not for other sexting behaviors. Respondents who had received unsolicited or unwanted sexts in the past 12 months were more distressed and the more sexts they received the more likely they were to be distressed (p = 0.002). Respondents who consumed more than six standard alcoholic drinks in one occasion at least once a month, were less likely to be distressed than those who did not (p = 0.008) (Table 3).
Sexting Behavior Versus Distress
All p-values calculated by Pearson χ2 test.
Bold values indicate that p-value is significant at p < 0.05.
Attitudes toward sexting
Overwhelmingly respondents thought that sexting can have a positive impact (73.1 percent, n = 564). When asked if sexting behaviors had an effect on their mood, the majority reported no or positive impact. Receiving sexually explicit images was the sexting behavior most likely to be associated with reported negative impact on mood (9.6 percent, n = 41) (Table 4).
Sexting and Impact on Mood
ORs for distress
Table 5 provides the multivariate model of distress based on the variables of receiving unsolicited sexts, gender, sexual orientation, and binge drinking behavior. Receiving unsolicited sext messages was a significant predictor of distress, after adjusting for gender, sexual orientation, and alcohol intake. Respondents who had received between three and five unsolicited sext messages in the previous 12 months were twice as likely to be distressed (OR = 2.06, 95% confidence interval [CI] = 1.20–3.56, p = 0.010). Respondents who had received more than five unsolicited sexts in the past 12 months had 2.4 times the odds of being distressed (OR = 2.42, 95% CI = 1.33–4.40, p = 0.004). LGBTQI respondents had 1.8 higher odds of being distressed compared with heterosexuals (OR = 1.82, 95% CI = 1.07–3.12, p = 0.028). Women had higher odds of being distressed compared with men (OR = 1.46, 95% CI = 1.05–2.02, p = 0.021). Drinking more than six drinks on one occasion was predictive for reduced distress, with participants who drank that amount monthly (OR = 0.56, 95% CI = 0.37–0.86, p = 0.008) or weekly (OR = 0.60, 95% CI = 0.39–0.91, p = 0.017) having a lower likelihood of being distressed than those who binge drank rarely or never.
Crude and Adjusted Odds Ratios of Receiving Unwanted Messages/Images Gender, Sexual Orientation, and Alcohol Intake with Psychological Distress (N = 722)
Bold values indicate that p-value is significant at p < 0.05.
CI, confidence interval; OR, odds ratio.
Discussion
This study explored sexting behavior among music festival attendees and its impact on young adult mental health. An association between receiving unsolicited or unwanted sexts and distress was found, but not for other sexting behaviors. Furthermore, receiving unsolicited sexts was associated with distress even after adjusting for gender, sexual orientation, and alcohol intake. Other key findings were that sexting is common and a majority of participants reported that sending or receiving sexually explicit messages had no impact or a positive impact on their mood.
Univariate analyses demonstrated that the frequency of sending or receiving sexually explicit messages or images was not associated with distress. These findings contribute to the mixed results that have been found in the literature 6 and are consistent with some of the wider international research on the interaction between sexting and mental health.6,8,11 Of importance, recent 2019 research has indicated that coerced/pressured sexting is associated with psychological distress. 23 In the absence of a coercion measure in our study, our findings need to be interpreted with care. It is also possible that festival patrons are not representative of the general young adult population and differ from the convenience sample by Klettke et al. who recruited participants through social media and university campus and e-mail distributions. The prevalence of sexting in younger age groups (e.g., 13- to 17-year-olds) and its impact on mental health is a potential area for future research, especially given the impact of factors such as sexual identity on mental health, 24 and the increasing prevalence of serious mental illness in young people.25,26
A significant relationship between receiving unsolicited sext messages and distress was found. It is acknowledged that it may not be the sexting practices per se, but the degree to which these practices are consensual that matters. Current literature places focus on the nonconsensual redistribution of sexts by receivers or third parties. Klettke et al. in their 2019 article 23 found that receiving unsolicited sexual images or sending them under coercion was correlated with symptoms of distress, anxiety, or stress, concurring with our findings. A qualitative study by Burkett found that receiving unsolicited sexts were threatening and induced a sense of risk and danger in the recipient, and found the motivation of senders to be a sense of normalization of this behavior. 27 Reyns et al. 28 found that sexting is a risk factor for online sexual harassment, including receiving unsolicited messages. A systematic review of unsolicited and nonconsensual sexting by Krieger 29 identified that current literature is focused on exploring other risky sexual behaviors as predictors of unsolicited sexting and attitudes toward nonconsensual sexting. 30 Livingston et al. found among an adolescent population 11 percent had received unsolicited sexts. 31 One in five of that subgroup were bothered by receiving unsolicited sexts. The higher prevalence of receiving unsolicited sexts in our sample could be because of the older population.
