Prevalence of Multiple Forms of Sexting Behavior Among Youth: A Systematic Review and Meta-analysis

Sin in the Digital Flesh? Religiosity and the Sexting Behavior of Women and Men in the United States

Scholars have noted a rise in sexting behavior in the aftermath of the COVID-19 pandemic. Although the association between religion and sexual behavior has been widely studied, researchers have yet to consider whether sexting behavior might vary according to levels of religiosity. Building on prior research, this study uses national survey data to formally test whether several dimensions of religiosity (religious attendance, divine control, and religious/spiritual struggles) are associated with the sexting behavior of women (n = 619, Mage = 40.28, SD = 11.50) and men (n = 548, Mage = 40.04, SD = 11.51). Results suggest that the odds of sexting are lower among women who report higher levels of in-person religious attendance (not virtual attendance) and greater perceptions of divine control. Among women and men, the odds of sexting are higher among those who report more religious/spiritual struggles. This study is among the first to show how various dimensions of religiosity might influence sexting behavior in different ways for women and men during the COVID-19 pandemic. It is important for future research to replicate our findings and to consider whether other dimensions of religiosity might also contribute to the likelihood of sexting in an increasingly digital world.

The Mental Health and Social Implications of Nonconsensual Sharing of Intimate Images on Youth: A Systematic Review

In the past decade, the sending and sharing of sexual images among youth has become normalized. An associated risk of sharing sexual images is the images being nonconsensually shared among peers or uploaded online. This is the first review to systematically identify, summarize, and critically evaluate existing research on the mental health and social impact of nonconsensual sharing of sexual images (NCSSI) on youth. Database (MEDLINE, PsycINFO, PsycArticles, Embase, PubMed, Web of Science, Scopus) and manual searches were conducted to identify eligible studies. A narrative synthesis and a Mixed-Methods Appraisal Tool were used for quality analysis. Of 4,013 articles retrieved, 13 met the eligibility criteria. The findings suggest that NCSSI is associated with negative mental health and social repercussions. Five quantitative studies found evidence suggestive of increased depression, anxiety, and suicidal ideation in young people following NCSSI. The identified qualitative evidence highlighted a range of adverse impacts in the social lives of those affected, including associated bullying, harassment, and victim-blaming attitudes that many individuals face following an experience of NCSSI, which may contribute to a negative sense of self and exacerbate distress. Some of the identified studies used unvalidated tools to assess mental health outcomes, and mainly measured depression and anxiety. Most studies more broadly discussed the sharing of sexual images rather than NCSSI specifically. Future research should adopt a narrow focus on the impact of NCSSI and use validated tools to measure various mental health outcomes.

Risk Factors for Non-Consensual Sexting Among Adolescents and Emerging Adults: An Extension of the Routine Activity Theory Perspective

Adolescence and emerging adulthood are developmental phases in which the exploration of one's own sexuality takes on a high priority, which can increase the risk of risky sexual behavior. Due to technological advances, (non-consensual) sexting has increased among young people and has become an integral part of their sexual socialization. Therefore, the main objective of this study was to examine non-consensual sexting (both victimization and perpetration) among adolescents and emerging adults and to identify potential risk factors associated with non-consensual sexting using routine activity theory. The sample consisted of a total of 3514 adolescents aged 10-17 years (43% males; 57% females) and 3674 emerging adults aged 18-25 years (23% males; 77% females) from Bosnia and Herzegovina and Croatia. The results showed that both male adolescents and emerging adults were at higher risk for experiencing non-consensual sexting victimization. Personal factors such as gender, age, social bond, and routine cell phone activity predicted the risk of becoming a victim of non-consensual sexting in adolescents. For emerging adults, gender, social connection to friends, and routine cell phone use predicted the risk of becoming a victim of non-consensual sexting. Relationship status and routine cell phone activity predicted the forwarding of other sexts for both age groups. According to international scientific research and the findings of this particular study, we can conclude that the study of personal factors and routine variables helps understand non-consensual sexting among youth but is also essential in planning educational resources and preventive activities.

Patterns of Sexting by Youths: A Latent Class Analysis

Sexting (exchanging sexual correspondence in the online space) is considered a practice that expresses sexuality in the online space. Between adolescents, sexting can be part of a couple relationship or outside of it, and can be voluntary or coercive. Regardless of motives, sexting has been linked to various negative outcomes. Understanding the factors that influence sexting behavior is essential for developing effective prevention and intervention programs. The present study aimed to identify and compare different profiles of sexting behavior in adolescents using latent class analysis. Participants were 487 Israeli adolescents aged 14-19 (male N = 215, 44%, female N = 272, 56%) years who completed an online survey of demographic factors, online parental mediation, family and friend cohesion, and perception of sexting norms. Two distinct classes of individuals were identified: those who engage in sexting ("sexters") and those who do not ("non-sexters"). Sexters were more likely to be secular, and without a romantic partner. These findings may inform interventions aimed at preventing negative outcomes associated with adolescent sexting.

Coping strategies and psychological resilience of parents with children victimized of sexual abuse: A cross-sectional descriptive study

AIM

The aim of this study is to assess the coping strategies and psychological resilience of parents of children who are victims of sexual abuse.

METHODS

The study's sample was compiled from parents of sexually abused children admitted to the Child Advocacy Centre for forensic interviews in a Northern Turkish province (N = 75). Data were collected from May to September 2022. A cross-sectional design was used to assess psychological resilience and coping skills. The Introductory Information Questionnaire, the Strategies for Coping with Family Stressors Scale, and the Psychological Resilience Scale for Adults were administered verbally during individual interviews. The study was approved by the institutional ethics committee.

RESULTS

According to the results, the psychological resilience and coping skills of parents played a significant role, particularly concerning touch-based abuse, a single occurrence of abuse, and the absence of family violence. Moreover, there was a positive correlation between coping skills with stressors and psychological resilience (p < 0.05).

CONCLUSION

In conclusion, empowering parents of children exposed to abuse proves crucial for reducing the traumatic impact on the victimized child. Further research, identifying risk factors for both the child and the family, and strategizing follow-up, educational, and counseling initiatives can enhance the provision of holistic health services in this context.

IMPLICATIONS TO PRACTICE

This study emphasizes the need to restructure issues of not only trauma in children who are victims of sexual abuse but also coping skills and psychological resilience in parents within nursing approaches aimed at children who are victims of sexual abuse.

School prevention of non-consensual sexting among middle adolescents: Does sexual preoccupation awareness matter?

