Abstract
Objective Sexting has been linked to negative mental health outcomes. This Taiwan-based study addresses the links between sexting, cyberbullying, self-harm, and gender differences in the association of sexting and self-harm behavior. Methods A two-stage stratified sampling of 5,190 Taiwanese adolescents aged 11-18 completed an online questionnaire measuring sexting, bullying/cyberbullying, and self-harm. Two-way interaction model was used to identify the effect of gender on the relationship between sexting and self-harm behavior. The relationship between sexting and self-harm risk was tested in both the total sample and in different gender groups using univariable and multivariable linear regression models. Results 2.5% of adolescents engaged in some form of sexting in the past year. 1.7% had sent their own picture or video. 1.0% had experienced non-consensual sexting, and 0.9% had sexted under pressure. Female gender, sexting one's own information, non-consensual sexting, and pressured sexting were associated with higher self-harm scores. Conclusion This is the first study to focus on gender differences in the association between different types of sexting and self-harm in a non-Western society. The impact of sexting on self-harm was found to differ between males and females. Different types of sexting may also be associated with different risks of self-harm. Psychiatry Investig 2025;22(9):989-996