The Journal of Sex Research

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Consequences of Casual Sex Relationships and

Experiences on Adolescents’ Psychological Well-
Being: A Prospective Study

Sophie Dubé, Francine Lavoie, Martin Blais & Martine Hébert

To cite this article: Sophie Dubé, Francine Lavoie, Martin Blais & Martine Hébert (2016):
Consequences of Casual Sex Relationships and Experiences on Adolescents’ Psychological
Well-Being: A Prospective Study, The Journal of Sex Research

To link to this article: http://dx.doi.org/10.1080/00224499.2016.1255874

Published online: 23 Dec 2016.

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Download by: [University of Newcastle, Australia] Date: 24 December 2016, At: 03:50
THE JOURNAL OF SEX RESEARCH, 00(00), 1–12, 2016
Copyright © The Society for the Scientific Study of Sexuality
ISSN: 0022-4499 print/1559-8519 online
DOI: 10.1080/00224499.2016.1255874

Consequences of Casual Sex Relationships and Experiences on

Adolescents’ Psychological Well-Being: A Prospective Study
Sophie Dubé and Francine Lavoie
École de psychologie, Université Laval

Martin Blais and Martine Hébert

Département de sexologie, Université du Québec à Montréal

Casual sexual relationships and experiences (CSREs) are still considered to be detrimental to the
psychological well-being of youth even though findings remain inconclusive. Most studies have
focused on emerging adulthood. Using a prospective design based on a representative sample of
high school students in the province of Québec, we measured sexually active adolescents’ (N = 2,304)
psychological well-being six months after engaging in these relationships while controlling for prior
well-being. We analyzed two forms of CSREs, friends with benefits (FWB) and one-night stand (ONS)
relationships, as well as levels of sexual intimacy. The results show that CSREs had a small impact
(small effect sizes) on subsequent psychological well-being, especially among girls; FWB relationships
involving penetrative contact increased girls’ psychological distress and both their alcohol and drug
consumption. ONSs including sexual touching increased girls’ psychological distress and their drug
use. None of the CSREs influenced boys’ psychological well-being. The findings underscored
the importance of using caution when arguing that CSREs are detrimental or harmless to the
psychological well-being of adolescents. The results also highlight the importance of taking into
account gender and forms of CSREs in prevention and health interventions.

The association of casual sexual relationships and experiences ones, play a defining role in sexual trajectories over the life span
(CSREs), defined as sexual contact occurring outside of a (Russell, Van Campen, & Muraco, 2012). Adolescents may also
romantic or dating relationship, with psychological well-being be more impacted because CSREs could be considered a viola-
has garnered great interest in recent years (e.g., Fielder & Carey, tion of age norms (Meier, 2007).
2010; Fielder, Walsh, Carey, & Carey, 2013; Grello, Welsh, & Studies of young adults suggested that at least half of
Harper, 2006; Owen & Fincham, 2011a, 2011b; Owen, college students have had a CSRE within the past few
Fincham, & Moore, 2011). Despite some evidence supporting months (56.6%) (Owen et al., 2011), during the past year
concerns about negative outcomes associated with CSREs, (52%) (Owen, Rhoades, Stanley, & Fincham, 2010), or
findings remain inconsistent. Psychological outcomes have during their lifetime (53%) (Grello et al., 2006). A preva-
mainly been investigated among college students and rarely lence of up to 80% was reported in one study asking about
among adolescents. However, investigating the impact of specific sexual behaviors (Reiber & Garcia, 2010).
CSREs in adolescence is important to clarify whether these Similarly, among representative samples of sexually active
relationships are part of normative sexual exploration (Furman adolescents, 37% to 77% (37% for Manning, Longmore, &
& Shaffer, 2003) or are expressions of sexuality related to Giordano, 2005; 61% for Manning, Giordano, & Longmore,
psychological problems, such as internalizing (e.g., depression) 2006; 77% for Grello et al., 2003) of 12- to 17-year-olds
and externalizing problems (e.g., high substance use) (Grello, and 85% of 17- to 21-year-olds (Grello et al., 2003) have
Welsh, Harper, & Dickson, 2003; Shulman, Walsh, Weisman, & had a CSRE within the past year. Percentages of non–
Schelyer, 2009). Because adolescents are generally less sexually sexually active adolescents who transitioned to CSREs are
experienced than young adults, their sexual choices may have smaller: 15% of 12- to 17-year-olds and 40% of 17- to 21-
different outcomes (Welsh, Grello, & Harper, 2003) than among year-olds have had a hookup within the past year (Grello
young adults. Those sexual experiences, especially the earlier et al., 2003). For sexually active 12- to 18-year-olds, the
lifetime prevalence varies from 28% in the United States
(Fortunato, Young, Boyd, & Fons, 2010) to 38% in Canada
Correspondence should be addressed to Sophie Dubé, École de psycho-
logie, Université Laval, 2325 Rue des Bibliothèques, Pavillon Félix-
(Frappier et al., 2008).
Antoine-Savard, Ville de Québec, Québec G1V 0A6, Canada. E-mail: This study sought to fill some gaps in the existing litera-
[email protected] ture. First, studies with adolescents generally focus on
 DUBÉ, LAVOIE, BLAIS, AND HÉBERT

