Sexting: Psychopathology or the New Normal in Adolescent Sexual Development?

A sizable and growing number of people under age 18 engage in sexting—which is defined as the practice of electronically sharing sexually explicit material, often provocative or nude pictures of themselves or peers. It is estimated that 1 in 7 teens are sending “sexts” and 1 in 4 are receiving them. In this meta-analysis by Madigan et al, 39 studies, which included 110,380 participants, revealed that the prevalence rate for sending and receiving sexts were 14.8% and 27.4%, respectively.

Previous research published in the Journal of Pediatrics (2016) suggests that sexting may be the new “normal” of adolescent sexual development and is not limited to the usual at-risk group of adolescents. Yet the results on sexting are confusing. The 2016 study showed that sexting may precede sexual intercourse, or it may not. The best available evidence does not find a statistically valid link between sexting and risky sexual behavior over time.

But why?

Despite this growing body of knowledge, the sexting research is cross sectional by design. The limitations of this methodology is that it can only produce a “snapshot” in time, across vast samples of diverse groups of young people. A longitudinal design would reveal trends and outcomes by following the same people over a predetermined timeframe.

As a result, it’s unclear to what degree sexting is a risk factor for future risky sexual behavior or an emerging behavioral norm in adolescent sexual development. That being said, some experts assert sexting, among any age cohort, is another form of pornography which is highly addictive for some, and increasing in prevalence. Pornography now with high speed internet is quite a different experience than magazines or dial up internet porn. This portends even more problems as virtual reality and sexbots are becoming more popular and very profitable. All cause craving, wanting, and increase dopamine levels in the brain’s reward center—which is the common thread in all addictive behavior.

Why Does This Matter?

The prevalence of health risk behavior among adolescents is an important public health issue. Substance abuse, sexually transmitted illness, pregnancy, depression and suicidality are leading causes of mortality among teens.

Further research focusing on both consensual and nonconsensual sexting, and the effects on adolescent sexual development and the psychological impact is an important next step if we are to identify targets for intervention, education, and policy development.


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Madigan  S, Ly  A, Rash  CL, Van Outsyel  J, Temple  JR.  Prevalence of multiple forms of sexting behavior among youth: a systematic review and meta-analysis  [published online February 26, 2018].  JAMA Pediatr. doi:10.1001/jamapediatrics.2017.5314