Does the Internet Really Make Everyone Crazy?

Sociologists call them moral panics — when a population pins its unanchored fear in uncertain times on a selected demon, whether or not the target is really a threat to society. Drugs are a frequent focus of these societal anxiety attacks, but this week, Newsweek tries to foment a classic panic against a more universal foe: the Internet.

Headlined online “Is the Web Driving Us Mad?” the article begins with the story of Jason Russell, the filmmaker behind the “Kony2012″ video about the African cult-leader and warlord Joseph Kony. After the video went viral and suddenly brought Russell international fame, he wound up naked and ranting on a San Diego street corner. To make the case that the Internet caused Russell’s psychotic break, the Newsweek article rapidly generalizes from rare, extreme experiences like Russell’s and wends through a selective reading of the research to argue, in the words of one quoted source, that the Net, “encourages — and even promotes — insanity.”

(MORE: The Internet Knows You’re Depressed, but Can It Help You?)

According to senior writer Tony Dokoupil:

The first good, peer-reviewed research is emerging, and the picture is much gloomier than the trumpet blasts of Web utopians have allowed. The current incarnation of the Internet—portable, social, accelerated, and all-pervasive—may be making us not just dumber or lonelier but more depressed and anxious, prone to obsessive-compulsive and attention-deficit disorders, even outright psychotic. Our digitized minds can scan like those of drug addicts, and normal people are breaking down in sad and seemingly new ways.

The problem is, this conclusion runs counter to what the research data actually show.

Dokoupil makes much of brain scan studies suggesting that Internet use “rewires” the brain in ways that look similar to changes seen in drug addiction. The reality is that any enjoyable activity leads to changes in the brain’s pleasure regions if a person engages in it frequently enough. Indeed, any activity we perform repeatedly will lead to brain changes: that’s known as learning. Riding a bicycle and playing the violin also rewire the brain, but we don’t choose to refer to these changes as “damage.”

As yet, there is no brain scan that can clearly determine whether certain brain changes signify addiction or simple, harmless enjoyment. Nor can brain scans predict, in the case of addiction, who will be able to regain control over their behavior and who will not.

(MORE: Hooked on Addiction: From Food to Drugs to Internet Porn)

Dokoupil cites a study that scanned 24 people, some experienced Web users and some who were less proficient. He says that the regular users had “fundamentally altered prefrontal cortexes,” but he fails to mention that the research only explored people’s Google use — comparing Google aficionados to newbies. He writes further that just five hours of time spent online (using Google) “rewired” the brains of the new users. This, of course, tells us nothing about addiction: we don’t know if the experienced Google searchers were even having trouble controlling their Internet use, or whether, based on one small study, a tiny bit of experience learning how to search the Web can “rewire” the brain dramatically. If so, then everyone’s addicted — or no one is, and the brain changes are meaningless.

Dokoupil acknowledges that the research linking Web and smartphone use to psychiatric problems cannot show clear cause and effect, but he brushes off this important caveat with quotes from experts who conduct this research and use it to confirm their own clinical observations — in other words, anecdotes, which are an even sketchier source of data — and make causal claims.

In truth, the research linking Internet use to addiction, depression or other behavioral and psychiatric problems simply cannot determine whether being online causes these ills or whether people who are already prone to such problems tend to go online more. In fact, there’s better evidence (not mentioned in the article) that the Internet can be used to treat anxiety and depression than there is suggesting it causes these problems. Randomized controlled trials of online therapy for depression have found it to be as effective as traditional therapy — and only randomized controlled trials, not the observational data cited by Newsweek, can scientifically demonstrate cause and effect.

(MORE: Study: Playing a Video Game Helps Teens Beat Depression)

Dokoupil also approvingly cites an expert who has become a target of widespread ridicule in the science blogosphere for her extreme claims about Internet-related brain damage. Baroness Susan Greenfield, a pharmacology professor at Oxford, told Dokoupil in her typically understated way that the Internet problem “is an issue as important and unprecedented as climate change.”

