IMPORTANCEThe existing literature on sexting among youth shows that sexting is a predictor of sexual behavior and may be associated with other health outcomes and risky behaviors. However, there remains a lack of consensus on the prevalence of sexting, which is needed to inform future research, intervention, and policy development.OBJECTIVE To provide a meta-analytic synthesis of studies examining the prevalence of multiple forms of sexting behavior, analyzed by age, sex, geography, and method of sexting.DATA SOURCES In an academic setting, electronic searches in MEDLINE, PsycINFO, EMBASE, and Web of Science were conducted for the period January 1990 to June 2016, yielding 1147 nonduplicate records.STUDY SELECTION Studies were included if participants were younger than 18 years and the prevalence of sexting explicit images, videos, or messages was reported.DATA EXTRACTION AND SYNTHESIS Literature review and data extraction followed established PRISMA guidelines. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive the mean prevalence rates. Thirty-nine studies met final inclusion criteria.MAIN OUTCOMES AND MEASURES Meta-analyses of the prevalence of sending, receiving, and forwarding without consent, as well as having one's sext forwarded without consent. RESULTS Among 39 included studies, there were 110 380 participants; the mean age was 15.16 years (age range, 11.9-17.0 years), and on average 47.2% were male. Studies were available for sending (n = 34), receiving (n = 20), forwarding without consent (n = 5), and having a sext forwarded without consent (n = 4). The mean prevalences for sending and receiving sexts were 14.8% (95% CI, 12.8%-16.8%) and 27.4% (95% CI, 23.1%-31.7%), respectively. Moderator analyses revealed that effect sizes varied as a function of child age (prevalence increased with age), year of data collection (prevalence increased over time), and sexting method (higher prevalence on mobile devices compared with computers). The prevalence of forwarding a sext without consent was 12.0% (95% CI, 8.4%-15.6%), and the prevalence of having a sext forwarded without consent was 8.4% (95% CI, 4.7%-12.0%). CONCLUSIONS AND RELEVANCEThe prevalence of sexting has increased in recent years and increases as youth age. Further research focusing on nonconsensual sexting is necessary to appropriately target and inform intervention, education, and policy efforts.

It has long been claimed that “maltreatment begets maltreatment,” that is, a parent's history of maltreatment increases the risk that his or her child will also suffer maltreatment. However, significant methodological concerns have been raised regarding evidence supporting this assertion, with some arguing that the association weakens in samples with higher methodological rigor. In the current study, the intergenerational transmission of maltreatment hypothesis is examined in 142 studies (149 samples; 227,918 dyads) that underwent a methodological quality review, as well as data extraction on a number of potential moderator variables. Results reveal a modest association of intergenerational maltreatment (k= 80;d= 0.45, 95% confidence interval; CI [0.37, 0.54]). Support for the intergenerational transmission of specific maltreatment types was also observed (neglect:k= 13,d= 0.24, 95% CI [0.11, 0.37]; physical abuse:k= 61,d= 0.41, 95% CI [0.33, 0.49]; emotional abuse:k= 18,d= 0.57, 95% CI [0.43, 0.71]; sexual abuse:k= 18,d= 0.39, 95% CI [0.24, 0.55]). Methodological quality only emerged as a significant moderator of the intergenerational transmission of physical abuse, with a weakening of effect sizes as methodological rigor increased. Evidence from this meta-analysis confirms the cycle of maltreatment hypothesis, although effect sizes were modest. Future research should focus on deepening understanding of mechanisms of transmission, as well as identifying protective factors that can effectively break the cycle of maltreatment.

Sexting is the sharing of sexually explicit images, videos, and/or messages via electronic devices. Prevalence estimates of sexting have varied substantially, potentially due to broad age ranges being examined. The current study sought to synthesize relevant findings examining the prevalence of consensual and non-consensual sexting in a specific developmental period, emerging adulthood (≥ 18-< 29), to try to explain discrepancies in the literature. Searches were conducted in electronic databases for articles published up to April 2018. Relevant data from 50 studies with 18,122 emerging adults were extracted. The prevalence of sexting behaviors were: sending 38.3% (k = 41; CI 32.0-44.6), receiving 41.5% (k = 19; CI 31.9-51.2), and reciprocal sexting 47.7% (k = 16;). Thus, sexting is a common behavior among emerging adults. The prevalence of non-consensual forwarding of sexts was also frequent in emerging adults at 15.0% (k = 7; CI 6.9-23.2). Educational awareness initiatives on digital citizenship and psychological consequences of the non-consensual forwarding of sexts should be targeted to youth and emerging adults with the hopes of mitigating this potentially damaging and illegal behavior.

The results of this study suggest that teaching medical students about the realities and impacts of stereotypes on Aboriginal peoples is a good starting point from which to address issues of racism and health inequities affecting the health of Aboriginal people.

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