depressive symptoms (e.g., Grello et al., 2003; Monahan & Suicidal ideation is another indicator of low psychologi-
Lee, 2008). However, depressive symptoms may co-occur cal well-being that is common in adolescence (Cheung &
with multiple symptoms of other psychological problems Dewa, 2006). Few studies have investigated this indicator in
(Starr et al., 2012). Thus, we extended our study to other association with CSREs, and the two that have done so
underexplored indicators of CSREs among adolescent presented divergent conclusions. On the one hand, a study
casual sex research, such as suicidal ideation, low self- reported that both young men and women who had no
esteem, and consumption of alcohol or drugs. Second, we suicidal ideation and engaged in CSREs during adolescence
used a longitudinal design to better understand the direction reported suicidal ideation in emerging adulthood (Sandberg-
of the link between psychological well-being and CSREs Thoma & Kamp Dush, 2014). On the other hand, another
(e.g., Deutsch & Slutske, 2015; Fielder & Carey, 2010; study with a better temporal precedence of variables
Furman & Collibee, 2014; Vrangalova, 2015a). Third, we reported that engagement in CSREs during adolescence
distinguished the type of sexual partners. To our knowledge, caused no suicidal ideation one year and five years after
only one previous study among adolescents did this the activity (Deutsch & Slutske, 2015).
(Manning et al., 2006), the others having examined Self-esteem has been studied in association with casual
CSREs more generally (i.e., encompassing any sexual con- sex among college students but not among adolescents.
tact between partners who are not dating or in a romantic Divergent conclusions emphasize the relevance of continu-
relationship). This distinction is important because well- ing this investigation. Studies have documented a negative
being outcomes may be different depending on the types association for young adults (Bersamin et al., 2014; Paul
of casual sexual partners (Bersamin et al., 2014; Sandberg- et al., 2000) and a positive association for men (Schmitt,
Thoma & Kamp Dush, 2014). We investigated one-night 2005). Fielder and Carey (2010) reported a decrease in self-
stand (ONS) and friends with benefits (FWB) relationships. esteem among women who transitioned to a penetrative
An ONS was defined as an unplanned sexual encounter, CSRE over 10 weeks compared to women who transitioned
usually occurring on one occasion between two people who to a nonpenetrative CSRE. The authors found no association
are strangers or brief acquaintances and do not plan to among men. However, another prospective study reported
become a couple (Paul, McManus, & Hayes, 2000), and that men who engaged in a CSRE involving intercourse also
FWB relationships were defined as sexual contact that had a decrease in self-esteem three months after the activity
usually occurs multiple times between two friends (Vrangalova, 2015a).
(Guerrero & Mongeau, 2008). Fourth, this study examined Investigating alcohol and drug use is relevant in a study
changes in psychological well-being across different sexual of psychological well-being because high consumption may
intimacy levels (i.e., sexual touching, oral sex, vaginal or be part of externalizing problems and an indicator of lower
anal intercourse), which has been done in a few studies psychological well-being (Hallfors et al., 2004; Schulte &
among young adults (e.g., Fielder & Carey, 2010; Hser, 2014). Cross-sectional studies among young adults
Vrangalova, 2015a) but not among adolescents. Finally, have reported an association between alcohol use and
our research used a representative sample of adolescents. CSREs (e.g., Cooper, 2002; Fielder & Carey, 2010; Owen
& Fincham, 2011a; Owen et al., 2011), which was stronger
among women (Owen & Fincham, 2010a; Owen et al.,
CSREs and Psychological Well-Being 2011). Alcohol use has been considered to be a strong
predictor of CSREs (Johnson, 2013), but few studies have
We examined five indicators of low psychological well- investigated substance use as a consequence of CSREs. A
being: depressive symptoms, suicidal ideation, low self- representative prospective study among 12- to 18-year-olds
esteem, alcohol use, and drug use. Some studies have found reported that casual sex was associated with a significant
a positive association between depressive symptoms and increase in substance use, including cigarettes, alcohol,
CSREs in adults (e.g., Bersamin et al., 2014; Fielder & marijuana, cocaine, and other illegal drugs, over one year
Carey, 2010; Grello et al., 2006), whereas others have found (McCarthy & Casey, 2008). Gender differences were not
no association (Eisenberg, Ackard, Resnick, & Neumark- studied. The distinction between alcohol and drugs is rele-
Sztainer, 2009; Owen & Fincham, 2011a). The prospective vant to examine because alcohol users are not necessarily
two-time-point studies by Grello et al. (2003) and Monahan drug users; such research would thus help detect different
and Lee (2008) reported more depressive symptoms 12 to patterns of consumption.
18 months after a transition to CSREs among 12- to 21-year- In sum, the negative impact of CSREs on adolescents’
old adolescents. Those youths were initially virgins and were depressive symptoms, suicidal ideation, self-esteem, and
compared to adolescents who remained virgins. Importantly, alcohol and drug use is not clear. Longitudinal studies
such depressive symptoms were present prior to hookups, have mostly focused on the long-term impact of CSREs,
which challenges the idea that CSREs cause depression. In especially for depressive symptoms and suicidal ideation,
comparison, no change in depressive symptoms was found one while the short-term impact deserves further study. This
year (Deutsch & Slutske, 2015) and five years after adoles- current prospective study will thus help clarify this question
cents engaged in CSREs (Deutsch & Slutske, 2015; Monahan while distinguishing two types of casual sexual partners and
and Lee 2008; Sandberg-Thoma & Kamp Dush, 2014). considering the effect of gender.