Greenfield has never published a study on Internet use. The logic behind her claims is often befuddling: for example, this is how she attempted to explain why she believes the Internet has something to do with the recent rise in autism, in a 2011 interview with the Guardian: “I point to the increase in autism and I point to Internet use. That’s all.” Obviously, that is not scientific reasoning, which is why her comments inspired an Internet meme (among other outrage and disdain) that trended on Twitter.

Dr. Ben Goldacre, a leading British science journalist and author of the “Bad Science” blog, sums up the criticisms of Greenfield this way: “[Her ideas] are never set out as a clear hypothesis, in a formal academic publication, with the accompanying evidence and a clear suggestion of what research programmes might be planned to clarify any uncertainties.”

The Newsweek feature also highlights stories from China, Taiwan and Korea, where Internet addiction has been accepted as a genuine psychiatric problem and treatment centers have been set up to deal with it. “Tens of millions of people (and as much as 30 percent of teens) are considered Internet-addicted” in these countries, Dokoupil writes.

Those facts, however, don’t necessarily mean that Internet addiction exists, let alone that it is widespread. Simply naming a disease and treating it doesn’t make it real, no more than the existence of witch hunts proves the existence of witches. Indeed, some of the treatments used for Internet addiction, such as the abusive Internet treatment boot camps in China where several teens have died, suggest how easily the cure can become worse than the disease when unproven therapies for ill-defined problems spring up. (Boot camps have never been shown to help with any form of addiction.)

(MORE: Blogging Helps Socially Awkward Teens)

In fact, while expanding the diagnoses for addiction overall, the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), psychiatry’s diagnostic manual, which will be published next year, rejected Internet addiction as a bona fide disorder. The Newsweek article spun this fact, highlighting instead that Internet addiction “will be included for the first time, albeit in an appendix tagged for “further study.’”

The truth is, we really don’t know much about how our online lives are affecting us. It’s quite possible that Internet use has the deleterious effects critics suggest — certainly some people do have difficulty controlling the amount of time they spend online. But is it the addictive effect of the Internet that keeps us checking our work emails on vacation or during evenings and weekends — or is it the fact that we fear we may lose our jobs if we don’t?

The Internet might indeed be a cause of our societal worries, but not necessarily because we’re addicted to it. And creating a moral panic based on flimsy evidence isn’t going to help, no matter what the real cause of our problems.

Maia Szalavitz is a health writer for TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland‘s Facebook page and on Twitter at @TIMEHealthland.

Read more: http://healthland.time.com/2012/07/13/does-the-internet-make-everyone-or-just-journalists-crazy/#ixzz20liW8KQU

Sexonomics: Putting your ‘erotic capital’ to work

2012-07-13

Madonna’s got it. So do George Clooney, Tina Turner and Robert Redford.

These celebrities are certainly good-looking, but they also possess what sociologist Catherine Hakim has dubbed “erotic capital” – a term that describes a certain je ne sais quoi that includes, but isn’t limited to, sexual attractiveness.

Harness your erotic capital, Hakim boldly suggests in her recent book by the same name and you’ve got the potential to not only land a mate, but to get ahead at work and in society as a whole.

Sociologists and economists have long recognized three main types of capital: social, economic and cultural. Your capital depends on the assets and resources you can potentially use for gain, whether that means making more money or making more friends. But we’re neglecting a fourth important kind of capital, Hakim argues.

By her definition, erotic capital is more than just good looks and has six main facets:

1. Beauty

2. Sexual attractiveness

3. Social skills/likeability

4. Liveliness

5. Style

6. Sexual competence

While one of these characteristics might make you gorgeous or funny or fun, you need the whole group to maximize erotic capital. And you don’t have to be born with it – erotic capital is cultivated and learned and has a lot to do with your self-esteem.

Even if you’ve got “it” you might not be capitalizing on it. Hakim says women have more erotic capital than men do — and that they should be exploiting it more as a result.

She bases this idea partly on studies that suggest that men tend to have stronger libidos than women.

“Men’s demand for sexual activity and erotic entertainment of all kinds greatly exceeds women’s interest in sex,” Hakim writes. In this line of thinking, sex has a market value, and women have the potential to leverage their ability to supply men’s demand for it.