Although non-consensual sexting seems to concern not only adults but also middle adolescent students, with detrimental consequences on their well-being, the related research-based effective school prevention programs are almost absent. Furthermore, there is an unanswered research question as to whether sex-related issues, such as sexual preoccupation, matters in adolescents' non-consensual sexting and its prevention. The present study investigated the effectiveness of a school-based intervention against non-consensual sexting among middle adolescents, based on the European funded program TABBY (Threat Assessment of Bullying Behavior in Youth). Furthermore, the predictive role of sexual preoccupation was examined. Overall, 280 Greek students from randomly selected junior high school responded to self-report scales on non-consensual sexting and sexual preoccupation. Based on an experimental longitudinal research design, only the experimental (N = 131), but not the control group of students (N = 149), participated in the intervention. To test the effectiveness of the intervention, both student groups completed the scales before (1st phase), immediately after (2nd phase), and six months after the intervention (3rd phase), which was implemented by trained teachers. The results showed both, the short-term and long-term effectiveness of the intervention. Also, the study highlighted the significant contribution of sexual preoccupation awareness in reducing non-consensual sexting, especially immediately after and six months after the intervention. The study implies the necessity to adapt existed prevention programs to the specific parameters of non-consensual sexting, integrating at the same time sexual preoccupation awareness activities to better address this issue.

Re-envisioning Youth Sexual Health Care: Supporting Sex Positivity in a Digital World

INTRODUCTION

Youth in a digital world face challenges to the healthy development of their sexuality from exposure to sexting, pornography, and other sexually explicit media. School-based sexual health education does not cover digital sexual content and its impact on sexuality and sexual relationships. Youth often avoid discussing sexual health with parents or other trusted adults, thus often relying on peers, making them ill-prepared to navigate the complexities (e.g., socially, emotionally, and romantically) of sexually explicit content.

METHOD

A review of emerging evidence for application into clinical practice.

RESULTS

This paper provides nurse practitioners with resources and information to incorporate this re-envisioned approach to sexual health care into practice to provide current, timely, and holistic youth sexual health care.

DISCUSSION

Youth sexual health care must be re-envisioned. Nurse practitioners can improve youth sexual health by incorporating pornography and sexual media literacy, safe sexting, and concepts of consent into care using a sex-positive lens.

Victims of Technology-Assisted Child Sexual Abuse: A Scoping Review

Over the past two decades, technology-assisted child sexual abuse (TA-CSA) has become the focus of attention in politics, legislation, society, as well as research. However, the majority of literature and studies focus primarily on the offenders. This scoping review therefore aims to illustrate how victims of TA-CSA are represented in studies as primary participants. The databases Embase, PsychInfo, PSYNDEX, Cochrane Library, and Web of Science as well as reference lists were searched. Studies needed to be published between 2007 and 2021 and obtain data directly from and about victims to be included in this review. A total of 570 articles were identified from which 20 studies met inclusion criteria. The analysis showed that data can be obtained via different samples like adult and minor victims or other data such as legal documents or sexualized images. The studies researched different types of TA-CSA including exposure to pornographic material, online grooming leading to both online and offline sexual abuse, sexting and sexualized images, and the visual depiction of sexually explicit content. Consequences due to the abuse were of an emotional and psychological nature, medical or physical or impacted relationships, and the social environment. Even though the impact of the abuse on the victims appeared to be similar between different types of TA-CSA, much remains unknown. In order to gain further and more detailed insight into victims of TA-CSA, a universally accepted definition of TA-CSA as well as its different types and their distinctions needs to be established.

Associations between receiving non-consensual image and video sexts and average sleep duration among adolescents and young adults

Background Sexting is the sending and receiving of nude or partially nude images or videos. Despite it being a part of contemporary relationships, it can have adverse effects. This is particularly the case when receiving non-consensual sexts. To date, there remains a gap in the literature on whether receiving non-consensual sexts is associated with poor sleep. Therefore, the aim of this study was to determine the association between receiving non-consensual sexts and average sleep duration. Methods Data from Wave 2 (2022) of the Canadian Study of Adolescent Health Behaviours (N =906) were analysed. Multinomial logistic regression analyses were used to determine the association between receiving non-consensual sexts (both image and video) in the past 12months and average sleep duration (≤5h, 6h, 7h, 8h, and ≥9h) in the past 2weeks. Analyses were stratified by gender. Results Girls and women who received non-consensual image and video sexts, compared to those who did not, were more likely to report ≤5h of average sleep in the past 2weeks, relative to 8h of average sleep. There were no significant findings among boys and men. Conclusion Findings underscore that receiving non-consensual image and video sexts may negatively impact sleep among girls and women, which may be contextualised by trauma responses experienced because of gender-based sexual violence. Healthcare and mental health professionals should be made aware of this association to provide effective care to girls and women.

A Latent Profile Analysis of Greek University Students' Sexting Profiles: Associations with Big Five Personality Traits

The aim of this study was to examine the associations between sexting profiles and five factor model (FFM) personality traits among Greek university students. A sample of 2913 participants predominantly aged between 18 and 25 years (M = 22; SD = 3.54; 69.6% females) completed a self-report online questionnaire that measured sexting behaviors and FFM traits. Latent profile analysis identified five distinct profiles which were labeled uninvolved, consensual sexters, non-consensual sexters, unwanted sexters, and highly involved sexters. The different sexting profiles were associated with distinct patterns of FFM trait scores. Specifically, the uninvolved scored higher on agreeableness, conscientiousness, and openness than those highly involved in sexting, consensual, non-consensual, and unwanted sexters. Furthermore, those who sent unwanted sexts were more likely to be emotionally unstable than the consensual sexters and those not involved. These findings indicate that sexting behaviors may be related to certain personality traits and emphasize the importance of considering individual differences when studying sexting behaviors. The practical implications of the findings are discussed.

Sexual health variation among gang-involved youth in Washington state: Social ecological implications for research and practice

INTRODUCTION

Gang-involved youth experience greater disparities in sexual health compared to non-gang-involved youth. Yet, little is known about how and why sexual behaviors vary within the youth gang population. Developing relevant and effective service approaches requires an understanding of this variation and the environmental factors that influence patterns of sexual health risk.

METHODOLOGY AND RESULTS

Using latent class analysis, we identified four sexual behavior classes within a school-based sample of gang-involved youth in Washington State (N = 2060): Non-Sexually Active (54%), Limited Partners with Condom Use (14%), Multiple Partner with Sexting (19%), and High Sexual Vulnerability (13%). These classes were distinguished by age at sexual debut, number of sexual partners, condom use, and sexting. Interpersonal and macrosocial factors differentiated the classes, including multiform violence exposures, limited social support, and socioeconomic instability. We also found differences according to sexual identity and substance use.

DISCUSSION

Findings highlight the need for service approaches that are responsive to both the individual needs of gang-involved youth and the factors that shape their living environments. We discuss the implications for research and practice, including the potential utility of a harm reduction framework to promote sexual health and reduce disparities in the youth gang population.

The prevalence of child sexual abuse with online sexual abuse added

BACKGROUND AND OBJECTIVE

Research efforts are measuring various forms of online sexual abuse. There is a need to incorporate such measures of online sexual abuse into the calculation of overall prevalence rates for child sexual abuse.

PARTICIPANTS

A sample of 2639 respondents aged 18-to-28 was recruited from a nationally representative online panel.

METHODS

Using an online questionnaire, respondents were assessed via self-report about 9 types of online sexual abuse in childhood and were also assessed with 2 questions that have been used to assess generic child sexual abuse prevalence in previous surveys.

