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Kokkinos CM, Krommida C, Markos A, Voulgaridou I. A Latent Profile Analysis of Greek University Students' Sexting Profiles: Associations with Big Five Personality Traits. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1129-1140. [PMID: 38151570 PMCID: PMC10920438 DOI: 10.1007/s10508-023-02762-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 11/24/2023] [Accepted: 11/25/2023] [Indexed: 12/29/2023]
Abstract
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.
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Affiliation(s)
- Constantinos M Kokkinos
- Department of Primary Education, School of Education Sciences, Democritus University of Thrace, N. Hili, 68131, Alexandroupolis, Greece.
| | - Christina Krommida
- Department of Primary Education, School of Education Sciences, Democritus University of Thrace, N. Hili, 68131, Alexandroupolis, Greece
| | - Angelos Markos
- Department of Primary Education, School of Education Sciences, Democritus University of Thrace, N. Hili, 68131, Alexandroupolis, Greece
| | - Ioanna Voulgaridou
- Department of Primary Education, School of Education Sciences, Democritus University of Thrace, N. Hili, 68131, Alexandroupolis, Greece
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Thorne E, Babchishin KM, Fisico R, Healey L. Sexting in Young Adults: A Normative Sexual Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:593-609. [PMID: 38082175 DOI: 10.1007/s10508-023-02728-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/10/2023] [Accepted: 10/17/2023] [Indexed: 02/07/2024]
Abstract
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.
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Affiliation(s)
- Evelyn Thorne
- John Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Kelly M Babchishin
- Department of Psychology, Carleton University, Ottawa, ON, K1S 5B6, Canada.
| | - Rebecca Fisico
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Lindsay Healey
- Department of Psychology, Carleton University, Ottawa, ON, K1S 5B6, Canada
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Walters TL, Hanna-Walker V, Clark AN, Farina RE, Lefkowitz ES. LGBTQ+ College Students' Relationship Satisfaction During the COVID-19 Pandemic. EMERGING ADULTHOOD (PRINT) 2023; 11:804-810. [PMID: 38603436 PMCID: PMC9988628 DOI: 10.1177/21676968231160305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Research suggests that COVID-19-related restrictions affected individuals' ability to engage in relationship maintenance behaviors and have led to poorer romantic relationship quality. Poor relationship quality may be especially problematic for lesbian, gay, bisexual, transgender, queer or questioning, and otherwise non-heterosexual or-cisgender (LGBTQ+) college students, who often lack family support and are at greater risk for mental health issues. We used a social exchange theory lens to examine correlates of relationship satisfaction for LGBTQ+ college students during the early months of the pandemic. The analytic sample consists of 175 LGBTQ+ students (Mage = 20.5) who completed an online survey and reported being in a romantic relationship. Our findings demonstrate that LGBTQ+ students with more supportive partners were more satisfied with their relationships. These results can inform clinicians how to better support LGBTQ+ college couples when they experience relationship stress.
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Calvete E, Fernández-González L, Orue I. A Growth Mindset and Self-Affirmation Intervention to Reduce Violent and Risky Online Behaviors: The Moderating Role of Previous Victimization. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:5875-5901. [PMID: 36213954 DOI: 10.1177/08862605221127221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The Internet is the setting for several forms of violent and risky behavior among adolescents, such as cyberbullying, sexualized interactions with adults, sexting, and online dating violence. Often, these behaviors are responses to experiences of online victimization. This study examined the differential effects of a wise intervention (WI), combining growth mindset and self-affirmation strategies, on these behaviors for adolescents who had experienced victimization and those who had not. A sample of 1,085 adolescents (54.3% girls; ages 11-18 years) were randomized into two intervention conditions (WI and an anti-stress control intervention). They completed measures of violent and risky behaviors at pretest and at 3- and 6-month follow-ups and measures of victimization at pretest. The results of multilevel analyses indicated that the WI was beneficial for adolescents without experiences of victimization at pretest, as they displayed smaller increases in online peer aggressions, sexualized interactions with adults, and sexting than the adolescents in the control condition. However, the WI was not beneficial for adolescents with experiences of victimization at pretest. Moreover, the adolescents under the anti-stress control condition displayed better outcome. These findings suggest that previous victimization experiences of adolescents should be considered to select an appropriate intervention.
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Seto MC, Roche K, Stroebel M, Gonzalez-Pons K, Goharian A. Sending, receiving, and nonconsensually sharing nude or near-nude images by youth. J Adolesc 2023. [PMID: 36938856 DOI: 10.1002/jad.12143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 03/21/2023]
Abstract
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 (Mage = 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.