I find this theory interesting, although I certainly don’t agree with it fully. As I’ve discussed in an earlier column on low male libido, there are plenty of couples in which the woman wants more sex and is coping with a male partner who has a low sex drive. And as the recent frenzy for the erotic trilogy “Fifty Shades of Grey” makes clear, women have a voracious appetite for sexual entertainment.

At the same time, we live in a culture that has become increasingly centered around sex. Many women already feel as if they need to compete with porn stars, strippers and celebrity sex tapes for male attention. Are we really suggesting that society needs more of this, not less?

Just as sexism still exists, so too does “looksism.” People considered attractive, regardless of their gender, tend to be treated more favorably than their less-attractive counterparts.

In his book “Beauty Pays: Why Attractive People are More Successful” economist Daniel Hamermesh contends that good-looking men earn approximately 17% more money than not so good-looking men, while attractive women earn 12% more; as a whole attractive people earn a total of $230,000 more than those considered unattractive (based on average wage of $20 per hour), according to Hamermesh.

While most would respond that “appearance-discrimination” is an unsavory aspect of our society that we should be seeking to transcend, Hakim maintains that erotic capital has been largely ignored because “it is held mostly by women, and the social sciences have generally overlooked or disregarded women in their focus on male activities, values, and interests.”

Yet she also blames feminists for neglecting an opportunity to exploit female erotic capital; feminist theory, she says, encourages women to choose between using their looks and using their intelligence to succeed.

As you might imagine, critics bridle at many of her claims. As Anna North writes on the post-feminist blog Jezebel, “The bottom line is that ‘erotic capital’ is all about others’ perceptions of women, rather than about things women themselves can do or acquire. That’s the main reason ‘soft power’ isn’t real power — because when your influence is based on someone else’s desire, he’s the one who’s really in control.”

I do think Hakim makes some compelling points. Sure, strippers, porn stars, cocktail waitresses and even geishas are financially dependent on their ability to take advantage of their erotic power by making themselves appealing to men. But erotic capital may have subtler effects, too.

Who among us — male or female — hasn’t found that a smile, laugh, and a little harmless flirting can have the potential to open doors, whether that means getting a better table at a restaurant, a raise at work or securing a second date?

And erotic capital isn’t solely the domain of women. “Men now find it necessary to develop their erotic capital as well,” admits Hakim. “They are devoting more time and money to their appearance, work out in gyms to maintain an attractive body, spend more on fashionable clothes and toiletries, and display more varied hairstyles.”

Perhaps they’ve realized that a little erotic capital never hurt anyone. And if the success of the hit male stripper film “Magic Mike” is any indication, women are happy to share the power.
Post by: Ian Kerner Ph.D. – sex counselor
Filed under: Living Well • Sex

Treatment guidelines for Gender Identity Disorder in development

2012-07-10

n recent years, stories about transgender people have been front page news. The transformation of Chaz Bono, son of singers Sonny and Cher, from female to male is perhaps the most well known.

“In puberty, I felt like my body was betraying me,” Bono said in an interview. Now the nation’s top psychiatrists are beginning to talk about developing treatment guidelines for transgender people.

Mental health experts say Bono and people like him have Gender Identity Disorder (GID). “People with GID are distressed with the sense that they were born in the wrong body”, says Dr. William Byne, chair of the American Psychiatric Association Task Force that recommended forming the guidelines.

As children, for example, people with GID may insist they are a boy when they are biologically female. Experts say it becomes a problem if they become anxious because of their gender and it interferes with their relationships and work.

It’s difficult to know exactly how many people have GID. Ken Zucker, Psychologist-in-Chief at the Centre for Addiction and Mental Health in Toronto, estimates 1 in 1,000 children have the disorder, but many grow out of it. Only about 1 in 30,000 adult males and 1 in 100,000 adult females seek sex-reassignment surgery.

The Task Force believes that the guidelines will help psychiatrists improve the quality of care for transgender people.

“For all age groups, we hope that having guidelines will increase the number of psychiatrists and other mental health professionals who are trained to provide care in this area,” Byne said.