Sexting seems to be common. Our study found that 53.1 percent of respondents had sent a sexually explicit message, similar rates were found in a university population in the United States at 67.4 percent. 32 This study by Dir et al. found men received sexually explicit images more frequently, as did our study (61.7 percent of all male respondents). Their article showed those in a relationship sent more sexually explicit texts than single respondents, as did our article.
A proportion of respondents believed that sexting behaviors had a negative effect on their mood. Further studies may focus on the reasons for these negative attitudes toward sexting, and whether these attitudes are associated with specific sexting behaviors or experiences (e.g., sharing of images without consent). The overall positive attitude toward sexting is consistent with previous research. Yeung et al. explored attitudes toward sexting among people 16–25 years of age, finding sexting to be a “common and normalised aspect of sexual development.” 4 Furthermore, Burkett's qualitative study found sexting to be a positive experience in relationships compared with casual sexual encounters. 27 Hence, these attitudes toward sexting can be considered representative of the target population but we acknowledge that this can be moderated by other factors including consent and coercion. This study expanded on the current literature findings concludes that festival patrons perceived sexting to have a neutral or positive impact on mood.
Limitations
One limitation of this study was the inability to show causal effects because of the cross-sectional study design; therefore, further research involving a longitudinal study examining the relationship between sexting and mental health over time is required.
As stated previously, the lack of a coercion measure is also recognized as a study limitation. If the study would have measured coercion factors, it could mean that sexting under coercion may have lead to different study results. A 2018 meta-analyses among youth showed that the prevalence of forwarding a sext without consent was 12.0 percent (95% CI = 8.4–15.6), and the prevalence of having a sext forwarded without consent was 8.4 percent (95% CI = 4.7–12.0). 33 It could therefore be that among those who were coerced or had not consented to the sexting activities could have experienced higher psychological distress. We recommend that future studies include coercion measures.
In addition, music festival attendees may not be representative of the general 18- to 30-year-old population. However, the demographics of the population sampled were similar to previous studies undertaken at the same music festival and show consistency across this population.15,34 Our population mostly comprised people living in urban areas, consistent with ABS statistics showing a higher representation of people 20–44 years of age living in capital cities. 35
Another limitation was that attendees were invited to complete the survey based on a convenience sampling method. Thus, the study may have some sampling error. This recruitment method was selected because it gave access to a high-risk group of young adults. However, the frequency of sexting within our study is comparable with previous studies on sexting, as another Australian music festival study 4 found that 40 percent respondents had ever sent or received a sext and a Spanish study found that 36.1 percent had ever sent a sext. 36
Finally, information bias may be evident because of self-reporting and the respondents' tendency to provide more socially acceptable answers. This was minimized by providing private areas to facilitate confidential completion of the survey.
Impact
Our findings tentatively point toward a need for a change in the approach toward harm minimization in relation to sexting. Wolak and Fiklehor 37 characterized sexting practices as falling into two groups, “aggravated” and “experimental.” Taking a similar approach in an educational context may be useful to help young people identify when they are being pressured into or exposed to potentially harmful sexting activities, and identify when their own actions (such as sending unsolicited sexts) can have harmful effects. Hayes and Drageiweicz 38 in their examination of the sending of unsolicited “dick pics” drew a thematic connection between sending unsolicited sexts and the crime of indecent exposure in Australian law. 39 In light of the harm we have identified, a debate or consideration of legal reform in regard to unsolicited sexting may be warranted. Further exploration of the impact of unsolicited and nonconsensual sexts on other outcomes, such as study and work productivity, or health outcomes is warranted.
Conclusions
In conclusion, this study showed that sexting is common and that the more unsolicited sexts that were received, the higher the distress level. The majority of festival attendees 18–30 years of age also reported that sending or receiving sexually explicit images or messages had no impact or a positive impact on their mood. The results of this study contribute to the body of knowledge regarding the impact of sexting on psychological distress and further research could explore the impact of unsolicited sexting and include coercion measures. Policymakers and program developers should be aware of the positive and negative impact of sexting.
Footnotes
Acknowledgments
The study group thanks the Positive Adolescent Sexual Health-North Coast Youth Sexual Health Consortium (PASH) for facilitating data collection.
Availability of Data and Materials
The data collected and analyzed during the study are not publicly available because of ethics considerations and data being used for further research.
Author Disclosure Statement
No competing financial interests exist.
References
Supplementary Material
Please find the following supplemental material available below.
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