2
 CASUAL SEX AND ADOLESCENTS' WELL-BEING

It has been suggested that the level of sexual intimacy as measured by increased psychological distress, increased
involved in CSREs may influence subsequent psycholo- suicidal ideation, decreased self-esteem, and increased use
gical well-being among young adults (e.g., Bersamin of alcohol or drugs, for both girls and boys.
et al., 2014). College students, especially women, who H2: Engagement in FWB relationships/ONSs will be
engaged in CSREs involving penetrative contact (i.e., oral associated with a greater decrease in psychological
sex, vaginal or anal intercourse) reported subsequently well-being for girls than for boys.
greater depressive symptoms (Fielder & Carey, 2010; H3: Penetrative FWB relationships/ONSs (oral sex, vaginal
Strokoff, Owen, & Fincham, 2015) and lower self-esteem or anal intercourse) will be associated with a greater
(Fielder & Carey, 2010) than those who engaged in non- decrease in psychological well-being than nonpenetra-
penetrative CSREs. When considering other indicators of tive FWB relationships/ONSs (sexual touching) for
well-being, in her prospective study, Vrangalova (2015a) both genders.
found different results. In men, three months later, CSREs
involving intercourse were associated with lower self-
esteem; CSREs involving oral sex were associated with Method
subsequently more severe depression; and CSREs invol-
ving genital touching, oral sex, and intercourse were all Participants
associated with subsequently higher anxiety. Only CSREs
involving oral sex were linked with higher anxiety in Of the 6,540 participants in the weighted sample at T1, the
women. Such complex and subtle results support the analyses were based on sexually active adolescents who had
relevance of further investigation while considering gen- already had sexual contact, which was defined as sexual
der, types of sexual contact, and the inclusion of multiple touching (above or below the waist) or penetrative contact
psychological indicators. (oral sex, vaginal and/or anal intercourse). The final weighted
sample was based on 2,304 participants, with statistically more
girls than boys (girls: 61.9%, 95% CI [55.7, 67.7], boys:
Gender Differences 38.1%, 95% CI [32.3, 44.3], p < 0.001). They were, on
average, 15.64 years old [SE = .10] at T1. Sociodemographic
Gender is important to consider when examining the asso- characteristics of the sample are presented in Table 1.
ciation between casual sex and psychological well-being. Girls
and women who reported lower psychological well-being
Procedure
engaged more in CSREs and generally suffered more from
those sexual relationships than did boys and men. Indeed, girls The study used the Quebec Youths’ Romantic
who did not have prior suicidal ideation and who then engaged Relationships Survey, which included 8,194 adolescents
in CSREs during adolescence reported subsequently higher (56.3% were girls) aged 14 to 20 years at T1, and 6,472
odds of suicidal ideation in adulthood than in adolescence adolescents at Time 2 (T2) (57.3% were girls). The time
(Sandberg-Thoma & Kamp Dush, 2014), an increase in depres- span between T1 and T2 was six months. Data were
sive symptoms (Fielder & Carey, 2010; Grello et al., 2003; collected through a one-stage, stratified cluster sampling
Monahan & Lee, 2008), and a decrease in self-esteem (Fielder of Quebec high schools. Schools were randomly selected
& Carey, 2010). In contrast, CSREs have been correlated in from an eligible pool from the Ministry of Education
some studies with higher psychological well-being among men Leisure and Sports of Quebec (MELS) database of public
(Grello et al., 2006; Owen et al., 2010). However, some studies and private schools. To obtain a representative sample of
have found contradictory results (Vrangalova, 2015a) or no students in grades 10 through 12, schools were first
association between CSREs and psychological well-being for classified into eight strata according to the metropolitan
women or men (Deutsch & Slutske, 2015; Eisenberg et al., geographical area, status of schools (public or private
2009; Owen & Fincham, 2011a). schools), language of instruction (French or English),
and socioeconomic deprivation index. The final sample
comprised 329 classes from 34 schools. Participants were
Objectives given a correction weight to compensate for biases due to
sample design. The weight was defined as the inverse of
This two-wave study aimed to investigate the association the probability of selecting the given grade in the respon-
between CSREs and later psychological well-being among a dent’s stratum in the sample multiplied by the probability
subsample of sexually active adolescents while controlling for of selecting the same grade in the same stratum in the
the Time 1 (T1) level of psychological well-being. The hypoth- population. The weighted sample included 6,540 youths
eses were as follows: at T1 and 4,447 youths at T2. The weighted sample
proved representative of Quebec French- and English-
H1: Engagement in FWB relationships/ONSs will be asso- speaking students in 14 to 18 years old in the public
ciated with a later decrease in psychological well-being, education system.

3
 DUBÉ, LAVOIE, BLAIS, AND HÉBERT

Table 1. Sociodemographic Characteristics of the Sample at T1 (Weighted N = 2,304)

Sample Characteristics % 95% CI

Gender
Girls 61.9 [55.7, 67.7]
Boys 38.1 [32.3, 44.3]
Age group
14 years old 12.0 [7.5, 18.9]
15 years old 32.2 [24.8, 40.6]
16 years old 38.3 [32.3, 44.7]
17 years old 15.0 [10.7, 20.7]
18–19 years old 2.4 [1.2, 4.9]
Spoken language
French 91.9 [88.0, 94.6]
English 3.6 [3.0, 4.4]
Other 4.5 [2.3, 8.4]
Sexual orientation
Heterosexual a 83.1 [81.5, 84.7]
Gay/lesbian b 1.8 [1.4, 2.5]
Bisexual c 13.4 [12.0, 14.9]
Questioning d 1.6 [1.1, 2.4]
Family structure
Two parents under the same household 56.5 [53.6, 59.3]
Shared custody 14.1 [12.4, 16.1]
Living with their mother 19.8 [17.7, 22.0]
Living with their father 6.3 [5.2, 7.6]
Other family structure 3.4 [2.4, 4.6]
Nationality
Born in Canada from Canadian parents 79.2 [69.9, 86.1]
Born in Canada from parents of another nationality 12.5 [8.7, 17.7]
Born in another country 8.3 [4.9, 13.7]
Parents’ ethnic or cultural group
Québécois or Canadian 83.5 [73.8, 90.1]
Latino American or African American 5.4 [2.8, 10.1]
European 4.0 [3.1, 5.1]
North African (Maghreb)/Middle Eastern 2.3 [1.1, 4.6]
Asian 1.3 [0.9, 2.0]
Other 3.5 [1.7, 7.0]
Parents’ education
Mother
Elementary degree 3.9 [3.2, 4.9]
Completed high school degree 26.1 [23.2, 29.1]
Completed college or professional degree e 34.4 [31.8, 37.1]
Completed university degree 26.3 [22.2, 30.8]
Other 0.2 [0.1, 0.6]
Father
Elementary degree 7.0 [5.9, 8.3]
Completed high school degree 28.5 [25.8, 31.4]
Completed college or professional degree e 27.2 [24.9, 29.6]
Completed university degree 22.6 [18.7, 27.1]
Other 0.3 [0.1, 0.6]
a
Sexually attracted only to persons of the other sex.
b
Attracted only to same-sex partners.
c
Attracted to both or not exclusively attracted to either sex.
d
Not sure or not knowing yet, or to no one.
e
A college degree is usually undertaken around 18 years old and not in a university setting.