Among the issues the task force says should be considered:

That the patient knows all treatment options
That the mental health needs of transgender people are addressed
And that ethical issues surrounding treatment are discussed

The biggest concern is how to treat children. Experts say when it comes to treatment, one size doesn’t fit all. Byne hopes the guidelines will help parents make informed decisions about what’s best for their child: Should they wait and watch, discourage the cross-gender actions, or just encourage cross-gender identity?

The Task Force report was published in the journal Archives of Sexual Behavior.
Post by: Krisha Desai – CNN Medical Intern
Filed under: Psychology • Sex

Women who fear childbirth just got something else to worry about: a recent Norwegian study found that women who were scared of giving birth ended up spending more time in labor, about 8 hours versus 6.5 for women who weren’t afraid. According to the study’s authors, 5% to 20% of pregnant women fear giving birth. The reasons vary, from the mothers being young or never having given birth before to their having pre-existing psychological problems, a lack social support or a history of abuse or bad obstetric experiences. The study also found that mothers who feared childbirth were also more likely than unafraid women to need an emergency C-section (11% versus 7%) or assistance with instruments such as forceps for vaginal delivery (17.0% versus 11%). Overall, about a quarter of women who feared childbirth delivered without any obstetric interventions, compared with nearly 45% of women who were not afraid. “Fear of childbirth seems to be an increasingly important issue in obstetric care. Our finding of longer duration of labor in women who fear childbirth is a new piece in the puzzle within this intersection between psychology and obstetrics,” study author Samantha Salvesen Adams of Akershus University Hospital at the University of Oslo in Norway said in a statement. (MORE: Patience, Mom: More Hospitals Say No to Scheduled Delivery Before 39 Weeks) The researchers studied 2,206 women from pregnancy through childbirth. When the women were 32 weeks pregnant, the researchers assessed their fear of childbirth using a standard questionnaire. Women who scored higher than 85 were considered fearful; out of all the women, 165, or 7.5%, scored higher than 85. The researchers then analyzed the time they spent in childbirth. Women who were afraid labored for an hour and 32 minutes longer than did other moms. Even after adjusting for other factors that affect labor, such as epidural anesthesia, induction and instrument-assisted delivery, fearful women took 47 minutes longer to deliver than women who had less apprehension about giving birth. The authors note, however, that despite their fear, 89% scared mothers still succeeded in delivering vaginally, as they’d intended. That proportion was close to the 93% of women without fear who also succeeded. “Generally, longer labor duration increases the risk of instrumental vaginal delivery and emergency caesarean section,” said Adams. “However, it is important to note that a large proportion of women with a fear of childbirth successfully had a vaginal delivery.” Adams suggests that elective C-section shouldn’t be routinely recommended for fearful women, since, as the study’s findings show, they can still deliver vaginally if they wish. (MORE: Pregnant Women Who Control their Epidural Dosage Use Less Medication) The authors offer two theories for why women who are afraid of labor spend more time doing it. One is that they may psych themselves out. “Mental stress is associated with physiological arousal and release of stress hormones. During labor, high levels of stress hormones may weaken uterine contractility and thereby prolong labor in women with fear of childbirth,” says Adams. Another explanation is that fear of childbirth may interfere with clear communication between the mother in labor and the obstetric staff. “Poor communication with health personnel may delay obstetric interventions,” Adams says. “There are a number of reasons why women may develop a fear of childbirth,” said John Thorp, editor-in-chief of BJOG: An International Journal of Obstetrics and Gynaecology, the journal in which the new study is published, in a statement. “This research shows that women with fear of childbirth are more likely to need obstetric intervention and this needs to be explored further so that obstetricians and midwives can provide the appropriate support and advice.”

2012-07-09

Children who are pushed, grabbed, shoved, slapped or hit are more likely to be diagnosed with mental illness. Just one more reason to embrace alternative forms of discipline
By Bonnie Rochman | @brochman

What if we, as a society, could cut down on the incidence of mental illness by backing away from hitting, grabbing or pushing our children?