RESULTS

The addition of the online abuse to the generic questions about child sexual abuse raised the overall prevalence rate from 13.5 % to 21.7 %. The rate for females increased from 19.8 % to 31.6 % and for males from 6.2 % to 10.8 %. The largest independent contribution to the overall combined increase were the offenses involving non-consensual image sharing and voluntary online sexual interactions with an impermissibly older adult partner. The inclusion of the online sexual abuse exposures also increased the ability to identify the survivors with the highest levels of current psychological distress.

CONCLUSION

The study highlights the importance of counting and including online sexual abuse in efforts to estimate the overall prevalence of childhood sexual abuse. The paper proposes 2 or 3 questions that could be added to sexual abuse questionnaires to assess these online offenses efficiently.

Nonconsensual Sexting: Are the Moral Processes the Same If Boys or Girls Appear in the Forwarded Content?

Sexting is a form of intimate communication available in today's digital society consisting of exchanging erotic-sexual content online. However, doing it without the consent of the person appearing in the content is becoming a normalized form of cyberviolence among adolescents. To advance our understanding of this phenomenon, further research is needed on its facilitating factors, which may include those related to its potential moral dimension and online disinhibition. This study aims to analyze, according to gender and age, the relationship between nonconsensual forwarding of erotic-sexual content, differentiating between the type of content and the gender of the person appearing in it, moral disengagement, and toxic online disinhibition. A total of 1,611 adolescents (47.9 percent girls) aged 12-15 years (M = 13.4; SD = 1.0) participated in the study. Moral disengagement and toxic disinhibition have been shown to facilitate nonconsensual forwarding of erotic-sexual content, but their relevance varies depending on the type of content, and whether girls or boys appear in it. Facilitating factors for nonconsensual forwarding of content featuring boys include age, the diffusion of the consequences, and toxic online disinhibition. For girls, identifying with the male gender and cognitive restructuring were the main facilitators. These findings represent an original advance in the field of study by discriminating between the type of content forwarded and the gender of the person who appears in it. The differences found contribute toward explaining the processes that lead to making immoral decisions when sexting and help lay the foundations for designing psychoeducational programs in the future.

Sexting in Young Adults: A Normative Sexual Behavior

With the advancement of technology, sexting has become more prominent in high school and university samples. The current study examined the rates and characteristics of sexting among an online sample of 2,828 young adults aged 18-30, primarily from the U.S. and Canada. We found that most participants sext (81%), sext often (most report ≥ 11 sexts), and start young (most by 16-17 years of age). Common reasons for sexting echoed reasons for participating in other normative sexual behaviors, including that it was sexually arousing, they were asked and wanted to reciprocate, or they wanted to flirt. Sexual coercion was a gendered phenomenon, with 1 in 10 cisgender women and 1 in 50 cisgender men reporting having sent a sext due to being threatened. The body parts captured in cisgender men's sexts were more diverse, whereas cisgender women focused on their chest, underwear/genitalia, and stomach. Sexual orientation was also found to be a relevant factor, with different patterns in sexting experiences emerging across identities. The current study adds to the mounting evidence that sexting is a normative sexual behavior. Sexual education programs should provide youth with information on consent and safe sexting practices rather than follow an abstinence approach.

How Risky is Online Sexting by Minors?

What proportion of minors who engage in sexting find themselves involved in an episode of image abuse? The data come from a US nationally representative sample of 2639 respondents aged 18-28 reporting about experiences before the age of 18, of whom 23% had engaged in sexting as minors. Among those who sexted the rate of image abuse was 37%, a risk ratio of 13.2 compared to those who did not engage in sexting. For females who sexted the victimization rate was particularly high, but sexting increased risk for females and males. Among the minors who only sexted occasionally (vs those who sexted frequently) the rate of abuse was still high (35%) and the reduction in risk modest. When we controlled for other background and demographic risk factors like adversities and prior sexual abuse, it did not substantially reduce the large risk entailed with sexting. Various harm reduction strategies may be needed to supplement messages about dangers and risks.

Crimes without a body: reflections on a case series of online crimes

There is a large volume of online crimes. The aim of this work is to reflect on virtual crimes that are apparently different but actually have commonalities. In these cases, the corporeal sphere that mediates interpersonal relationships is absent, and perceptions of the real world and emotional regulation may be altered, which poses the risk of destructive behaviours. From this standpoint, self/hetero-directed aggression is the result of a certain type of transition from the real to the virtual world, where the body either is not involved at all or is experienced in an aberrant manner. In this study, we present three cases that clearly illustrate this concept.

A Qualitative Examination of School Counselors' Experiences of Sextortion Cases of Female Students in Israel

Sextortion (a portmanteau of "sexual" and "extortion") is a relatively new phenomenon of sexual exploitation, which occurs when a person threatens another with the distribution of sexual content on the Internet, to obtain more pictures or videos, money, or have some other demand met. The current study examined how school counselors in Israel perceive the phenomenon of online sextortion. To this end, we conducted a qualitative study based on 20 semi-structured in-depth interviews with school counselors working in middle schools and high schools in Israel, who treated adolescent girls blackmailed over the Internet on sexual grounds. Findings indicate that the school counselors had difficulty in identifying and defining the cases they treated as instances of sextortion, and that in their view the harm was slight. Findings also indicate that school counselors associated the causes of sextortion with the victims and their backgrounds. We found differences between the Arab and secular and national-religious state education in the way Jewish counselors treated the victims and involved additional actors such as the victim's parents and the police. This underscores the importance of providing educational staff with adequate knowledge and tools that are culturally suited to the victims.

Interpretation of medical findings in suspected child sexual abuse: An update for 2023

Health care professionals who examine children who may have been sexually abused need to be able to recognize, and photo-document any physical signs, and to have access to expert reviewers, particularly when signs concerning for sexual abuse are found. Although the general consensus among practitioners is that children will show few signs of sexual abuse on examination, there is considerable variability and rates of positive exam findings among practitioners of different professions, practice settings, and countries. This review will summarize new data and recommendations regarding the interpretation of medical findings and sexually transmitted infections (STIs); assessment and management of pediatric patients presenting with suspected sexual abuse or assault; and testing and treating patients for STIs. Updates to a table listing an approach to the interpretation of medical findings are presented, and reasons for changes are discussed.

Estimating the Prevalence and Identifying the Correlates of Sexting Behaviors Among Cambodian Male Adolescents

Male youths are more likely to experience peer pressure that encourages them to engage in risky behaviors than female youths, and this pressure can lead to an increased risk of sexting among male youths. This study aimed to investigate the prevalence of and factors associated with sexting among Cambodian male youths. The correlational cross-sectional study design was utilized. This study surveyed 647 Cambodian male youths aged 15 to 24 years. The measurement included sending or receiving messages (sexts) that contain sexually explicit messages, images, or videos, and affecting factors to sexting. Around 32.5% of participants sent sexts, and 38.9% received them. Open relationships, pornographic website use, perception of friends' sexual activity, frequent thoughts about sex, higher sexual sensation-seeking tendencies, positive attitudes toward sex, and sexual experience were associated with increased likelihood of sending and receiving sexts. Based on the findings of this study, by offering suitable education, guidance, and intervention programs, we can effectively mitigate the adverse repercussions of sexting while fostering healthy sexual behaviors among youths.