The class response rate and the overall student response present in most of the classes (320/329 classes); for the
rate were determined as the ratio between the number of remaining classes, the response rate ranged from 90% to
students who agreed to participate (students from whom 98%. The survey was finalized with an overall response rate
consent was obtained) and the number of approached stu- of 99% of students who agreed to participate. The retention
dents, calculated per class and for the entire set of partici- rate between T1 and T2 was 71% (i.e., 71% of the students
pants. The response rate was 100% of all students who were who completed T1 also completed T2). This research was

4
 CASUAL SEX AND ADOLESCENTS' WELL-BEING

approved by the Ethics Committee of the Université du Children and Youth 2006–2007 (NLSCY) (Statistics Canada
Québec à Montréal, which agreed that the research could and Human Resources and Skills Development Canada,
be conducted without parental consent and with the consent 2008). These items had a high internal consistency (α = .89,
of adolescents aged 14 and older. α = .88 on our sample). Participants rated their agreement with
each statement, with no period of reference, on a 5-point scale
from 1 (False) to 5 (True). An average score was calculated,
Measures
with a high score indicating good self-esteem. For the same
Casual Sexual Relationships and Experiences. The reason as for psychological distress, a logarithmic
four items measuring CSREs at T1 were inspired by transformation was performed on average scores.
Manning et al. (2006) and were distinguished from items
on romantic sexual contact. The items measured consensual Suicidal Ideation. Suicidal ideation was measured at
sexual contact occurring during the past 12 months. The T1 and T2 by one item from the National Longitudinal
definition of ONS was “sexual contact with an acquaintance Survey of Children and Youth 2006–2007 (NLSCY)
or with a stranger,” and an FWB relationship was defined as (Statistics Canada and Human Resources and Skills
“sexual contact with your best friend or a friend.” The levels Development Canada, 2008), which was “(In the last
of sexual intimacy were assessed by asking whether the 6 months [at T2]) have you ever seriously thought of
participants had engaged in sexual touching (0) or in oral, committing suicide?” The response scale was dichotomous
vaginal, and/or anal penetration (1) for both FWB (0 = No, 1 = Yes).
relationships and ONSs. Participants could answer that they
had more than one type of casual sexual partner and had Consumption of Both Alcohol and Drugs. Three
more than one type of intimate sexual contact. The terms items at T1 and T2 assessed substance use. They were
FWB relationship, ONS, and casual sex were never used. inspired by the DEP-ADO and were used in national
Four binary independent sexual intimacy variables (IVs) surveys, including the Quebec Survey on Smoking,
were created according to types of intimacy: (a) for sexual Alcohol, Drugs, and Gambling in High School Students
touching in FWB relationships, (b) for sexual touching in (QHSHSS) (Institut de la statistique du Québec, 2008).
ONSs, (c) for penetrative contact (i.e., oral, vaginal, and/or These items measured the frequency of alcohol, cannabis,
penetration) in FWB relationships, and (d) for penetrative and other drug use (e.g., ecstasy, amphetamines, cocaine,
contact in ONSs. These variables were independent and not acid) during the past 12 months (T1) or the past six months
mutually exclusive. On the one hand, the variable for sexual (T2). The response scale was 0 (Not at all), 1 (Occasionally),
touching in FWB relationships included acts of touching in 2 (About once a month), 3 (On weekends or once or twice a
FWB relationships regardless of what other sexual contact week), 4 (3 times a week or more, but not every day), and
may have also occurred in ONSs. On the other hand, a 5 (Every day). Continuous variables for alcohol consumption
participant who answered that he or she had penetrative and for drug consumption, including the items for cannabis
contact was coded only for the penetrative CSRE variable and other drugs, were created. These nonnormally distri-
regardless of whether he or she had participated in a CSRE buted variables were statistically transformed. A high score
involving touching. indicated high consumption.

Psychological Distress. Psychological distress was Gender. Gender was coded as dichotomous (0 = Girls,
measured at T1 and T2 using the 10-item Psychological 1 = Boys) and was taken into account by conducting path
Distress Scale (K10; Kessler et al., 2002). This scale analysis separately for girls and boys.
measures a state of psychological distress in the broadest
sense within nonclinical and clinical populations, including Control Variables. We controlled for youth’s well-
depressive and anxious symptoms (Kessler et al., 2002). Its being at T1 and sexual orientation, which were associated
validity has been confirmed by various criteria, including an with well-being at T2. Sexual orientation was coded as
excellent internal consistency (α = .93, α = .88 on our dichotomous (0 = Heterosexual and 1 = Homosexual,
sample) (Kessler et al., 2002). Participants responded in a Bisexual, or Questioning). We examined whether sex with
five-point scale ranging from 1 (None of the time) to 5 (All a romantic partner at T1, occurring in the past 12 months,
of the time). An average score was used, with a high score was linked to psychological well-being at T2, six months
indicating high distress. A logarithmic transformation was later. Because no significant association was found, we did
performed on average scores because the distribution was not control for romantic sex at T1.
not normal.