That’s a prospect raised by a new study in Pediatrics, which finds that harsh physical punishment increases the risk of mental disorders — even when the punishment doesn’t stoop to the level of actual abuse.

What qualifies as appropriate punishment is a hot-button topic among parents. The American Academy of Pediatrics opposes corporal punishment, but studies have shown that up to 80% of parents report that they rely on it to some extent. What constitutes physical punishment is also wide-ranging: everything from a light slap on the hand to an all-out whipping with a belt or a paddle.

“In the general population, there is a belief that physical punishment is O.K. as long as you’re not doing it in anger and you’re a warm and loving parent,” says Tracie Afifi, the study’s author and an assistant professor in the Department of Community Health Sciences at the University of Manitoba in Canada. “But there’s no data supporting that.”

(MORE: Why Spanking Doesn’t Work)

Afifi and colleagues decided to examine five forms of physical punishment — pushing, grabbing, shoving, slapping and hitting — that took place in the absence of even more severe acts of abuse or neglect such as punching, burning, physical neglect or sexual abuse. Other related research has not specifically included or excluded more severe types of abuse, meaning that the abuse — and not the grabbing or slapping — may be driving the relationship between physical punishment and mental disorders.

She did not examine spanking because it’s not easy to define: what’s considered spanking varies from parent to parent. But, she says, “a push is a push, and a grab is a grab.”

In the study, researchers analyzed more than 20,000 people in the U.S. who were age 20 or older: 1,258 who had experienced pushing, grabbing, shoving, slapping and hitting sometimes or very often, and 19,349 who reported they had experienced it rarely or never. They adjusted results for gender, race, marital status, education and a history of family dysfunction; if the person’s parents had drug problems or were hospitalized for mental illness, that could have affected their use of physical punishment.

Across the board, people who’d experienced physical punishment were more likely to experience nearly every type of mental illness examined. Their risk of mood disorders, including depression and mania, was 1.5 times greater than people who hadn’t been slapped or grabbed. The risk of depression alone was 1.4 times greater, which was the same rate for anxiety. People who’d been physically punished were 1.6 times more likely to abuse alcohol, and 1.5 times more likely to abuse drugs.

(MORE: How Child Maltreatment May Scar the Brain)

“There’s going to be lot of people that think that a parent absolutely needs to use physical force to raise a compliant child,” says Afifi. “It’s pretty well established that physical abuse has a negative impact on mental health, but this is showing the same effect even when you look at milder forms of physical force. This is saying that physical punishment should not be used on children of any age.”

George Holden, a professor of psychology at Southern Methodist University in Dallas who published research last year on the first real-time study of parents physically disciplining their kids, says Afifi’s findings fit into a “large constellation” of studies that show children whose parents use physical force are at greater risk for depression and anxiety. “This is yet another study documenting that this practice can result in unintended negative consequences,” says Holden. “Other studies have shown corporal punishment in childhood carries over to adulthood in terms of aggression, so there’s no reason why it wouldn’t in the area of mental health.”

Afifi hopes that “reasonable” parents will read about her research and decide to swear off physical punishment. Pediatricians can be part of the solution, talking to parents about alternative methods. “It’s never too late to stop,” she says, though she acknowledges a “cultural shift” needs to happen in order to turn the tide.

MORE: The New Science Behind Children’s Temper Tantrums

Rochman is a reporter at TIME. Find her on Twitter at @brochman. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.

Read more: http://healthland.time.com/2012/07/02/physical-punishment-increases-your-kids-risk-of-mental-illness/?iid=hl-article-editpicks#ixzz206BL2Na6

Why Women Who Fear Childbirth Spend More Time in Labor

Women who fear childbirth just got something else to worry about: a recent Norwegian study found that women who were scared of giving birth ended up spending more time in labor, about 8 hours versus 6.5 for women who weren’t afraid.

According to the study’s authors, 5% to 20% of pregnant women fear giving birth. The reasons vary, from the mothers being young or never having given birth before to their having pre-existing psychological problems, a lack social support or a history of abuse or bad obstetric experiences.

