Sexting: The Influence of Improving Emotion Regulation in Young, at-Risk Adolescents

Introduction: Sexting is a common adolescent behavior (15% to 28% of adolescents) that has been linked to substance use, sexual behavior, and risky sexual behavior. Teen sexting has also been associated with lower emotional awareness and limited access to emotion regulation strategies. However, this link has yet to be tested in a prospective clinical trial. Project TRAC is an effective intervention designed to improve emotion regulation in at-risk middle school students.  The intervention focused on sexual risk, but did not explicitly target sexting behavior. This analysis examines whether improving emotion regulation can influence sexting in a group of at-risk middle school students. 

Methods: Project TRAC included 420 seventh-grade adolescents from five public middle schools were identified by school staff as being at-risk for behavioral and emotional problems. Participants were randomized to an Emotion Regulation (ER) intervention or an intensive Health Promotion (HP) control. Each arm consisted of 12 hour-long sessions that met bi-weekly after school over the course of 6 weeks, as well as two booster sessions at 6- and 12-months post-intervention. Participants were administered computerized questionnaires pre-intervention, and at 6, 12, 18, and 24 months post-intervention. Participants were asked self-report questions regarding sexting behaviors at each time point, including a) whether they have sent or received sexually explicit messages during the last 6 months, and b) whether messages were text only, text and picture, or picture only. Analyses focused on whether or not participants sent an explicit picture.   

Results: At baseline, 5% reported sending an explicit picture (ER = 6%; HP = 5%). Time-to-event analyses were used to test the treatment effect for ER vs HP in delaying the onset of sending an explicit picture (Hazard Ratio = .67, p = .06). Generalized Estimating Equations were used to examine longitudinal differences between ER vs. HP in the number of participants who reported sending a picture. Two linear effects were tested—one from baseline to 12 months (Odds Ratio [OR] = .64, p = .03) and one from 12 to 24 months (OR = 1.50, p = .04), suggesting that the participants in the ER condition were less likely to report sending an explicit picture through the 12 month assessment but “caught-up” to the HP condition by the 24 month assessment.

Conclusions: Results suggest that improving emotion regulation influences whether or not young adolescents send or receive sexually explicit pictures. These findings provide additional support to previously reported findings that improving emotion regulation helps to reduce sexual risk behaviors among young adolescents who are at risk for emotional and behavioral difficulties.