select search filters
roundups & rapid reactions
factsheets & briefing notes
before the headlines
Fiona fox's blog

expert reaction to study on sexting, sexual behaviours and metal health in adolescents

Research published in JAMA Pediatrics suggests that sexting is  associated with sexual behaviour and mental health difficulties, especially in younger adolescents.


Dr Qazi Rahman, Senior Lecturer in Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London

“This study is a collation of existing research on the relationship between sexting, sexual behaviour and mental health outcomes. The study finds expected associations but these are correlational and so we cannot know about causation. The associations look pretty small to me, and there was lots of variability between the studies and in the scientific quality of the studies examined. It is also likely that there may some common factor which links sexting, sexual activity and mental health. These could include many things such as personality, environmental variables, and even biological factors.”


Prof Cicely Marston, Professor of Public Health, London School of Hygiene & Tropical Medicine (LSHTM), said:

“This study provides some indicative findings relating to correlates of sexting but suffers from lack of clear definitions throughout and any conclusions need to be treated with caution. Most of the key terms are left undefined and as a result it is unclear what we can learn from the analysis. There is no clear definition of ‘sexting’: the authors note there is no universal definition and seem to take an inclusive approach, but do not provide the definitions used in the included studies so it is unclear what ‘sexting’ the data relate to.

“Similarly, the authors use the term ‘sexual activity’ but do not explain what they mean by this. It would be plausible to include sexting itself as ‘sexual activity’, for example, and it seems possible that the correlation between sexting and ‘sexual activity’ is because the two are facets of a sexual relationship rather than sexting ‘causing’ sexual activity (however defined). As with the other categories, the frequency/timing of ‘sexual activity’ is also left undefined (sexual activity ever? Once? Recently?).

“’Lack of contraception use’ is also not defined – for example no contraceptive methods are specified and nor is any frequency/timing of ‘lack of use’ e.g. does using withdrawal on one occasion but using condoms on all others count as ‘lack of contraception use’ or would a person have to report never using contraception at all to be added to this category? All of the other categories suffer from the same lack of precise definition, and also do not have any specification about the frequency/timing. For instance, what is ‘delinquent behaviour’ in this context? Do people self-define as ‘delinquent’ or having been caught doing something ‘delinquent’? How often? When? How are anxiety and depression defined? What counts as alcohol use? What drugs are counted under ‘drug use’? Does ‘smoking’ imply ‘ever smoking’ or ‘regularly smoking’ and so on.

“There also seems to be an assumption that ‘sexting’ is a heterosexual activity (otherwise why mention contraception?) and certainly there is no explicit consideration of diverse gender identities or sexualities which again limits what we can understand from the findings.”


‘Association of Sexting With Sexual Behaviors and Mental Health Among Adolescents’ by Camille Mori et al. was published in JAMA Pediatrics at 16:00 UK time on Monday 17th June.  


Declared interests

Dr Qazi Rahman: No interests to declare

None others received.



in this section

filter RoundUps by year

search by tag