The study also found that mothers who feared childbirth were also more likely than unafraid women to need an emergency C-section (11% versus 7%) or assistance with instruments such as forceps for vaginal delivery (17.0% versus 11%). Overall, about a quarter of women who feared childbirth delivered without any obstetric interventions, compared with nearly 45% of women who were not afraid.

“Fear of childbirth seems to be an increasingly important issue in obstetric care. Our finding of longer duration of labor in women who fear childbirth is a new piece in the puzzle within this intersection between psychology and obstetrics,” study author Samantha Salvesen Adams of Akershus University Hospital at the University of Oslo in Norway said in a statement.

(MORE: Patience, Mom: More Hospitals Say No to Scheduled Delivery Before 39 Weeks)

The researchers studied 2,206 women from pregnancy through childbirth. When the women were 32 weeks pregnant, the researchers assessed their fear of childbirth using a standard questionnaire. Women who scored higher than 85 were considered fearful; out of all the women, 165, or 7.5%, scored higher than 85.

The researchers then analyzed the time they spent in childbirth. Women who were afraid labored for an hour and 32 minutes longer than did other moms. Even after adjusting for other factors that affect labor, such as epidural anesthesia, induction and instrument-assisted delivery, fearful women took 47 minutes longer to deliver than women who had less apprehension about giving birth.

The authors note, however, that despite their fear, 89% scared mothers still succeeded in delivering vaginally, as they’d intended. That proportion was close to the 93% of women without fear who also succeeded.

“Generally, longer labor duration increases the risk of instrumental vaginal delivery and emergency caesarean section,” said Adams. “However, it is important to note that a large proportion of women with a fear of childbirth successfully had a vaginal delivery.”

Adams suggests that elective C-section shouldn’t be routinely recommended for fearful women, since, as the study’s findings show, they can still deliver vaginally if they wish.

(MORE: Pregnant Women Who Control their Epidural Dosage Use Less Medication)
The authors offer two theories for why women who are afraid of labor spend more time doing it. One is that they may psych themselves out. “Mental stress is associated with physiological arousal and release of stress hormones. During labor, high levels of stress hormones may weaken uterine contractility and thereby prolong labor in women with fear of childbirth,” says Adams.
Another explanation is that fear of childbirth may interfere with clear communication between the mother in labor and the obstetric staff. “Poor communication with health personnel may delay obstetric interventions,” Adams says.

“There are a number of reasons why women may develop a fear of childbirth,” said John Thorp, editor-in-chief of BJOG: An International Journal of Obstetrics and Gynaecology, the journal in which the new study is published, in a statement. “This research shows that women with fear of childbirth are more likely to need obstetric intervention and this needs to be explored further so that obstetricians and midwives can provide the appropriate support and advice.”

Read more: http://healthland.time.com/2012/06/29/why-women-who-fear-childbirth-end-up-spending-more-time-in-labor/?iid=hl-main-feature#ixzz2068d1Fz1

Nearly 1 in 3 Teens Sext, Study Says. Is This Cause for Worry?

2012-07-05

Nearly 1 in 3 teens has sent a nude picture of him or herself to someone else, and more than half have been asked to do so, according to new research on nearly 1,000 Texas teens. The study, published Monday in the Archives of Pediatrics and Adolescent Medicine, also found that teen “sexting” is strongly linked to actual sexual behavior.

About 77% of girls aged 14 to 19 who had sent a sext reported having had intercourse, compared with 42% of those who hadn’t sexted. For boys, 82% of those who had sexted had had sex, while 46% of non-sexters had done so. The study included teens in the 10th and 11th grades, with an average age of about 16 (the overall age range spanned 14 to 19).

The new research suggests that sexting is far more common than past data have indicated. For example, one previous national study of more than 1,500 youth, published in the journal Pediatrics, found that just 1% of children and teens had sent a sext and 7% had received one. The authors of the new study, led by Jeff Temple of the University of Texas Medical Branch, take issue with the sampling of that data, however, noting that it included mainly white teens from two-parent families and many with higher-than-average incomes.