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Affiliation(s)
- Michael C Seto
- Forensic Research Unit, Royal Ottawa Health Care Group, Ottawa, Ontario, Canada
| | - Kailey Roche
- Forensic Research Unit, Royal Ottawa Health Care Group, Ottawa, Ontario, Canada
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Bonfanti RC, Garro M, Lavanco G, Ruggieri S. The role of sexting in couple wellbeing for Italian women during the second wave of the COVID-19 pandemic. Front Psychol 2023; 14:1105556. [PMID: 36968735 PMCID: PMC10030598 DOI: 10.3389/fpsyg.2023.1105556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/20/2023] [Indexed: 03/10/2023] Open
Abstract
The social isolation due to the COVID-19 pandemic had an impact on the sexuality and quality of life of people around the world. A particularly negative effect was detected on women’s sexual health. As a consequence, many women began to use social media not only to stay in touch with their social networks, but as a way of maintaining sexual contact. The main aim of this research is to observe the positive effects of sexting in women’s wellbeing as a strategy to manage the negative effects of a condition of forced isolation. We collected all our data between November 2020 and March 2021 during a period of strict restrictions in Italy due to the second wave of the COVID-19 pandemic. In Study 1, the relationship between loneliness, sexting behaviors, and sexual satisfaction was tested on 312 adult women. The results showed the mediator role of motivation for sexting in the relationship between loneliness and sexual satisfaction. In Study 2, 342 adult women were organized into two groups (women who had sexting at least once during the second wave of the pandemic = 203, and women who did not have sexting during the pandemic = 139) and were assessed on a couple’s wellbeing (intimacy, passion, commitment, and couple satisfaction) and electronic surveillance. The results show that women who had sexting during isolation had higher scores on intimacy, passion, couple satisfaction, and electronic surveillance. These findings suggest the important role of sexting as an adaptive coping strategy during particular conditions of social isolation.
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Affiliation(s)
- Rubinia Celeste Bonfanti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Maria Garro
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
- *Correspondence: Maria Garro,
| | - Gioacchino Lavanco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Stefano Ruggieri
- Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
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Le L, Goegan LD, Daniels LM. The Impact of Autonomous and Controlled Sexting Motivations on Subjective Well-being and Relationship Quality. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:243-254. [PMID: 35881253 DOI: 10.1007/s10508-022-02361-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
Although many studies have examined reasons for sexting among young people, few have taken into account the underlying motivations associated with different reasons and how that may be associated with divergent positive or negative outcomes. This study addressed this gap by employing Self-determination Theory to assess how autonomous and controlled motivations for sexting were related to subjective well-being and relationship quality among emerging adults. Online survey data from 267 emerging adults (72 men, 195 women) ages 18-25 who had sent sexually explicit images or videos of themselves through electronic means to a committed partner were analyzed using Structural Equation Modeling. Autonomous and controlled motivations for sexting were significantly related to pleasant affect, with autonomous motivation predicting more pleasant affect and controlled motivation predicting less pleasant affect. Autonomous motivations for sexting were related to enhanced relationship quality, whereas controlled motivations for sexting were related to decreased relationship quality. Neither form of motivation had a statistically significant relationship with unpleasant affect or life satisfaction. These results demonstrate that the quality of motivations for sexting among emerging adults in committed relationships may contribute to different outcomes, particularly in terms of relationship quality. Implications for counselors, educators, and practitioners working with emerging adults who sext are discussed.
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Affiliation(s)
- Lily Le
- 6-123F Education North, Department of Educational Psychology, University of Alberta, Edmonton, AB, T6G 2G5, Canada.