Self-Esteem. The five items measuring self-esteem at T1 Analytic Plan

and T2 were inspired by the Marsh and O’Neill Self-
Description Questionnaire III (SDQ-III) (1984). The same We took the complex sample into account in our analysis
five items were used in the National Longitudinal Survey of (Muthén & Muthén, 1998–2012). Regressions for continuous

5
 DUBÉ, LAVOIE, BLAIS, AND HÉBERT

dependent variables (DVs) (psychological distress, self- Multigroup Models

esteem, and consumption of both alcohol and drugs at T2)
Path analysis was used to examine whether levels of
were conducted by path analysis, and a logistic regression was
sexual intimacy in FWB relationships and ONSs during
conducted for the dichotomous DV (suicidal ideation at T2)
the past 12 months were related to later changes in psycho-
using Mplus 7.00 software (Muthén & Muthén, 1998–2012).
logical well-being while controlling for T1 psychological
The four variables of sexual intimacy in CSREs were IVs, and
well-being.
the psychological well-being variables at T1 were entered as
For girls, FWB relationships involving penetrative con-
control variables to control for the initial level of well-being.
tact (i.e., oral sex, vaginal and/or anal intercourse) and
Two models were employed, one for girls and one for boys, for
ONSs with sexual touching were linked to an increase in
the following reasons: We expected girls to be different from
psychological distress at T2, β = .20, SE = .08, p < .05;
boys in their psychological well-being, as reported by some
β = .29, SE = .12, p < .05 (Table 4). Standardized regression
epidemiological surveys (e.g., Cheung & Dewa, 2006); there
coefficients indicated that for ONSs, sexual touching was
were more girls than boys in the study; and preliminary ana-
the most important factor in the increase in psychological
lysis showed differences between the genders.
distress (β = .29). Penetrative FWB relationships were
The percentage of missing data for regression models
linked to an increase in alcohol use at T2, β = .30,
varied from 1% to 41%, depending on the model vari-
SE = .07, p < .001, and drug use, β = .22, SE = .08,
ables (psychological well-being variables at T1, sexual
p < .01. ONSs with sexual touching were also linked to an
orientation, IVs of levels of sexual intimacy, and psycho-
increase in drug use at T2, β = .20, SE = .10, p < .05. For all
logical well-being outcomes at T2). This latter proportion
well-being outcomes at T2, their respective well-being vari-
was largely due to missing responses for T2 items.
ables at T1 were associated. The final models, with sexual
Gender had no missing data. Furthermore, the analysis
intimacy variables and T1 well-being variables, explained
of missing data did not indicate the presence of a specific
31% of the variance of psychological distress at T2
pattern of non-response. Missing data were addressed
(R2 = .31, p < .001), 31% of the variance of alcohol use at
using the full information maximum likelihood (FIML)
T2 (R2 = .31, p < .001), and 43% of the variance of drug use
procedure, which took the approach of maximum like-
at T2 (R2 = .43, p < .001). As expected, the T1 well-being
lihood to estimate the model parameters when considering
variables explained more variance than the sexual intimacy
all the raw data available (Wothke, 2000).
variables; indeed, the latter explained 1% to 2% of the
variance in psychological well-being at T2. Sexual orienta-
tion other than heterosexual also explained the variance
Results
of only two outcomes: girls’ psychological distress and
suicidal ideation at T2. For boys, CSRE was not linked to
Table 2 presents CSRE prevalence among sexually
T2 well-being; only well-being at T1 was (Table 5).
active adolescents. Without a distinction between the
Three adjustment indices were used to determine whether
forms of CSREs (i.e., FWB relationships and ONSs),
the two models studied corresponded optimally to the sam-
40.7% had engaged in at least one CSRE in the
ple data. The comparative fit index (CFI), the root mean
12 months preceding the survey; 34 (34.3%) reported
square error of approximation (RMSEA), and the standar-
engaging in at least one FWB relationship, and 15%
dized root mean square residuals (SRMR) were considered.
reported engaging in at least one ONS. Z tests to com-
A CFI between .80 and .90 means a moderate adjustment. If
pare two proportions indicated that more sexually active
it is higher than .90 or .95, the fit is then considered to be
adolescents engaged in FWB relationships than ONSs
good or excellent, respectively (Tabachnick & Fidell, 2013).
regardless of the level of sexual intimacy. Indeed,
An SRMR and an RMSEA between .05 and .08 represent a
16.9% of sexually active adolescents had engaged in
moderate adjustment, while a lower value of .05 represents a
FWB relationships involving either sexual touching or
good fit. Indices of adjustment show evidence that the data
penetrative contact, while 6.6% had engaged in ONSs
are well represented by the models (model for girls:
involving sexual touching only, and 8.2% in ONSs
CFI = .96, SRMR = .04, RMSEA = .04 with CI at
involving penetrative contacts. Within each form of
90% = .03, .05; model for boys: CFI = .98, SRMR = .03,
CSREs, there was no significant difference in the pro-
RMSEA = .03 with CI at 90% = .01, .04).
portions of sexually active adolescents involved in sex-
ual touching and those involved in penetrative contact.
For all levels of sexual intimacy, more boys than girls
Discussion
had engaged in FWB relationships and ONSs.
At both time points, sexually active girls had a higher
Our study aimed to examine the short-term conse-
level of psychological distress and were more likely to
quences of FWB relationships and ONSs for psychological
report suicidal ideation than sexually active boys
well-being based on a subsample of sexually active ado-
(Table 3). These boys also had higher levels of self-
lescents. Four out of 10 sexually active adolescents had at
esteem and both alcohol and drug use than sexually
least one CSRE in the 12 months preceding the survey,
active girls.