Toward a Global Definition and Understanding of Child Sexual Exploitation: The Development of a Conceptual Model

Child sexual exploitation (CSE) is a serious and persistent global issue affecting up to 5% of the child and youth population worldwide; yet there is no universally accepted definition. To develop a theoretically robust definition of CSE, this review systematically synthesized literature examining CSE definitions aiming to develop a conceptual model and typology. Electronic databases were searched to February 2021, yielding 384 nonduplicative records. Inclusion criteria were peer-reviewed and grey literature investigations of sexual exploitation, with a mean sample age of 18 years or younger, available in the English language. Literature review and data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Sixty-six studies met final inclusion criteria. Two independent reviewers extracted relevant data and used an epistemological approach to thematically analyse meaning and patterns across CSE definitions. Key findings demonstrate that CSE nomenclature is widely inconsistent, and despite growing awareness of this severe form of abuse, language continues to perpetuate stigma and criminalisation, utilising terms such as 'adolescent or child prostitute'. Our findings propose a scientifically and trauma-informed definition and conceptualisation of CSE, based on the following four-dimensional components: (1) A child/young person; (2) sexual acts; (3) abuse; and (4) exploitation (abuse + exchange). In this systematic review, a unified definition and conceptual model aims to advance knowledge and understanding of CSE, contributing to the progression of social norms which embrace nuances of trauma-informed practice and support for the identification and recovery of children, young people and families affected by sexual exploitation.

Prevalence and risk factors for nonconsensual distribution of intimate images among Italian young adults: Implications for prevention and intervention

Nonconsensual distribution of intimate images (NCII), also known as revenge porn, has become a significant social issue in recent years, with severe consequences for victims. The present study aimed to investigate the prevalence and predictors of NCII victimization among young Italian adults, focusing on the role of sexting, intimate partner violence (IPV), impulsivity, and self-disclosure. An online survey was conducted among a sample of 2047 Italian young adults (F = 29.3 %, M = 53.4 %, Not Indicated=16.9 %; mean age = 24.4, SD = 4.4) using a convenience sample recruited through internet. The survey included questions on NCII victimization, sexting behavior, sextortion, and IPV. Our findings showed that 33.9 % of respondents reported engaging in sexting behavior, with females being three times more likely to engage in sexting than males. Furthermore, 3.3 % of participants reported being victims of NCII, with over one-third of victims experiencing three or more types of NCII victimization. Multiple regression analysis revealed that sexting and IPV were significant predictors of NCII victimization, and the interaction effect between self-disclosure and impulsivity was also a significant predictor. This study contributes to the understanding of NCII in Italy and highlights the need for interventions and prevention strategies to address both NCII and IPV, given their strong continuity. The results also suggest that the relationship between self-disclosure, impulsivity, IPV, and NCII victimization is complex and requires further investigation, suggesting a scenario where the climate of violence may impair the victim's decision-making.

Experiences of Online Sexual Violence: Interviews With Swedish Teenage Girls in Psychiatric Care

Research about online sexual violence (OSV) is needed to be able to better meet the needs of girls in psychiatric care. The objectives of this study are to explore experiences of online sexual violence among young female psychiatric service users. Interviews with nine girls with psychiatric care needs were analyzed with thematic analysis. The findings are summarized in four themes which contribute to the notion that online sexual violence is only one, albeit important, part of a more complex picture of violence among young girls in psychiatric care. The girls' narratives are shaped by, as well as reproducing gender norms.

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

BACKGROUND

Exposure to sexual content, such as online pornography or live sexual content, has been posited in the literature as a risk factor for problematic sexual behaviors (PSBs) in children and adolescents, and has been identified as an important avenue for research and intervention, particularly given the ubiquitous access to technology among children.

OBJECTIVE

To examine the association between live/violent and non-violent sexual content exposure and PSB among children and adolescents. Objectives also include informing future research on sexual content exposure as a risk factor for PSB, and providing clinical recommendations related to prevention and intervention.

PARTICIPANTS AND SETTING

Results are based on 16,200 participants (28.65 % female; Mage = 14.26; range = 4.74-17.92) and 27 studies conducted in North America, Europe, Asia, and Africa.

METHODS

A systematic review was conducted of available literature published up to September 2021. Abstract and full-text review were conducted to assess whether studies met inclusion criteria. Random-effects meta-analyses were conducted on included studies.

RESULTS

Significant associations were found between exposure to non-violent sexual content and likelihood of engaging in PSB (OR = 1.82; p < .001; 95 % CI: 1.50-2.21), and between exposure to violent/live sexual content and PSB (OR = 2.52; p < .001; 95 % CI: 1.75-3.61). Sex emerged as a moderator of the association between exposure to non-violent sexual content and PSB, such that the association was stronger in studies with a greater proportion of females.

CONCLUSIONS

Results support the need for future research on risk factors and mechanisms implicated in PSB. Prevention and intervention programs for children with PSB and their families could benefit from incorporating education on sexual content exposure.

A systematic review of social processes and mechanisms in the community that influence risky sexual behaviour among adolescents and young adults

AIMS

To examine the associations between social processes and mechanisms within the community and risky sexual behaviour (RSB) among adolescents and young adults.

DESIGN

Systematic review.

METHODS

We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and conducted a literature search in August 2020. From 11,216 identified articles, 605 were for full-text screen. We used 24 articles, 22 after applying inclusion criteria and 2 manually searched relevant articles.

RESULTS

Social processes and mechanisms within the community included collective efficiency and social support, community safety and community norm. Collective efficacy and social support and community safety were examined using 10 and 16 studies, respectively. We found that collective efficiency and social support, and community norms partially supported the occurrences of RSB among adolescents and young adults. Community safety displayed inconclusive relationships with RSB.

CONCLUSIONS

The findings highlight the importance of social processes and mechanisms within the community in preventing RSB among adolescents and young adults. Community-based programs to improve community efficacy and social support would be effective strategies to reduce such RSB and to promote better reproductive health among adolescents and young adults.

Child sexual abuse images and youth produced images: The varieties of Image-based Sexual Exploitation and Abuse of Children

BACKGROUND AND OBJECTIVE

This paper presents a categorization of sexual image crimes and abuse that occur against children, and it compares their frequency, dynamics, and emotional impact.

PARTICIPANTS

A national sample of 2639 respondents aged 18-to-28 disclosed 369 childhood episodes involving a variety of image abuse.

METHODS

Online self-administered questionnaire.