| | - Lauren D Goegan
- 230L Education Building, Department of Educational Administration, Foundations and Psychology, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Lia M Daniels
- 6-123F Education North, Department of Educational Psychology, University of Alberta, Edmonton, AB, T6G 2G5, Canada
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Lefebvre AA, Audet A, Savard M, Mackay MC, Brassard A, Daspe MÈ, Lussier Y, Vaillancourt-Morel MP. A contemporary exploration of the relationship between attachment and sexual satisfaction: the role of technology-mediated sexual interaction. SEXUAL AND RELATIONSHIP THERAPY 2022. [DOI: 10.1080/14681994.2022.2130231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Affiliation(s)
| | - Ariane Audet
- Department of Psychology, Université de Sherbrooke, QC, Canada
| | - Mathilde Savard
- Department of Psychology, Université de Sherbrooke, QC, Canada
| | | | - Audrey Brassard
- Department of Psychology, Université de Sherbrooke, QC, Canada
| | - Marie-Ève Daspe
- Department of Psychology, Université de Montréal, QC, Canada
| | - Yvan Lussier
- Department of Psychology, Université du Québec à Trois-Rivières, QC, Canada
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9
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Guest C, Denes A. Too much too soon?: Perceived appropriateness of sexting across stages of relationship development and attachment tendencies among emerging adults. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Okumu M, Logie CH, Ansong D, Mwima S, Hakiza R, Newman PA. Digital technologies, equitable gender norms, and sexual health practices across sexting patterns among forcibly displaced adolescents in the slums of kampala, Uganda. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Kokkinos CM, Krommida C. Prevalence of Sexting among Greek University Students: A Matter of Relationships? THE JOURNAL OF PSYCHOLOGY 2022; 156:459-477. [PMID: 35881415 DOI: 10.1080/00223980.2022.2093822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
The study examines sexting among 3,171 Greek university students in the context of different relationship types (i.e. romantic partners, friends, strangers). Participants completed an anonymous online survey, assessing sexting during the last year along with demographic and relationship status information. Sexting was a common practice among participants, with the use of mobile phones and the Messenger application to exchange sexts. Sexting was more common among males and non-heterosexuals. Participants aged 25 and above were more likely to exchange sexts with strangers than those aged between 18 and 24. Romantic partners reported exchanging sexts more often than strangers. Hierarchical regression analyses indicated that non-heterosexual males in a long-distance romantic relationship were more likely to participate in sexting, and that non-heterosexual older males who have been single for the last year were more likely to exchange sexual or provocative messages with strangers. Findings are discussed in terms of their implications.
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12
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Galovan AM, Carroll JS, Schramm DG, Leonhardt ND, Zuluaga J, McKenadel SEM, Oleksuik MR. Satisfaction or connectivity?: Implications from the strong relationality model of flourishing couple relationships. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:883-907. [PMID: 34661918 DOI: 10.1111/jmft.12559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/17/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
A central feature of couple relationships research is the use of self-report measures of relationship satisfaction. Despite the widespread use of such measures in couples' research, scholars have raised critical questions about satisfaction-focused assessment, including concerns about taking an ontologically individualistic focus. Moving beyond ontological individualism, drawing from the Strong Relationality Model of Relationship Flourishing and data from 615 couples in the United States and Canada (N = 1230 individuals), we explored similarities and differences between assessments of relationship satisfaction and a measure based on strong relationality (relational-connectivity). We evaluated associations with other scales assessing relationship factors including indicators of well-being, relationship processes, virtues, and responsible actions. Using confirmatory latent profile analysis, we classified individuals as Flourishing (55.4%), Languishing (31.8%), Connected, Less-Satisfied (7.8%), or Satisfied, Less-Connected (5.0%). Our results suggest that attending to richer perspectives of relationship quality may spur additional understanding of many factors associated with meaningful couple relationships.
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Affiliation(s)
- Adam M Galovan
- Department of Human Ecology, University of Alberta, Edmonton, Alberta, Canada
| | - Jason S Carroll
- School of Family Life, Brigham Young University, Provo, Utah, USA
| | - David G Schramm
- Human Development and Family Studies, Utah State University, Logan, Utah, USA
| | - Nathan D Leonhardt
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Johana Zuluaga
- Department of Human Ecology, University of Alberta, Edmonton, Alberta, Canada
| | | | - McKenna R Oleksuik
- Department of Human Ecology, University of Alberta, Edmonton, Alberta, Canada
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13
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Expectations VS reality: Expected and actual affective reactions to unsolicited sexual images. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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14
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Idoiaga Mondragon N, Santamaria MD, Txertudi MB, Saez IA. Image-based Abuse: Debate and Reflections on the "Iveco Case" in Spain on Twitter. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP7178-NP7201. [PMID: 33107396 DOI: 10.1177/0886260520967143] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The instance of image-based abuse that ended in the victim's suicide, known as the "Iveco case," had an unprecedented social impact in Spain in 2019. This case provoked a great social reaction and became particularly viral on social networks such as Twitter. The present research investigates how this case has been dealt with through Twitter discourse. In particular, this study aimed to identify the main elements that could explain how people engaged with the problem of nonconsensual sharing of sexually explicit images in general, and with this case in particular. In total, 1,895 tweets with the word "Iveco" written in Spain were selected by streaming API, and their content was analyzed by lexical analysis using Iramuteq software (Reinert method). This software carries out an automatic lexical classification cluster analysis that groups the most significant words and text segments according to their co-occurrence. The results revealed that, on Twitter, it was stressed that the victim was a married woman with children who had practiced sexting. However, in response to this initial description, many voices also emerged that labelled this image-based abuse as gender-based online violence. Criticism was aimed at both the passivity of the company, and the attitude of hundreds of thousands of people who share the sexting video by WhatsApp groups without permission. Consequently, several feminist mobilizations emerged, framing this case within a sexist and patriarchal society and asking for accountability. However, in contrast, countermovements such as the #NotAllMen also emerged.