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 CASUAL SEX AND ADOLESCENTS' WELL-BEING

Table 2. Prevalence of CSREs at T1 and Gender Differences Across Levels of Sexual Intimacy (Weighted N = 2,304)

All Girls Boys

Type of Sexual Intimacy % Z p % Z p % Z p χ2 (1)

FWB
a
Sexual touching 16.9 0ab 1 15.1 0.2ab 0.82 19.8 0.3ab 0.78 11.35**
3.1*ac 0.002 2.2*ac 0.03 2.3*ac 0.02
2.8*ad 0.005 2.0*ad 0.04 2.0ad 0.05
b
Penetrative 16.9 0ba 1 14.3 0.2ba 0.82 21.0 0.3ba 0.78 22.86***
3.1*bc 0.002 2.0*bc 0.04 2.5*bc 0.01
2.8*bd 0.005 1.9bd 0.06 2.2*bd 0.03
ONS
c
Sexual touching 6.6 3.1*ca 0.002 5.8 2.2*ca 0.03 7.8 2.3*ca 0.02 4.73*
3.1*cb 0.002 2.0*cb 0.04 2.5*cb 0.01
0.6cd 0.58 0.3cd 0.78 0.6cd 0.58
d
Penetrative 8.2 2.8*da 0.005 6.8 2.0*da 0.04 10.4 2.0da 0.05 12.01**
2.8*db 0.005 1.9db 0.06 2.2*db 0.03
0.6dc 0.58 0.3dc 0.78 0.6dc 0.58

Note. FWB = friends with benefits; ONS = one-night stand. Z tests were conducted to test the significance difference between two proportions of categories of
sexual intimacy designated by letters. Each chi-squared test was calculated within each category of sexual intimacy and indicated significant gender difference.
*p < .05; **p < .01; ***p < .001.

Table 3. Descriptive Information and Gender Differences for Psychological Well-Being Variables at T1 and T2 (Weighted N = 2,304)

Girls Boys

t Test a or
Variables M or % SE M or % SE Chi-Squared Test b

T1
Psychological distress 2.26 0.03 1.72 0.03 16.60***
Self-esteem 3.59 0.03 4.02 0.03 −14.05***
Suicidal ideation 41.4 1.5 23.5 1.8 100.69***
Alcohol use 2.05 0.06 2.12 0.04 −1.91
Drugs use 1.03 0.06 1.23 0.08 −2.55*
T2
Psychological distress 2.11 0.02 1.63 0.03 12.30***
Self-esteem 3.62 0.04 4.12 0.04 −11.55***
Suicidal ideation 16.2 1.0 7.3 1.1 31.08***
Alcohol use 1.99 0.04 2.13 0.06 −2.20*
Drugs use 0.98 0.05 1.26 0.09 −2.83**
a
A t test was performed after log transformation to reduce nonnormality. When Levene’s test for equality of variances was significant at p < .05, a t test for
equal variances not assumed was used.
b
A chi-squared test was performed for dichotomous variable of suicidal ideation. Percentage of suicidal ideation at T1 was in the past 12 months and at T2 in
the past six months.
*p < .05; **p < .01; ***p < .001.

and this prevalence was similar to that in other representa- Our results partially support the first and second hypoth-
tive studies among adolescents (e.g., Manning et al., eses, in that engagement in FWB relationships/ONSs was
2005). In addition, more sexually active adolescents associated with a decrease in psychological well-being espe-
engaged in FWB relationships than in ONSs, and more cially for girls; the reason for partial support is that the
boys engaged in CSREs than girls, which has also been decrease is very small, as shown by the R2. However, only
documented among adolescents (e.g., Manning et al., girls had a decrease in their well-being, which more strongly
2006) and young adults (e.g., Vrangalova, 2015a). With supports the second hypothesis. When we controlled for
regard to levels of sexual intimacy, as many sexually well-being at T1, girls who engaged in FWB relationships
active adolescents had engaged in sexual touching only involving penetrative contact at T1 reported a small increase
and in penetrative contact within each form of CSRE, the in psychological distress six months later, as well as an
results support the use of a widespread definition of increase in both alcohol and drug use. Girls who engaged
CSREs that includes a wide range of sexual acts. in ONSs involving sexual touching also had a small increase

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 DUBÉ, LAVOIE, BLAIS, AND HÉBERT

Table 4. Regressions Predicting Psychological Well-Being at T2 by Levels of Sexual Intimacy in CSREs for Girls

Psychological Distress Self-Esteem Suicidal Ideation Alcohol Use Drug Use

Type of Sexual Intimacy β (SE) [95% CI] β (SE) [95% CI] OR (SE) [95% CI] β (SE) [95% CI] β (SE) [95% CI]

Psy IV T1 0.51 (0.03)*** 0.69 (0.02)*** 10.27 (0.23)*** 0.51 (0.03)*** 0.61 (0.02)***
[0.46, 0.57] [0.65, 0.74] [6.57, 16.08] [0.46, 0.56] [0.57, 0.66]
Sexual orientation 0.25 (0.07)*** 0.05 (0.05) 1.65 (0.21)* −0.002 (0.06) 0.01 (0.06)
[0.12, 0.38] [−0.05, 0.15] [1.03, 2.47] [−0.12, 0.12] [−0.10, 0.13]
Sexual touching FWB 0.12 (0.07) 0.03 (0.06) 1.09 (0.24) −0.03 (0.07) −0.05 (0.06)
[−0.01, 0.25] [−0.08, 0.14] [0.68, 1.75] [−0.16, 0.10] [−0.17, 0.08]
Penetrative FWB 0.20 (0.08)* 0.01 (0.07) 1.15 (0.27) 0.30 (0.07)*** 0.22 (0.08)**
[0.03, 0.36] [−0.13, 0.14] [0.68, 1.94] [0.15, 0.44] [0.07, 0.37]
Sexual touching ONS 0.29 (0.12)* −0.01 (0.08) 0.98 (0.39) 0.16 (0.10) 0.20 (0.10)*
[0.05, 0.53] [−0.17, 0.14] [0.46, 2.13] [−0.04, 0.37] [0.001, 0.39]
Penetrative ONS 0.21 (0.12) −0.13 (0.10) 1.37 (0.34) 0.03 (0.10) 0.13 (0.10)
[−0.03, 0.45] [−0.31, 0.07] [0.71, 2.66] [−0.16, 0.22] [−0.07, 0.32]

R2 control variables 0.30 0.50 0.30*** 0.29 0.42

R2 total 0.31* 0.50*** 0.31*** 0.31*** 0.43***
ΔR2 0.01 0 0.01 0.02 0.01

Note. FWB = friends with benefits; ONS = one-night stand. Psy IV T1 is the same psychological variable as the outcome, but at T1. Psy IV T1 and sexual
orientation were controlled. R2 control variables: Variance of the psychological well-being variable at T2 only explained by the same well-being variable at T1
and sexual orientation. R2 total: Variance of the psychological well-being variable at T2 explained by the well-being variable at T1, sexual orientation, and
variables of levels of sexual intimacy.
*p < .05; **p < .01; ***p < .001.