RESULTS

The analysis classified the cases into five incident types: 1) adult made images (child sexual abuse images), 2) images non-consensually made by other youth, 3) voluntarily provided self-made images that were non-consensually shared by other youth, 4) voluntarily provided self-made images non-consensually shared by adults, and 5) voluntarily provided self-made images to adults that entailed an illegal age difference or were part of a commercial transaction. We propose to refer to this aggregation of types as Image Based Sexual Exploitation and Abuse of Children (IBSEAC). Only 12 % of the image episodes qualified as adult produced, child sexual abuse images. Such adult produced image experiences were also not higher in negative emotional impact than the youth produced images. Only 10 % of the episodes involved images of children under age 13.

CONCLUSION

The study highlights the predominance of youth made sexual images among the image exploitation and abuse affecting youth according to self-report. It also highlights the difference between what victim surveys reveal about the problem and what is inferred from police record studies.

Adolescent Sexting, Violence, and Sexual Behaviors: An Analysis of 2014 and 2016 Pennsylvania Youth Risk Behavior Survey Data

BACKGROUND

Sexting is common among adolescents and is associated with numerous health risk behaviors and negative psychosocial constructs. This study examined the relationships between high school students' experiences with sexual violence victimization, dating violence victimization, and engagement in risky sexual behaviors with experiences of receiving sexts.

METHODS

Cross-sectional data from the 2014 to 2016 data from Pennsylvania Youth Risk Behavior. Participants were selected using an independent 2-stage cluster sample design to produce a statewide population-based sample. The pencil and paper surveys were conducted in school. Participants included 6734 Pennsylvania high school students in grades 9-12.

RESULTS

Overall, 29.0% of Pennsylvania high school students had received a sext, which varied by sex, race/ethnicity, school grade, and sexual identity. Students who engaged in sexual risk behaviors, experienced dating violence, or experienced lifetime sexual violence outside of the dating context had a significantly higher prevalence of receiving a sext than students who did not engage in those behaviors or have those experiences.

CONCLUSIONS

Early screening and prevention efforts that include discussions about sexting behaviors may help prevent other negative outcomes, such as risky sexual behaviors and interpersonal violence. Addressing sexting in the education and health sectors may help to prevent other related harmful health and violence experiences during adolescence.

A Qualitative Study of How Israeli Arab Educational Counselors Handle Image-Based Sexual Abuse of Female Adolescents

Image-based sexual abuse (IBSA) refers to the nonconsensual production, dissemination, or threat of dissemination of private sexual images of another. Arabs belong to a conservative society where the distribution of a nude photo constitutes a violation of the dignity of the family and may have serious consequences. Based on semistructured in-depth interviews, the present study examined how 32 Arab educational counselors in Israel handle IBSA. Findings suggest that counselors identified the victim as experiencing difficulties that allowed her to be harmed. Also, it was found that counselors were afraid it might harm the victims on the grounds of family honor. These findings indicate that it is necessary to find culturally sensitive solutions both for the prevention and treatment of this phenomenon.

Adolescent experiences of sexting: A systematic review of the qualitative literature, and recommendations for practice

INTRODUCTION

Sexting among adolescents continues to garner interest across disciplines due to its prevalence in the lives of young people and the potential for extremely negative outcomes associated with the behavior. The present review aimed to integrate the existing qualitative research on adolescent sexting experiences, to provide empirically-supported recommendations for professionals working with adolescents.

METHODS

A search of four databases relating to adolescent experiences of sexting was conducted, resulting in the inclusion of 28 studies in the review. Quality appraisal of these studies was completed in line with the Critical Appraisal Skills Profile qualitative checklist.

RESULTS

Major themes in the qualitative studies were synthesized to generate recommendations for professionals. These recommendations are categorized as (a) "proactive" (enhancing positive and contextualized education and attempting to mitigate the likelihood of young people having negative experiences with sexting), (b) "responsive" (management of disclosures of distressing experiences with sexting, including image-based sexual abuse [IBSA]), and (iii) "clinical" (increasing awareness among clinicians of pertinent issues concerning intervention with young people who are engaging in sexting, or who have been victimized by IBSA).

CONCLUSIONS

The qualitative literature was found to provide rich insight into adolescent experiences of sexting, thus allowing for the generation of evidence-based recommendations which are consistent with young peoples' own interests and preferences. Limitations in the existing literature base were discussed (e.g., lack of specificity in methodological reporting), and suggestions were given for future research (including the need to explore sexting experiences of LGBTQ + adolescents in more depth).

Retrospective and Prospective Analysis on "Sexting": Indicators of Productivity, Dispersion, and Content (2009-2019)

In the last decade, research on "sexting" has undergone an exponential increase, giving rise to the publication of numerous studies clarifying its meaning, offering information of educational value, and favoring a good use of technology to prevent problems caused by this exchange of sexual information. The aim of this article was to analyze the production, performance, impact, and content of scientific articles evaluating the "sexting" thesaurus (title, abstract, and/or keywords) between 2009 and September 2019. Articles were sourced from two internationally recognized databases: Scopus and Web of Science. A scientometric study was then carried out on a sample of 641 articles that met the established inclusion criteria. The main findings indicate that "sexting" is a very recent research focus, but one in full growth phase, with scientific production related to the topic likely to double over the next few years. Although "sexting" has been researched worldwide, the scientific production of the US and American authors is the most notable. There were also some differences between the Scopus and Web of Science databases, mainly in the volume of production and the trend. However, the studies do show a common research line, "cyberbullying," and a common target population: adolescents. Therefore, the content analysis reveals that research on "sexting" is mostly carried out with adolescents and takes into consideration other themes such as cyberbullying, dating violence, and sexuality.

Sexting among British adults: a qualitative analysis of sexting as emotion work governed by 'feeling rules'

Sexting has generated considerable public and professional interest with concerns centring on young people, and potential harms to mental and sexual health. Little research thus far has explored the practice among adults and none has focused on the cultural norms relating to the emotional experience of sexting across different ages and genders. We conducted 40 semi-structured interviews with a diverse sample of adults aged 18-59 years in Britain on the role of digital technologies in participants' sexual lives. In this paper, we draw on the accounts of 34 people with experience of sexting. We identified three main themes in participants' accounts related to the emotional aspects of sexting: (1) trust, (2) desire/intimacy and (3) shame. Under each theme, we identified motivations, 'feeling rules', and examples of 'emotion work' relating to the self, the other and the dyad. We conclude that there are shared cultural norms that constitute what appropriate sexting should feel like. Interventions aiming to minimise harms arising from sexting need to build on commonly held cultural conventions regarding the 'rules of the game' concerning feelings as well as behaviours.