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15
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A Cross-Cultural Examination of the Sexting Motives and Attitudes: Bosnia and Herzegovina vs. Croatia. HUMAN BEHAVIOR AND EMERGING TECHNOLOGIES 2022. [DOI: 10.1155/2022/7606949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Many sexting studies conducted in the Western cultures have shown that the percentage is higher in less traditional cultures. However, the generalizability of this phenomenon to non-Western cultures has not been extensively researched. The purpose of this study is to examine and explain cross-cultural differences in sexting behavior among subjects from Bosnia and Herzegovina and Croatia. A mixed methods approach was used. The first, qualitative phase included focus groups with two groups of high school students from Bosnia and Herzegovina and Croatia (
), aged 15 to 19. In the second, quantitative phase, questionnaires were sent to 440 young adults with an average age of 21 years (
). From the interviews with the young people, nonconsensual sexting was perceived as less beneficial. Sexting was viewed as a double standard. The quantitative study revealed gender and country differences in attitudes toward sexting and motives for sexting. Positive attitudes toward sexting were found to predict different forms of sexting motives in both samples. In the sample from Bosnia and Herzegovina, age was found to predict sexting with instrumental motives and body image reinforcement motives. Gender, on the other hand, was found to be predictive of instrumental sexting motives in the Croatian sample and body image reinforcement sexting motives in the Bosnia and Herzegovina sample. This study illustrates the value of cross-cultural approaches combined with mixed methods as a design to study sexting behavior.
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Falconer T, Quinn-Nilas C, Milhausen R. Body image self-consciousness, sexting, and sexual satisfaction among midlife Canadians. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2022. [DOI: 10.3138/cjhs.2021-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Life circumstances at midlife are often different than those for younger adults (e.g., relationship type and duration, physical health, experience of sexual problems), and these circumstances impact experiences of sexuality and sexual behaviour. Past research on sexual behaviours like sexting, which has been primarily conducted on young people, may not generalize to middle-aged adults. Sexting may be a beneficial activity for midlife adults in long-term relationships who are seeking private and convenient ways to communicate sexual interest. Furthermore, as in younger samples, sexting may be associated with body image and sexual satisfaction. A cross-sectional study with a sample of 640 midlife (40–59 years old) married Canadians was conducted to address these suppositions. Structural equation modelling was used to test the factorial validity of a body image self-consciousness (BISC) scale and to investigate the connections between BISC, sexting frequency (to communicate sexual interest, to initiate sexual activity, and that include a picture), and sexual satisfaction. Almost one-half of participants (43%) reported sexting to communicate sexual interest, 37% sexted to initiate sexual activity, and 18% sexted sexy pictures of themselves. Women with lower levels of BISC were more likely to sext (communicate, initiate, and pictures), and men with lower levels of BISC were more likely to send sexts with pictures. Both men and women with lower levels of BISC and those who engaged in sexting to communicate sexual interest had higher levels of sexual satisfaction. Sexting may be an opportunity for busy marital partners to engage in technology-mediated sexual activity when apart. The current results indicate that technology-mediated sexual communication has similar psychological mechanisms to face-to-face interactions and that sexting may be a beneficial behaviour for sexual satisfaction within midlife marriages.