Table 5. Regressions Predicting Psychological Well-Being at T2 by Levels of Sexual Intimacy in CSREs for Boys

Psychological Distress Self-Esteem Suicidal Ideation Alcohol Use Drug Use

Type of Sexual Intimacy β (SE) [95% CI] β (SE) [95% CI] OR (SE) [95% CI] β (SE) [95% CI] β (SE) [95% CI]

Psy IV T1 0.52 (0.03)*** 0.61 (0.04)*** 9.35 (0.31)*** 0.62 (0.04)*** 0.69 (0.03)***
[0.45, 0.59] [0.53, 0.69] [5.06, 17.31] [0.55, 0.68] [0.63, 0.76]
Sexual orientation 0.23 (0.14) −0.07 (0.12) 1.79 (0.43) −0.03 (0.13) 0.05 (0.11)
[−0.04, 0.51] [−0.30, 0.15] [0.78, 4.11] [−0.29, 0.24] [−0.16, 0.25]
Sexual touching FWB 0.11 (0.08) −0.06 (0.08) 1.08 (0.40) 0.04 (0.09) −0.17 (0.09)
[−0.04, 0.27] [−0.21, 0.09] [0.50, 2.35] [−0.13, 0.20] [−0.34, 0.00]
Penetrative FWB 0.09 (0.08) 0.03 (0.10) 1.11 (0.40) 0.11 (0.09) −0.10 (0.10)
[−0.07, 0.26] [−0.16, 0.22] [0.51, 2.41] [−0.06, 0.28] [−0.29, 0.09]
Sexual touching ONS 0.16 (0.12) 0.05 (0.11) 1.71 (0.46) 0.08 (0.15) 0.02 (0.13)
[−0.07, 0.39] [−0.16, 0.26] [0.69, 4.24] [−0.22, 0.37] [−0.23, 0.28]
Penetrative ONS −0.002 (0.09) −0.04 (0.14) 0.77 (0.51) 0.18 (0.11) 0.18 (0.12)
[−0.18, 0.18] [−0.32, 0.24] [0.28, 2.07] [−0.04, 0.40] [−0.07, 0.42]

R2 control variables 0.31 0.38 0.21*** 0.36 0.48

R2 total 0.32*** 0.38*** 0.22*** 0.36*** 0.48***
ΔR2 0.01 0 0.01 0 0

Note. FWB = friends with benefits; ONS = one-night stand. Psy IV T1 is the same psychological variable as the outcome, but at T1. Psy IV T1 and sexual
orientation were controlled. R2 control variables: Variance of the psychological well-being variable at T2 only explained by the same well-being variable at T1
and sexual orientation. R2 total: Variance of the psychological well-being variable at T2 explained by the well-being variable at T1, sexual orientation, and
variables of levels of sexual intimacy.
*p < .05; **p < .01; ***p < .001.

in psychological distress and in drug use. This result sup- considering previous well-being, since many other events
ports the conclusion that CSREs may have no significant and factors in an adolescent’s life may be more significant.
impact on psychological well-being (Deutsch & Slutske, In the long run, it is important to consider that CSREs may
2015; Eisenberg et al., 2009; Owen & Fincham, 2011a; have a more negative impact on psychological well-being in
Vrangalova, 2015b). It appears plausible that CSREs have adolescence than in adulthood because adolescents aim to
no major impact on psychological well-being when develop close and committed relationships (Paul, Wenzel, &