Victim Blaming and Non-Consensual Forwarding of Sexts Among Late Adolescents and Young Adults

This study explored late adolescents' and young adults' willingness to engage in non-consensual forwarding of sexts (NCFS) and its relation to victim blaming beliefs toward female and male victims. The study further examined important determinants in the development of victim blaming beliefs (e.g., perceived victim blaming of peers). An online survey was conducted among 1343 Belgian respondents of which 78.4% were female (M_age = 21.62 years, SD = 3.57 years). Structural equation modeling showed that victim blaming beliefs (i.e., responsibility-based and characteristic-based) were related to willingness to engage in NCFS, which was related to NCFS, regardless of the victim's sex. Further, victim blaming beliefs in the context of NCFS were shaped by parents' and peers' perceived victim blaming, and respondents' high levels of narcissism and low levels of empathy. Surprisingly, pornography use was negatively correlated with characteristic-based victim blaming beliefs. Additionally, males and late adolescents appeared to hold more victim blaming beliefs toward female and male victims in comparison with females and young adults. Lastly, the willingness to engage in NCFS was more strongly related to responsibility-based victim blaming (not characteristic-based victim blaming) if the victim was male. The findings demonstrate how victim blaming encourages NCFS and emphasize that educational programs should avoid victim-focused strategies.

Relations between peer influence, perceived costs versus benefits, and sexual offending among adolescents aware of sex offender registration risk

A policy's general deterrent effect requires would-be offenders to be aware of the policy, yet many adolescents do not know they could be registered as sex offenders, and even adolescents who do know may still commit registerable sexual offenses. We tested whether peer influences shape the perceived costs/benefits of certain sexual offenses and, subsequently, registration policy's general deterrent potential in a sample of policy-aware adolescents. The more adolescents believed their peers approve of sexting of nude images, the more likely they were to have sexted. For forcible touching, having more positive peer expectations about sex and perceiving forcible touching as more prevalent among peers related to adolescents' likelihood of engaging in that behavior. Perceiving registration as a possible consequence was unrelated to sexual offending. Findings highlight the nuanced roles peers play in adolescent sexual decision-making and support emerging evidence that juvenile registration policy has limited general deterrent efficacy.

Sending, receiving, and nonconsensually sharing nude or near-nude images by youth

INTRODUCTION

There is growing evidence about the prevalence of sending, receiving, or resharing nude images by youth (sexting). Less is known about the demographic, technology use, and social context correlates of sexting. Using logistic regression, we looked at predictors of sexting behaviors in minors.

METHODS

Participants were a market panel sample of 394 youths aged 9-12 and 602 youths aged 13-17 (M_age  = 13.5, SD = 2.50, 60.3% females) recruited for an anonymous online survey in the United States. The survey comprised questions about demographic characteristics, sexting behaviors, technology use, attitudes, and perceived norms. The four outcomes were sending nude or near-nude images or videos (images), receiving images sent without the depicted person's knowledge, nonconsensually resharing images, or having one's own images nonconsensually reshared.

RESULTS

Regression analyses showed gender, gender/sexual minority status, use of dating apps and particular online platforms, self-sharing and resharing attitudes, and friend norms predicted sending images. Age, resharing attitudes, and friend norms all predicted receiving nude images of other youths. Household income, geographic location, some online platforms, resharing attitudes, and friend norms all predicted nonconsensual resharing of nudes. Age, use of encrypted apps, and friend norms predicted having one's own image nonconsensually reshared.

CONCLUSIONS

We partially replicated prior research by finding associations between age and gender. Further, we identified technology use factors including the use of dating apps and particular platforms. Attitudes about sexting and perceived friend norms were robust across sexting behaviors, suggesting these factors are potentially important for intervention.

Sexting Behaviors Before and During COVID-19 in Italian and Colombian Young Adults

Introduction

Recent research highlight increasing at-risk online sexual activities and behaviors during the COVID-19 pandemic among young adults. Specifically, sexting refers to exchanging sexually suggestive messages, photos, and videos through technological devices, and it can be placed on a continuum from safer to riskier behavior. This study aims to improve our knowledge about sexting behaviors in Italian and Colombian young adults before and during the COVID-19 pandemic.

Methods

A survey online was filled in by all recruited participants through a snowball sampling procedure (from December 2019 to June 2021) both in Italy and Colombia, resulting in a total of 2931 participants (2051 from Italy and 880 from Colombia) aged 18 to 35 years old (Mage = 23.85; SDage = 3.63; 67.6% girls).

Results

Italian youth were more engaged in risky sexting than Colombian participants, while Colombians indicated being more engaged in non-consensual sexting than Italians. Sexual minority people reported more sharing their own sexts, higher levels of sexting under pressure, and 3.2 times more risky sexting than exclusively heterosexual counterparts. During the pandemic period, participants sent their own sexts 1.5 times more and were less involved in non-consensual sexting than in the pre-pandemic era.

Conclusions

The present research could help understand better the cultural dynamics underlying the differences in sexting behaviors, suggesting the relevance of investigating how sexting behaviors and online at-risk activities have changed since the pandemic started.

Policy Implications

Results provide implications for educational and prevention programs to improve young people's awareness of sexting behaviors.

Understanding the Vicious Cycle: Relationships between Nonconsensual Sexting Behaviours and Cyberbullying Perpetration

With the increased ubiquity of digital technology, sexting behaviours, defined as the online sending, receiving, or disseminating of sexually explicit messages, images, or videos, have become increasingly frequent, particularly among young adults. While prior research found sexting behaviours to be associated with cyberbullying behaviours, the role of consent as part of this association has been largely unexplored. The current study investigates whether the relationship between sexting behaviours and cyberbullying perpetration might be explained by a subset of nonconsensual sexting behaviours, such as engagement in nonconsensual sext dissemination and sext-hassling. A large convenience sample of young Western cisgendered adults (n = 1688, M age = 23.15, SD = 3.23, 52.7% women) completed an anonymous online survey exploring harmful online behaviours (nonconsensual sext dissemination, sext-hassling, cyberbullying victimisation/perpetration). A hierarchical logistic regression was used to analyse predictive relationships between variables. The results showed no significant association between consensual sext-sending and cyberbullying perpetration in young adults. However, nonconsensual sexting behaviours, particularly sext-hassling and nonconsensual sext dissemination, were predictive of cyberbullying perpetration. Finally, cyberbullying victimization appeared to be the most strongly associated factor with cyberbullying perpetration. These findings suggest that future research and prevention efforts surrounding sexting and cyberbullying perpetration would benefit from a focus on consent and the bidirectional nature of cyberbullying behaviours.

Digital Sexual Violence and Suicide Risk in a National Sample of Sexual Minority Adolescents

This paper aimed to examine the association between digital sexual violence (threat to post or nonconsensual posting of sexually explicit media) and suicidal (ideation, planning, and attempt) and non-suicidal self-harm behavior. The data for the current analysis come from an online sample of sexual minority adolescents (aged 14-17) recruited from across the United States (n = 970). Multivariate logistic regressions were used to examine the association between digital sexual violence with suicide (ideation, planning, and attempt) and self-harm. In the sample, 9.1% of participants reported being threatened to have their sexually explicit media posted without their consent, while 6.5% reported their sexually explicit media had been posted without their consent. Threat to post sexually explicit media without consent was associated with higher odds of reporting suicidal ideation (odds ratio [OR] = 1.88), suicide plan (OR = 2.12), suicide attempt (OR = 3.56), and self-harm (OR = 1.96). While nonconsensual posting of sexually explicit media was associated with higher odds of reporting suicidal ideation (OR = 1.82) and suicide attempt (OR = 2.20). All models controlled for age, assigned sex at birth, sexual identity, and race and ethnicity. These findings underscore important considerations and future research directions. Given the associations between digital sexual violence and suicide risk among sexual minority adolescents, suicide prevention efforts with adolescents must be responsive to the needs of sexual minority adolescents and the changing landscape of sexual violence in digital spaces. Future research should examine the trajectories of digital sexual violence among adolescents and comparative analyses by demographic subgroups to better understand changes in these processes over time.