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Affiliation(s)
- Tasha Falconer
- Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Christopher Quinn-Nilas
- Department of Psychology, Memorial University of Newfoundland, St. John’s, Newfoundland & Labrador, Canada
| | - Robin Milhausen
- Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
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Galovan AM, Hawkins AJ, Harris SM, Simpson DM. What are they doing? A national survey of help-seeking and relationship-repair behavior of individuals who are thinking about divorce. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:371-390. [PMID: 33405252 DOI: 10.1111/jmft.12480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/08/2020] [Indexed: 06/12/2023]
Abstract
Guided by the Stages of Change (SOC) model, we explored relationship-repair behaviors among those thinking about divorce, employing a recent national longitudinal survey of married individuals (N = 745). Person-centered analyses explored whether there were distinct typologies of relationship-repair behaviors. We found four distinct classes: Intense Seekers (6%), who engaged at high levels of all kinds of repair behaviors, including professional services; Moderate-fading Seekers (14%), who engaged in moderate levels of various repair behaviors, including professional services, but did not sustain that behavior over a year; and Minimal-private Seekers (42%) and Private-sustained Seekers (38%), who eschewed professional services and engaged in low-to-moderate personal and private repair behaviors. We discuss possible applications of the SOC model to the divorce decision-making process and conclude with implications for practice, including the need to allocate greater attention to personal and self-help interventions that match the way most people try to repair their relationships.
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Affiliation(s)
- Adam M Galovan
- Department of Human Ecology, University of Alberta, Edmonton, AB, Canada
| | - Alan J Hawkins
- School of Family Life, Brigham Young University, Provo, UT, USA
| | - Steven M Harris
- Department of Family Social Sciences, University of Minnesota, St. Paul, MN, USA
| | - David M Simpson
- School of Family Life, Brigham Young University, Provo, UT, USA
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Ehrenreich SE, George MJ, Burnell K, Underwood MK. Importance of Digital Communication in Adolescents' Development: Theoretical and Empirical Advancements in the Last Decade. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2021; 31:928-943. [PMID: 34820954 DOI: 10.1111/jora.12643] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 03/19/2021] [Accepted: 04/02/2021] [Indexed: 06/13/2023]
Abstract
The past decade saw a sharp increase in the use of smartphones and digital communication platforms. This manuscript reviews advancements in the study of digital communication and adolescent development over the last decade. We highlight theoretical models that seek to explain the power of digital media in adolescents' lives. We then examine research conducted over the last decade on five aspects of digital media: (1) potential to contribute to adolescent development, (2) associations with mental health, (3) differential impact of active versus passive social media use, (4) cyberbullying, and (5) sexting. We conclude with a discussion of potential opportunities and challenges for studying the role of digital communication in adolescents' development during the coming decade.
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Moderating factors of the association between being sexually solicited by adults and active online sexual behaviors in adolescents. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106935] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Dream It, Do It? Associations between Pornography Use, Risky Sexual Behaviour, Sexual Preoccupation and Sexting Behaviours among Young Australian Adults. SEXES 2021. [DOI: 10.3390/sexes2040034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
While sexting behaviours have attracted increasing research focus over the last decade as both normative and deviant forms of sexual activity, little attention has been paid to their potential associations with sexual preoccupation and heightened interest in sex. The current study sought to identify whether sexual preoccupation significantly predicts sending, receiving, and disseminating sexts, after controlling for pornography use and risky sexual behaviours. Young Australian adult participants (N = 654, 78.8% women) aged 18 to 34 (M = 19.78, SD = 1.66) completed an anonymous online self-report questionnaire regarding their engagement in sexting behaviours (sending, receiving, and dissemination), pornography use, risky sexual behaviours, and sexual preoccupation. Results showed that individuals with higher sexual preoccupation were more likely to engage in pornography use and risky sexual behaviours. Binary hierarchical logistic regressions revealed that sexual preoccupation predicted higher rates of sending and receiving sexts. However, sexual preoccupation did not significantly contribute to increased rates of sext dissemination. Our study illustrates the need to incorporate pornography viewing and sexting into the promotion of safe sexual behaviours in online and offline contexts, and the potential to utilise modern technology to negotiate safer sex practices.
