Association between sexting and depression among youth: Evidence from a large-sample cross-sectional study in...

Sexting has become increasingly common among youth worldwide, yet evidence from mainland China is limited. This study aimed to estimate the prevalence of sexting and examine how its characteristics-such as frequency, partner relationship, medium, and non-consensual experiences-are associated with depression among youth in Guangzhou. A cross-sectional survey was conducted between October and November 2022 among 17,035 vocational college students aged 16-24 years, selected through multistage stratified cluster sampling (response rate: 57.0%). Sexting characteristics were assessed across five dimensions: frequency, partner relationship, transmission medium, media type, and non-consensual experiences. Depression was measured using the CES-D10 scale. Logistic regression models were applied to examine associations. Overall, 2.5% (n = 427) reported ever engaging in sexting. Among them, 62.8% exhibited depressive symptoms. Specific characteristics of sexting showed differential associations with depression. Monthly (ORa = 2.66, 95% CI: 1.45-4.98) and weekly sexting (ORa = 3.19, 95% CI: 1.77-5.90) were significantly associated with depression, while daily sexting was not. Non-consensual sexting-sending nude images under pressure (ORa = 2.70, 95% CI: 1.27-6.28) or receiving unsolicited nude images (ORa = 2.42, 95% CI: 1.20-5.24)-was also linked to increased depression risk. In contrast, variations in partner type, medium, or media form showed no significant associations. Despite the relatively low prevalence of sexting, specific characteristics-particularly sporadic and non-consensual sexting-were associated with elevated risk of depression. These findings highlight the importance of culturally tailored sexual health education addressing digital consent, privacy, and mental well-being among Chinese youth.