What are the predictors of sexting behavior among adolescents? The positive youth development approach

INTRODUCTION

Research supporting adolescent sexual health and empowerment is needed. The study investigates sexting among adolescents using the resources that characterized the Positive Youth Development Approach (PYD) and considering the impact of parental monitoring. The study aims to describe sexting among three different groups of adolescents (i.e., Non Sexters [NS], Passive Sexters [PS], and Active Sexters [AS]) considering age and sex (first aim). It also seeks to identify predictors among the PYD's resources and parental monitoring that explain the probability of falling into the sexter or the non sexter groups (second aim) as well as the probability of falling into the active or the passive sexter groups (third aim).

METHOD

The national representative sample was composed of 1866 Italian adolescents: 980 girls and 886 boys aged between 13 and 19 years old (M = 16.26; SD = 1.49). Participants completed a questionnaire that measured sexting behavior, PYD resources, and parental monitoring scales. Chi-squared and multivariate logistic regressions were performed.

RESULTS

Almost half of the participants (46.0%) were NS, 36.2% were PS, and 17.8% were AS. Results show that sex, age, Connection, and Child Disclosure are significant predictors of sexting behavior.

CONCLUSIONS

Results highlighted that sexting can be seen as a relational activity that adolescents use to establish connections as part as their sexual exploration. A parenting approach that promotes disclosure may help adolescents explore safely their sexuality and be accountable. Results also indicate that parents need to build educational alliances with schools to promote sexual health and empowerment among teenagers while preventing risk of harm.

Sexting at an Early Age: Patterns and Poor Health-Related Consequences of Pressured Sexting in Middle and High School

BACKGROUND

Sexting is sending, receiving, or forwarding sexually explicit messages, images, or videos through electronic means. Research has examined sexting in high school and college students. This study seeks to add to the existing literature by exploring the nature of pressured or problematic sexting in middle school-aged subjects.

METHODS

We asked participants in public colleges in Massachusetts, Colorado, and Virginia, to recall their sexting-related experiences in middle and high school. We utilized an online survey tool for data collection. We performed bivariate quantitative statistical analyses to examine attitudinal and behavioral differences, as well as motivations and consequences of adolescent sexting.

RESULTS

The study revealed unique patterns of early-onset sexting compared to sexting in later adolescence. Early-onset adolescents typically start sexting before they become sexually active and are at a higher risk for poor outcomes associated with sexting, they are more likely to seek therapy. Early sexting is significantly more pressured than sexting in later adolescence.

CONCLUSIONS

The study is an important contribution to the existing research on pressured sexting. Exploring pressured sexting at very early ages finds that early sexting activity is more likely pressured, creates more stress than later in life, and hence, it needs attention from school mental health professionals and education programs. The authors suggest that comprehensive sex education, including sexting should begin earlier than middle school to prevent risky online sexual behavior and provide for learning coping mechanisms for adolescents.

Sexual Victimization in the Digital Age: A Population-Based Study of Physical and Image-Based Sexual Abuse Among Adolescents

Adolescents increasingly use social media platforms, and these practices open up new forms of sexual victimization, in particular image-based sexual abuse (IBSA). Few studies have examined prevalence rates and correlates of both physical sexual victimization (PSV) and these new forms of victimization in representative samples. We used data from 5,245 adolescent girls (53%) and 4,580 adolescent boys (47%) from the population-based Young in Oslo Study (mean age 17.1 years, SD = 0.9). Of all respondents, 2.9% had experienced IBSA, 4.3% PSV, and 1.7% both IBSA and PSV in the course of the previous 12 months. Multivariate analyses revealed that PSV victims, after control for other variables, had many characteristics described in previous studies of sexual victimization. Girls had higher prevalence rates than boys, many had been victims of other types of violence, and were part of peer groups with much use of alcohol and drugs. PSV victims also reported early intercourse onset and a higher proportion had been commercially sexually exploited. Lesbian, gay, and bisexual adolescents had higher victimization rates. Victims of both PSV and IBSA had a similar but even more pronounced profile. The IBSA victims were different: They lacked many of the traditional risk factors for sexual victimization, there were no significant gender differences in this group, and IBSA victims more often came from high socioeconomic backgrounds. In conclusion, we observe a reconfigured landscape of sexual victimization patterns among Norway adolescents due to their increasing participation on social media and digital platforms.

Did They Deserve It? Adolescents' Perception of Online Harassment in a Real-Case Scenario

Online harassment, particularly cyberbullying and the non-consensual sharing of intimate images, is a widespread phenomenon among adolescents and young adults. Descriptive research was carried out to investigate any differences among Italian school classes in the perception of cybercrime through a real-case scenario. Following the Italian school system, the final sample of 1777 adolescents (Mage = 15.37, SD = 1.65; Male = 52%) was divided into three groups based on the school class attended: middle school (N = 562; Mage = 13.37, SD = 0.48); high school biennium (N = 728; Mage = 15.55, SD = 0.50), and triennium (N = 487, Mage = 17.40, SD = 0.71). Participants completed a self-report questionnaire investigating the use of the Internet and the perception of a real case scenario involving the non-consensual sharing of intimate images and cyberbullying received by the National Centre for Combating Child Pornography Online (NCPO). Results showed differences among the three groups' perceptions of the event's features, motivations underlying the offense, victim-blaming and harassment justification (e.g., cyberbullying, in particular non-consensual sharing of intimate images, is recognized as a crime as age increases). The findings provide significant insights for future research and age-specific factors to consider when developing prevention programs for online risks.

Sexting with benefits? Exploration of sexting behaviours through the lens of protection motivation theory

Sexting is a common form of sexual communication that is often considered normative and beneficial despite some research highlighting its negative social, psychological, and legal repercussions. Using protection motivation theory (PMT), this study examines how young adults weigh the pros and cons of sending consensual sexts, sexting under pressure, and deciding against sending sexts, and whether body image dissatisfaction interacts with any of the decision-making processes. In total, 906 participants (554, 61.14% women), aged 18-25 years (M = 21.65, SD = 2.01), completed an online measure of sexting behaviours, body image, and protection motivation. Overall, 71.41% of respondents ever sent a sext. Of those, 45.07% and 36.32% felt pressure to sext or sent a sext because of pressure. Further, 63.90% participants ever considered and decided not to send a sext. All models predicting various sexting behaviours were significant and provided a partial support for the PMT. Body image was a unique predictor of 'pressured' sexting but its interactions with the PMT subscales for pressured sexting and decisions against sexting were non-significant. Our study illustrates the need for increasing young people's self-efficacy and body image to improve their sexting agency and experience.