8
 CASUAL SEX AND ADOLESCENTS' WELL-BEING

Harvey, 2008). CSREs may thus fail to satisfy their emo- fact of having engaged in sexual touching with a lesser-
tional needs (Baumeister & Leary, 1995) and hinder the known person, such as a stranger or an acquaintance, may
development of their aptitude for intimate relationships be viewed as a violation of “standards” for women’s sexual
(Paul et al., 2008). behavior (e.g., Crawford & Popp, 2003). Regret may be
When CSREs slightly decrease psychological well-being, strongly associated with such sexual touching and may
one possible explanation is that girls with preexisting dis- increase psychological distress. Girls may regret having
tress may engage in FWB relationships or ONSs to relieve hooked up with a particular partner (Napper, Montes,
their low psychological well-being (Owen et al., 2011), but Kenney, & LaBrie, 2016). By having engaged in sexual
these experiences may have the opposite effect. Indeed, girls touching without more sexually intimate contact such as
are reported to be more vulnerable than boys to a lack of intercourse, these girls may also feel that they were used
commitment in relationships that include sex (Meier, 2007). for boys’ sexual pleasure and may feel like a sexual object.
Ambiguity in expectations (i.e., lack of clarity about roman- They may engage in ONSs involving sexual touching to
tic commitment, closeness, or exclusivity) and lack of com- please their ONS partner or to respond to his sexual desires
munication (Lovejoy, 2015) may contribute to conflicting even if they do not truly enjoy these sexual acts themselves
feelings and emotional vulnerability, such as frustration (Armstrong, England, & Fogarty, 2012). They may thus
about unreciprocated deeper feelings and feelings of blame themselves for not having respected themselves and
betrayal (Lovejoy, 2015; Weaver, MacKeigan, & not setting limits.
MacDonald, 2011), and consequently to greater psycholo- Our study was the first to investigate self-esteem in
gical distress. Girls may also feel manipulated, even more so association with CSREs among adolescents. We found no
if they develop romantic interest, and may blame themselves change in self-esteem after CSREs for girls or boys, in
when their casual partner does not show interest afterward contrast to the results obtained by Fielder and Carey
(Lovejoy, 2015; Meier, 2007; Paul & Hayes, 2002). Higher (2010) and Vrangalova (2015a), who used the same scale
alcohol and drug use may therefore be a strategy to cope as ours (i.e., the Rosenberg scale). The impact of CSREs on
with their increased psychological distress. It is also possi- self-esteem appears to be different according to whether the
ble that girls may suffer from negative appraisals of double individual is an adolescent or adult. We found no links
standards (Crawford & Popp, 2003), acquiring a negative between CSREs and later suicidal ideation, which corrobo-
reputation from having engaged in a CSRE. rates the findings of Deutsch and Slutske (2015) for twins
For FWB relationships, the small decrease in psycholo- one year after CSREs. Because CSREs did not have an
gical well-being may be related to disappointment, lone- important effect on later psychological well-being in our
liness, and psychological distress if the friendship ends study, it appears plausible that CSREs themselves do not
(Owen, Fincham, & Manthos, 2013). The way that a lead to suicidal ideation, which is an indicator of intense
young woman’s FWB partner treated her during the rela- psychological pain.
tionship may also influence her subsequent psychological
well-being (Owen et al., 2013). A qualitative study among
Limitations and Strengths
college women reported that uneasiness and distress may
arise when sex is added to friendship because the new focus This study had some limitations. First, we did not take
on sex may suppress emotional intimacy (Lovejoy, 2015). into account the number of different casual sexual partners.
As Vrangalova (2015a) suggested, when FWB relationships Indeed, a high engagement with many different partners
last longer, their effects may also be stronger and longer. might be part of a constellation of behavioral problems
Thus, girls who engage in more sexually intimate contact, (Bersamin et al., 2014) that may contribute to decreased
such as penetrative FWB relationships, may suffer more, as psychological well-being. We did not know the relational
indicated by both an increase in psychological distress and context in which the CSREs occurred, such as the presence
substance use, because they develop stronger attachment of abuse or the duration of the experiences, or the teens’
and expectations. other life situations that could contribute to the lower psy-
Our results did not support the third hypothesis, that chological well-being of our participants. One potential
penetrative CSREs are associated with a greater decrease confounding variable that might explain the association
in psychological well-being than nonpenetrative CSREs are. between CSREs and increased alcohol and drug use
Indeed, we found that sexual touching in the context of among girls is the exposure to settings where CSREs and
ONSs had a more detrimental impact on girls’ psychological consumption are more likely to occur, such as parties.
well-being, with the strongest association with psychologi- Future studies should control for the effect of this variable.
cal distress and an increase in drug use. This result is the Because CSREs explained a small amount of the var-
opposite of some findings of a greater association between iance in girls’ psychological well-being in our design,
genital penetrative CSREs and lower psychological well- further research should identify moderators to better under-
being among girls and young women (e.g., Fielder & stand the conditions under which these relationships may
Carey, 2010; Grello et al., 2006; Monahan & Lee, 2008). lead to lower psychological well-being (Vrangalova,
However, these studies did not distinguish forms of CSREs, 2015b). Possible moderators that could be examined include
which may explain the difference in our results. The simple the following: individual-level factors such as personality,

9
 DUBÉ, LAVOIE, BLAIS, AND HÉBERT

attachment styles, communication skills, and motivations girls choose other strategies, because even though
(Vrangalova, 2015b); negative social or health hookup con- CSREs do not dramatically decrease psychological well-
sequences (Napper et al., 2016); and contextual factors such being, they do not increase it either. Practitioners should
as social norms, peer pressure, coercion, or relationship also encourage girls to clarify their expectations about
breakups. Identifying other variables that may be associated CSREs and the conditions under which they could
with alcohol and drug use, such as delinquency, poorer become positive experiences. For some, CSREs can be a
grades, and truancy (e.g., McCarthy & Casey, 2008), positive exploration of sexuality or an unplanned one-
would be useful to verify whether CSREs are part of a time event without negative consequences, but youth
constellation of externalizing problems. General self-esteem workers should discuss CSREs with girls and boys as a
was not associated with engagement in CSREs in our study, means of initiating and maintaining satisfying emotional
but a measure of sexual self-esteem could be interesting to and intimate relationships.
examine among boys and girls. Especially among girls,
sexual self-esteem could indicate whether they feel more
attractive after a CSRE (Weaver et al., 2011). Funding
This research had many strengths; our results emphasize the
relevance of continuing to distinguish forms of CSREs and This research was supported by a grant from Canadian
levels of sexual intimacy in further research. The findings high- Institutes of Health Research (#103944; principal investi-
light the importance of not underestimating sexual touching and gator: Martine Hébert) and by a doctoral research scholar-
verifying how girls subjectively live and interpret such contact. ship from Fonds de Recherche du Québec—Société et
The distinction between alcohol and drugs revealed the use of Culture (FRQSC) awarded to the first author.
diverse substances among girls who engaged in CSREs, which
was a distinction that had not been made in other studies of
casual sex among adolescents (e.g., McCarthy & Casey, 2008). ORCID
We also used T1 CSREs as predictors of T2 psychological well-
being while controlling for T1-well-being, thereby assuring the Martin Blais http://orcid.org/0000-0001-8513-6596
temporal precedence of CSREs in influencing later well-being.
The inclusion of R2, which was not reported in previous studies,
also showed the effect size and provided a more critical under- References
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