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21
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Coundouris SP, Tyson CL, Henry JD. Social networking site use and relationship quality: A double edged sword. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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22
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Garrido-Macías M, Villanueva-Moya L, Alonso-Ferres M, Sánchez-Hernández MD, Badenes-Sastre M, Beltrán-Morillas AM, Herrera A, Expósito F, Herrera MC. Sexting during confinement in Spain: prevalence, motivations and predictor variables ( Sexting durante el confinamiento en España: prevalencia, motivaciones y variables predictoras). STUDIES IN PSYCHOLOGY 2021. [DOI: 10.1080/02109395.2021.1950460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
| | - Laura Villanueva-Moya
- Centro de Investigación, Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada
| | - María Alonso-Ferres
- Centro de Investigación, Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada
| | | | - Marta Badenes-Sastre
- Centro de Investigación, Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada
| | | | - Antonio Herrera
- Centro de Investigación, Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada
| | - Francisca Expósito
- Centro de Investigación, Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada
| | - M. Carmen Herrera
- Centro de Investigación, Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada
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23
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"More Than Buying Extra Fruits and Veggies, Please Hide the Fats and Sugars": Children's Diet Latent Profiles and Family-Related Factors. Nutrients 2021; 13:nu13072403. [PMID: 34371913 PMCID: PMC8308907 DOI: 10.3390/nu13072403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 12/12/2022] Open
Abstract
Promoting children’s healthy diets is a key public health priority. Family can play a relevant role in children’s eating patterns. The goals of the current research were to identify different latent diet profiles in children based on their food consumption and to assess the relationship between profiles and family-related factors. A total of 678 school-aged children from the fifth and sixth grades participated. The study design was cross-sectional and questionnaire based. Research assessed healthy (fruit and vegetables) and unhealthy (fast food, sugar-sweetened beverages, and candies) food consumption and family-related factors. A latent profile analysis and multivariate data analysis were developed. Four diet profiles were identified: Combined Diet, Mainly Healthy Diet, Mainly Unhealthy Diet, and Very Unhealthy Diet. Nearly half of the children (45.22%) showed a Combined Diet profile, meaning that they reported eating nearly the same amount of healthy and unhealthy types of foods. Associations between the diet profiles, family income, and food availability were found. For example, the Mainly Healthy Diet profile was statistically associated with a higher family income and less access to unhealthy foods. The present study reinforces the idea that profiling diets can allow for a tailored healthy eating intervention model according to the specific needs of each diet profile.
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McDaniel BT, Drouin M, Dibble J, Galovan AM, Merritt M. Are You Going to Delete Me? Latent Profiles of Post-Relationship Breakup Social Media Use and Emotional Distress. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2021; 24:464-472. [PMID: 34152851 DOI: 10.1089/cyber.2020.0714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
When a relationship ends, former partners must make decisions about their online, often public, connections and history, which involve a complex disentangling process. We examined post-breakup behaviors including monitoring, interacting, deleting posts/photos, deleting the former partner, deleting the partner's family/friends, stopping social media (SM) use, and keeping digital possessions. Participants (N = 256) who had experienced a breakup within the last year completed an online survey. Approximately 38 percent reported experiencing distress over the breakup sometimes or more often. Utilizing latent profile analysis, we identified four latent classes (or profiles) of breakup SM behaviors; we also examined associations between the class and breakup emotional distress. Most participants were clean breakers (61.3 percent), who did zero to very little monitoring, interacting, or deleting and were unlikely to delete their ex-partner, stop use, or keep digital possessions. Wistful reminiscers (12.9 percent) were similar to clean breakers in terms of engaging in very little of any deleting behaviors, stopping use, or keeping digital possessions; however, they engaged in frequent amounts of monitoring their ex-partner as well as interacting with their ex-partner and their ex-partner's family/friends. Ritual cleansers (15.6 percent) were similar to clean breakers in terms of engaging in very little to no monitoring and interacting; however, they engaged in deleting their SM history, their ex-partner's family/friends, and their ex-partner. Impulsives (10.2 percent) engaged in high amounts of all the SM behaviors. In terms of emotional distress, impulsives showed the highest levels of distress, followed by wistful reminiscers, ritual cleansers, and then clean breakers.
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Affiliation(s)
- Brandon T McDaniel
- Parkview Mirro Center for Research and Innovation, Fort Wayne, Indiana, USA
| | - Michelle Drouin
- Parkview Mirro Center for Research and Innovation, Fort Wayne, Indiana, USA.,Purdue University Fort Wayne, Fort Wayne, Indiana, USA
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Bianchi D, Morelli M, Baiocco R, Cattelino E, Chirumbolo A. Patterns of love and sexting in teen dating relationships: The moderating role of conflicts. New Dir Child Adolesc Dev 2021; 2021:133-155. [PMID: 34109733 PMCID: PMC9292559 DOI: 10.1002/cad.20427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
According to the triangular love theory, this study investigated the roles of three components of love (i.e., passion, intimacy, commitment) and the moderating role of conflicts in predicting different forms of sexting (i.e., experimental, nonconsensual, under pressure) in teen dating relationships. Participants were 409 adolescents (Mage = 17.20, SDage = 1.61; 62.6% girls) who completed an online questionnaire. Three moderated regressions were performed. Conflicts positively predicted all forms of sexting. Passion positively predicted experimental sexting. Intimacy negatively predicted experimental and nonconsensual sexting, and positively predicted sexting under pressure. Three interaction effects emerged, pointing out the moderating role of conflicts. Passion positively predicted nonconsensual sexting in the presence of high conflicts, while this relationship became negative when conflicts were low. Commitment negatively predicted nonconsensual sexting and sexting under pressure in the presence of high conflicts, but these relationships were not significant when conflicts were low. Research and applicative implications are discussed.