In contrast, the teens included in Temple’s study, recruited from seven public schools, were relatively evenly split between black, white and Hispanic students, with smaller percentages of Asians and mixed-race teens. But a co-author of the Pediatrics paper, David Finkelhor, director of the Crimes Against Children Research Center at the University of New Hampshire, finds the sampling in the newer research problematic as well. “The [authors] don’t describe how the schools were chosen and there’s no analysis of nonresponse,” says Finkelhor, noting that since parental permission was required for participation in the current study, those whose parents said no and were excluded might have been less likely to sext.

However, the new research does conform with earlier studies in another way, suggesting that sexts are generally not sent casually. They are typically intended to be viewed only by an intimate partner with whom the teen already has or wants to start an ongoing relationship. Whether or not the images are actually kept private depends on the trustworthiness of that partner, of course, and more importantly, on their impulse control — a trait that is not usually at its strongest during adolescence.

(MORE: Kids Sexting May Not Be as Big a Problem as We Thought)

The study found a few differences by gender: while girls and boys were equally likely to send nude images, boys were more likely to ask for one and girls were more than twice as likely to report having been asked. Girls were far more likely to say they were “bothered” by such requests, however: more than 90% were at least somewhat bothered, with a majority being bothered “a lot” or “a great deal”; nearly half of boys said that being asked for a nude photo didn’t bother them at all.

For girls, sexting was also linked with risky sexual behavior: more than half (56%) of those who’d sent a sext had had more than one sexual partner in the previous year, compared with 35% who had not sexted. Using alcohol or other drugs before sex was also more common in female sexters than non-sexters: 40% versus 27%. Among boys, only those who had been asked to send a sext were more likely to show risky sexual behaviors.

The authors theorize that these gender differences are linked to the good old double standard that characterizes sexual behavior by males as admirable and acceptable, while scorning the same activity in females. They write:

It is possible that sexting, like actual sexual behaviors, is perceived more permissibly and positively for boys…and therefore less likely to be associated with other risky behaviors. Girls, on the other hand, may risk being stigmatized for their sexting behaviors (e.g., being identified as a “slut”).

(MORE: Blogging Helps Socially Awkward Teens)

Sexting itself does carry legal risks. Even self-created images of teens are considered child pornography by law, if they are sexual in nature, and can lead to prosecution, incarceration and lifetime inclusion on sex offender registries. “The ubiquity of sexting supports recent efforts to soften the penalties of this behavior. Under most existing laws, if our findings were extrapolated nationally, several million teens could be prosecuted for child pornography,” the authors write.

Further, they note: “In an adolescent period characterized by identity development and formation, sexting should not be considered equivalent to childhood sexual assault, molestation and date rape. Doing so not only unjustly punishes youthful indiscretions, but minimizes the severity and seriousness of true sexual assault against minors.”

Our legal system criminalizes behavior that is “normal” for many teens, says psychologist Christopher Ryan, author of the bestselling Sex at Dawn, which looks at the prehistoric origins of human sexuality. “We shouldn’t panic about the fact that kids are sexual beings. We should adopt an approach based upon the Dutch understanding that we must ‘tolerate in order to control,’” he says. “Kids will be kids, whether they’re playing doctor, spin the bottle or sexting. It’s the adults and our legal institutions that have to grow up already.”

(MORE: What the U.S. Can Learn from the Dutch About Teen Sex)

But the worst fears about prosecution may have been overblown. In another Pediatrics study published in December, Finkelhor and his colleagues found that nearly 3,500 cases of sexual images produced by teens came to the attention of law enforcement agencies in the U.S. between 2008 and 2009. Two-thirds of these cases, however, had “aggravating” factors — such as involvement of an adult or use of the images by a teen to harass, bully or intimidate the victim. Teens were arrested in 18% of cases where there was no aggravating factor, and registration as a sex offender occurred in only 10 cases, nine of which involved actual sexual assault, not just the sending of images. In the tenth case, which involved a boy who sent a picture of his penis to a peer, the perpetrator had an extensive criminal history.

The research also found that the majority of the images involved in these cases — two-thirds — had been distributed by cell phone, not over the computer. However, that means one-third were posted somewhere on the Internet.