"I do not remember… You are reminding me now!": Children's difficult experiences during forensic interviews about online sexual solicitation

BACKGROUND

Forensic interviews for children who have undergone online sexual solicitation (OSS) constitute a unique setting compared to other forms of child sexual abuse (CSA). In these cases, the interviewer holds concrete evidence of the abuse in the form of pictures or texts. During the interview, interviewers use these materials to advance the data collection regarding the abuse, a practice that may significantly influence the child's wellbeing.

OBJECTIVE

The current study aims to explore children's experiences during forensic interviews concerning OSS.

PARTICIPANTS AND SETTING

The sample included 20 Jewish children in Israel who were referred to and participated in a forensic investigation.

METHODS

A thematic qualitative methodology was used to analyze the children's narratives.

RESULTS

The findings demonstrate the children's difficulties when confronted with materials related to the abuse. The children detailed the different ways the interview challenged their wellbeing, including visualizing and verbalizing the abuse, new insights, and being videotaped.

CONCLUSIONS

The findings in the current study emphasized the intrinsic challenges that children face in OSS forensic interviews resulting from the tension between the interviewer's need to collect details about the abuse and the child's desire to forget it. Practical ramifications pertaining to these threats to the child's wellbeing, future recommendations, and limitations of the study will be discussed.

Perpetration of Image-Based Sexual Abuse: Extent, Nature and Correlates in a Multi-Country Sample

Image-based sexual abuse (IBSA) is a form of technology-facilitated abuse in which intimate (nude or sexual) images of a person are taken, distributed, or threats are made to distribute the images, without a person's consent. It is an increasingly criminalized form of sexual abuse, and yet little is known about the perpetrators of these harms, including the extent, relational nature and correlates of perpetration. This article reports on the first multi-country survey study to comprehensively investigate IBSA perpetration. An online panel survey of the general community (aged 16-64 years) in the United Kingdom (UK), Australia, and New Zealand (NZ) (n = 6109) found that self-reported IBSA perpetration was relatively common, with one in six (17.5%, n = 1070) respondents engaging in at least one form of IBSA. Logistic regression analyses identified nine characteristics that significantly increased the odds of having engaged in IBSA perpetration during their lifetime, namely: residing in the NZ as opposed to the UK or Australia, being male, having disability/assistance needs, holding attitudes that minimize the harms and excuse the perpetrators of IBSA, engaging in online dating behaviors, engaging in sexual self-image behaviors, and experiencing IBSA victimization (images taken, images distributed, and images threatened). Policy and prevention implications of the findings, as well as directions for future research are discussed.

Comparing the prevalence of sexual behaviors and victimization among adolescents based on child welfare system involvement

OBJECTIVE

Sexual behavior presents risks, particularly among vulnerable groups such as adolescents with child welfare system involvement. This study compares the prevalence of sexual behaviors and victimization among adolescents in Los Angeles County with and without child welfare system involvement. It examines associations between online and offline sexual behaviors and victimization.

METHODS

The sample included middle and high school students (N = 2365) and high school students only (N = 1068) participating in the 2015 Los Angeles Youth Risk Behavior Survey (YRBS). Measures included child welfare system involvement with or without foster care placement, demographics (race, ethnicity, gender, age), in-person sexual behaviors (e.g., unsafe sex), online sexual behaviors (e.g., sent/received sext), and sexual victimization (forced sex, dating physical violence, dating sexual assault). Logistic regressions examined variability in sexual behaviors and victimization based on child welfare involvement, net of demographics. Path analyses associated online sexual behaviors with victimization and offline risk.

RESULTS

Greater reported sexual behavior and victimization among foster care youths was found, relative to youths without child welfare system involvement (maximum OR = 9.8). Youth with child welfare system involvement but not placed in foster care reported more unsafe sex, sexting because of pressure, finding a sex partner online, having sex with a partner met online, and forced sex (maximum OR = 10.4). Sexting was associated with forced sex and dating sexual assault, finding a sexual partner online, and physical violence.

CONCLUSIONS

Targeted prevention is needed for online and offline sexual risks and victimization among youth with child welfare system involvement.

Socially Disadvantaged Community Structures and Conditions Negatively Influence Risky Sexual Behavior in Adolescents and Young Adults: A Systematic Review

Objectives: This review aims to examine the association between community-level factors, namely, community structure and condition, and risky sexual behavior (RSB) including early sexual debut, having multiple sex partners, and unprotected sex, in adolescents and young adults.

Methods: In total, 17 observational studies were identified for review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Among the 11,216 identified articles, excluded articles comprised 8,361 duplicates, 2,855 articles by title screening, 893 by abstract screening, and 667 by full-text screening. Finally, eight additional articles were added by manual search.

Results: The community structural factors included social disadvantage, economic, employment, education status, racial or ethnic composition, residential stability, and physical environment. The current review found that social disadvantage (six studies) and economic status (10 studies) were most frequently examined. Particularly, higher levels of social disadvantage were associated with higher rates of early sexual initiation, inconsistent condom use, and multiple sexual partners.

Conclusion: This study highlights that community structure and conditions in terms of social disadvantages should be addressed to prevent RSB in the young population.

Cardiac arrest and complications during non-invasive ventilation: a systematic review and meta-analysis with meta-regression

PURPOSE

The aim of this study was to perform a systematic review and meta-analysis to investigate the incidence rate of cardiac arrest and severe complications occurring under non-invasive ventilation (NIV).

METHODS

We performed a systematic review and meta-analysis of studies between 1981 and 2020 that enrolled adults in whom NIV was used to treat acute respiratory failure (ARF). We generated the pooled incidence and confidence interval (95% CI) of NIV-related cardiac arrest per patient (primary outcome) and performed a meta-regression to assess the association with study characteristics. We also generated the pooled incidences of NIV failure and hospital mortality.

RESULTS

Three hundred and eight studies included a total of 7,601,148 participants with 36,326 patients under NIV (8187 in 138 randomized controlled trials, 9783 in 99 prospective observational studies, and 18,356 in 71 retrospective studies). Only 19 (6%) of the analyzed studies reported the rate of NIV-related cardiac arrest. Forty-nine cardiac arrests were reported. The pooled incidence was 0.01% (95% CI 0.00-0.02, I² = 0% (0-15)). NIV failure was reported in 4371 patients, with a pooled incidence of 11.1% (95% CI 9.0-13.3). After meta-regression, NIV failure and the study period (before 2010) were significantly associated with NIV-related cardiac arrest. The hospital mortality pooled incidence was 6.0% (95% CI 4.4-7.9).

CONCLUSION

Cardiac arrest related to NIV occurred in one per 10,000 patients under NIV for ARF treatment. NIV-related cardiac arrest was associated with NIV failure.