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Affiliation(s)
- Dora Bianchi
- Department of Social & Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | - Mara Morelli
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Roberto Baiocco
- Department of Social & Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | - Elena Cattelino
- Department of Human and Social Science, University of Valle d'Aosta, Aosta, Italy
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26
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Hipp CJ, Carlson RG. The Dyadic Association among Technoference and Relationship and Sexual Satisfaction of Young Adult Couples. JOURNAL OF SEX & MARITAL THERAPY 2021; 47:508-520. [PMID: 33955320 DOI: 10.1080/0092623x.2021.1922562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Technology use within relationships has been shown to produce potential rewards and costs that influence relationship development and/or sustainment; however, the negative influence of modern technology (i.e., smartphone, computer, tablet, and/or television) use in romantic relationships during quality time spent together (i.e., technoference) remains an understudied area. Even less is known about the effects of technoference on young adult couples' relationship satisfaction and sexual satisfaction. The current study utilized a descriptive correlational survey design with 158 young adult couples. We used actor-partner interdependence modeling to test the dyadic associations between technoference and relationship and sexual satisfaction among the young adult couple sample. Results indicated statistically significant negative actor effects between technoference and relationship and sexual satisfaction and statistically significant negative partner effects between technoference and relationship satisfaction.
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Affiliation(s)
- Christopher J Hipp
- Department of Educational Studies, University of South Carolina, Columbia, SC, USA
| | - Ryan G Carlson
- Department of Educational Studies, University of South Carolina, Columbia, SC, USA
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27
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Currin JM, Ireland ME, Cox K, Golden BL. Sextually aroused: A mixed-methods analysis of how it feels for romantic and sexual partners to send and receive sext messages. COMPUTERS IN HUMAN BEHAVIOR 2020. [DOI: 10.1016/j.chb.2020.106519] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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28
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Sexting within young adults’ dating and romantic relationships. Curr Opin Psychol 2020; 36:55-59. [DOI: 10.1016/j.copsyc.2020.04.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/18/2020] [Accepted: 04/21/2020] [Indexed: 11/19/2022]
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Cornelius TL, Bell KM, Kistler T, Drouin M. Consensual Sexting among College Students: The Interplay of Coercion and Intimate Partner Aggression in Perceived Consequences of Sexting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197141. [PMID: 33003567 PMCID: PMC7579237 DOI: 10.3390/ijerph17197141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022]
Abstract
Recent empirical data suggests that the majority of adolescents and emerging adults utilize digital technology to engage with texting and social media on a daily basis, with many using these mediums to engage in sexting (sending sexual texts, pictures, or videos via digital mediums). While research in the last decade has disproportionately focused on the potential risk factors and negative consequences associated with sexting, the data are limited by failing to differentiate consensual from non-consensual sexting and account for potential influences of intimate partner aggression (IPA) and sexting coercion in these contexts. In the current study, we assessed the positive and negative consequences associated with sexting, using behavioral theory as a framework, to determine the relationship between an individual's personal history of IPA victimization and the perceived consequences. Undergraduate students (N = 536) who reported consensual sexting completed a series of measures examining their most recent sexting experience, including perceived sexting consequences, and their history of sexting coercion and IPA. Results suggested that those reporting a history of any type of IPA victimization endorsed more negative reinforcing consequences after sending a sext, and those with a history of physical or sexual IPA victimization endorsed more punishing consequences after sending a sext than those without such history. Additionally, experience with IPA was found to be positively correlated with perceived pressure/coercion to send a sext. The implications of these data for research, policy, prevention, and intervention are explored.