Finkelhor cautions against making too much of the new stats on sexting. “I just like to point out to people that if you look at the global measures of teen sexual behavior, all of them are moving in the direction we’d like to see: teen pregnancy is down, the number of teens with multiple sex partners is down, the percent who have ever had sexual intercourse has been declining, and the percent of teens who use contraception has been going up,” he says, adding, “I don’t think people should be complacent, but I don’t think that sexting or the Internet is looking like it’s provoking some drastic worsening of sexual risk behavior.”

(MORE: Profanity in Teen Novels: Characters Who Curse Are Often the Most Desirable)

The new research also suggests that pediatricians discuss sexting with their teen patients. Although no parent wants to imagine their child engaged in sexting, the authors argue that there may be a clinical benefit for doctors to talk about it:

Asking about sexting could provide insight into whether a teen is likely engaging in other sexual behaviors for boys and girls, or risky sexual behaviors for girls. … [Q]uestions about sexting may be easier for teens to answer honestly than questions about sex and risky sex behaviors.

The authors encourage pediatricians to use the issue to start a discussion about safer sex, concluding that it is “essential that pediatricians, adolescent medicine specialists and other health care providers become familiar with, routinely ask about and know how to respond to teen sexting.”

Is This Teen Angst or an Uncontrollable Anger Disorder?

With all those raging hormones, every teenager is bound to “lose it” at one time or another. But a recent study suggests that adolescents’ attacks of anger may indicate something more serious than your standard puberty-related mood swings: nearly two-thirds of youth report having had a bout of uncontrollable anger that involved threatening violence, destroying property or engaging in violence toward others, and nearly 8% — or close to 6 million teens — meet the criteria for intermittent explosive disorder (IED), which is characterized by persistent, out-of-control anger attacks that can’t be explained by a mental or medical disorder or substance use.

The findings, by researchers at Harvard Medical School, came from national surveys of nearly 6,500 American teens, aged 13 to 17, and their parents. The researchers found that IED was more common than thought, and that it is severe and persistent; kids usually start showing signs of IED in late childhood and the disorder persists through adolescence, the authors say. IED in teens is also linked with later problems, like depression and substance abuse in adulthood.

The study found, however, that many teens weren’t getting the help they needed. Among the study participants, 38% of those with IED received treatment for emotional problems in the year prior to the survey, but only 17% of these teens — or just 6.5% of all teens who had diagnosable IED — had received treatment specifically for anger.

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If IED could be detected and treated early, however, clinicians could help prevent a substantial amount of future violence and related mental harms, said senior author Ronald Kessler, professor of health care policy at Harvard Medical School.

To meet the definition of IED, according to the Diagnostic and Statistical Manual of Mental Disorders, a person must have three episodes of “impulsive aggressiveness grossly out of proportion to any precipitating psychosocial stressor,” at any time during their lives. In the current study, the researchers also used narrower definitions of IED that required attacks of anger within the previous 12 months and found that many teens met the standard. (The study excluded teens with other mental or emotional disorders like bipolar disorder, ADHD, oppositional defiant disorder and conduct disorder.)

“It’s a problem because it really gets in the way of your life,” says Kessler. “There are lots of things people don’t get treatment for because it doesn’t really impact them. This does. The problem is an awful lot of people have it — more than I thought — it’s awfully chronic, and it’s impairing.”

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The authors find that IED is not only underdiagnosed, but understudied as well. They write: “The number of PubMed research reports dealing with panic attacks is roughly 60 times the number dealing with anger attacks even though the lifetime prevalence of IED is considerably higher than the prevalence of panic disorder.”

Part of the problem may be that overly angry or aggressive people fail to acknowledge their own behavior. “I think one reason [IED] is understudied is that people who have these anger problems very often do not consider it a problem. They don’t go in for help. They may get arrested, but they don’t seek help on their own,” says Kessler. “Some things like this and other social disorders can fall through the cracks, and this is one of them.”

The authors say further research is needed to understand the risk factors for IED in teens and to improve diagnosis, screening and treatments.

The findings are published in the journal Archives of General Psychiatry.