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Affiliation(s)
- Tara L. Cornelius
- Department of Psychology, Grand Valley State University, 1 Campus Drive, Allendale, MI 49401, USA;
- Correspondence:
| | - Kathryn M. Bell
- Department of Psychology, Acadia University, Wolfville, NS B4P 2R6, Canada;
| | - Tylor Kistler
- Department of Psychology, Grand Valley State University, 1 Campus Drive, Allendale, MI 49401, USA;
| | - Michelle Drouin
- Department of Psychology, Purdue University-Fort Wayne, Fort Wayne, IN 46805, USA;
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30
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Predicting type of sext message sent in adults 25 and older using motivations to sext and relational attachment. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00680-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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31
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Currin JM, Pascarella LA, Hubach RD. “To feel close when miles apart”: qualitative analysis of motivations to sext in a relationship. SEXUAL AND RELATIONSHIP THERAPY 2020. [DOI: 10.1080/14681994.2020.1714024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Joseph M. Currin
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | | | - Randolph D. Hubach
- Department of Rural Health, Oklahoma State University Centre for Health Sciences, Tulsa, OK, USA
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Abstract
AbstractIn the midst of a ‘care crisis’, attention has turned again to families who are viewed both as untapped care resources and as disappearing ones. Within this apparent policy/demographic impasse, we test empirically theorised trajectories of family care, creating evidence of diverse patterns of care across the lifecourse. The study sample, drawn from a Statistics Canada national survey of family care, comprised all Canadians aged 65 and older who had ever provided care (N = 3,299). Latent Profile Analysis yielded five distinct care trajectories: compressed generational, broad generational, intensive parent care, career care and serial care. They differed in age of first care experience, number of care episodes, total years of care and amount of overlap among episodes. Trajectories generally corresponded to previously hypothesised patterns but with additional characteristics that added to our understanding of diversity in lifecourse patterns of care. The five trajectories identified provide the basis for further understanding how time and events unfold in various ways across lifecourses of care. A gap remains in understanding how relationships with family and social network members evolve in the context of care. A challenge is presented to policy makers to temper a ‘families by stealth’ policy approach with one that supports family carers who are integral to health and social care systems.
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33
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Falconer T, Humphreys TP. Sexting outside the primary relationship: Prevalence, relationship influences, physical engagement, and perceptions of “cheating”. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2019. [DOI: 10.3138/cjhs.2019-0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Research has not yet investigated the frequency of sexting outside of a primary relationship. Research consistently shows that most sexting occurs within the context of a relationship, but few studies have taken relationship status into account. Additionally, limited research has investigated if sexting is considered infidelity. This study aims to fill those gaps by examining sexting outside of the primary relationship. University students and community members were asked about their sexting activities outside of their primary relationship using an online questionnaire. Results indicate that 23% of participants have sexted outside of their relationship. Those who cohabitate with their primary partner or are in a non-monogamous relationship are more likely to sext with a secondary partner. The majority of people who sext outside of their relationship do so with five or less partners and do so less than once a month, indicating that sexting outside of the primary relationship is infrequent. Seventy-five percent of those that sexted secondary partners considered this act cheating. Lastly, 36% also engaged in face-to-face sexual activity with the secondary partners they sexted. The importance of considering relationship status variables in understanding sexting and infidelity is discussed.
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Affiliation(s)
- Tasha Falconer
- Department of Psychology, Trent University, Peterborough, ON
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Van Ouytsel J, Walrave M, Ponnet K. Sexting within adolescents' romantic relationships: How is it related to perceptions of love and verbal conflict? COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2019.03.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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35
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Longitudinal and reciprocal relationships between sexting, online sexual solicitations, and cyberbullying among minors. COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2019.01.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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36
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Currin JM, Hubach RD. Motivations for Nonuniversity-Based Adults Who Sext Their Relationship Partners. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:317-327. [PMID: 30638162 DOI: 10.1080/0092623x.2018.1526837] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Little is known about motivations of adults who sext their relationship partners. Participants (N = 126, 71 male) completed an online questionnaire to assess their motivations for sexting their current relationship partner(s). The results of a MANOVA indicated the overwhelming motivation was to initiate sexual behaviors for all groups. Other motivations of instrumental/aggressive reasons were significantly higher for heterosexual men, and body image reinforcement was significantly higher for sexual-minority men. With results indicating the main motivation to sext was to initiate sexual behaviors, the potential of using sexting as an intervention to increase sexual intimacy in relationships is discussed.
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Affiliation(s)
- Joseph M Currin
- a Department of Psychological Sciences , Texas Tech University College of Arts and Sciences , Lubbock , Texas , USA
| | - Randolph D Hubach
- b Department of Rural Health , Oklahoma State University Center for Health Sciences , Tulsa , Oklahoma , USA
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