1 A systematic literature review pertaining to the psychological effects of multimedia-induced sexualisation of girls in middle childhood C Koekemoer 22745459 Mini-dissertation submitted in partial fulfilment of the requirements for the degree Magister Artium in Clinical Psychology at the Potchefstroom Campus of the North-West University Supervisor: Heleen Coetzee Co-supervisor: Prof. Esmé van Rensburg March 2017 2 TABLE OF CONTENTS Acknowledgements 4 Summary 5 Opsomming 7 Preface 9 Structure of the Mini-Dissertation 10 Guidelines for Authors 11 Permission to Submit Article for Examination Purposes 15 Language and Technical Editing Certificate 16 Turnitin Originality Report 17 SECTION I: Introduction and Contextualization of the study Introduction 18 Conceptualising sexualisation 20 Defining middle childhood 21 Understanding psychological effects 23 The digital transformation of childhood: The impact of multimedia 24 The effect of the different media vehicles. 28 Television 28 Magazines 30 Internet 31 Video-computer games 33 Music videos and music performances 34 Rationale for the study 35 Aim of the study 37 Methodology 37 Ethical considerations 41 References 43 3 SECTION II: Manuscript Article 53 Title of Article, Authors and Contact Details 53 Abstract 54 A systematic literature review pertaining to the psychological effects of multimedia- induced sexualisation of girls in middle childhood. 55 Introduction 55 Aim of the study 60 Method 61 Results 64 Discussion and Recommendations 70 Limitations 73 Conclusion 74 References 75 SECTION III: Critical Reflection Critical Reflection About the Study 84 APPENDICES: Tables and Figures Table 1- Data Extraction of Selected Studies 90 Figure 1- Schematic Representation of Selected Studies 94 Critical Appraisals 95 4 Acknowledgements I would like to express my sincere gratitude and appreciation to the following: • My almighty God. Your everlasting love and grace had given me the strength to tread this journey to the best of my ability. You make all things possible in my life. All praise and glory goes to You. • Heleen Coetzee, my supervisor. Thank you for your support, guidance, kindness, encouragement, and effort. Thank you for always availing yourself when I needed your assistance. And mostly, thank you for treading unchartered academic territory with me and for making this dissertation possible. It is an honor to have you as a supervisor. • Professor Esmé Van Rensburg, my co-supervisor. Thank you for sharing your knowledge and expertise throughout this process. Thank you for your guidance, willingness and patience and for investing your precious time into this study. It is a privilege for me to learn from you and apply your teachings in my life. • The Psychology Department of the North-West University, Potchefstroom Campus. Thank you for granting me this opportunity to further my studies and for your belief in my future and development as a growing practitioner. • My parents, René and Deon Koekemoer. Thank you for your support and guidance. Thank you for granting me this opportunity to further my studies and for teaching me the value of education. You enrich my life on a daily basis. • My family members, friends and colleagues. Thank you for your support and endless belief in me on all fronts of my life. Your words of encouragement and humor had preserved my sanity. • Kobus du Plooy, my fiancé. Words will never be able to express my love, gratitude and appreciation for you. Thank you for your endless love, support and encouragement throughout this journey. I will always cherish your presence in my life. 5 Summary International reports recently issued in countries such as America, England, Australia and Scotland have sparked debate pertaining to the sexualisation of young children. Healthcare clinicians, psychologists, caregivers, parents, and educators have become concerned about the concept of multimedia-induced sexualisation. Although international reports have been released, information is limited on the causes, effects and the future management thereof. Available literature indicates that the enhanced access to, and exposure to different media modalities and the messages young children receive from these modalities, could be at the leading foreground of sexualisation. Although the exposure to sexual materials is not new for children, disturbing new trends and developments are cause for concern because children are currently being directly targeted in the media (Gale, 2008). Self-motivated sexual exploration and age-appropriate exposure to information about sexuality is not viewed as sexualisation. Sexualisation refers to the inappropriate imposition of adult sexuality onto children and young individuals before they are mentally, emotionally or physically capable of dealing with it; whereby excessive emphasis and value is placed on sexual appeal or behaviour; and whereby young children are evaluated in terms of physical characteristics (American Psychological Association Task Force on the Sexualisation of Girls, 2010; Bailey, 2011). Some of the most alarming findings reveal that the sexualisation of young girls have started to occur at alarming earlier ages and also indicate potential harmful effects thereof, especially on girls in middle childhood. The latter appears to be closely linked with the access to technology and enhanced exposure to sexualised content in the media (Papadopoulos, 2010). The aim of this study was to systematically review, explore, synthesize and summarize current available research pertaining to the psychological effects of multimedia- 6 induced sexualisation of girls in middle childhood. A summary and comprehensive outline of the literature available on this phenomenon will add to international debate, inform readers regarding the most recent evidence on this phenomenon, hopefully inform further research, and create awareness of this phenomenon in the context of developing countries such as South Africa. A systematic review was conducted through a comprehensive electronic search. The initial search produced 1934 results. Studies were further excluded based on not being applicable to the review question, not meeting the inclusion criteria or being rated as poor quality research. A final nineteen studies were identified for inclusion in the review. The nineteen studies were found to be of acceptable quality, as agreed by both the reviewers. These studies were published between 2001 and 2016, which comprised of different methodologies and research designs. Data was analysed by means of qualitative content analysis and revealed two themes. Theme one encapsulates the possible detrimental psychological effects of multimedia- induced sexualisation for girls in the form of internalization, objectification, mental health and gender-stereotyping. Theme two relate to the possible positive effects of multimedia- induced sexualisation. Findings appear to indicate that the psychological effects on girls in middle childhood, resulting from sexualisation, to be more detrimental than promoting their well-being. It is necessary for healthcare practitioners involved in the treatment of young girls in middle childhood, to take the above mentioned into consideration in order to better understand these girls’ functioning. A paucity of research on the topic, in the context of developing countries, was also found and as such a precautionary approach pertaining to sexualisation of girls in middle childhood is advocated. 7 Opsomming In lande soos Amerika, Engeland, Australië, en Skotland is internasionale verslae onlangs uitgereik met betrekking tot seksualisering van jong kinders. Hierdie verslae het vele debatvoering ontlok. Verskeie gesondheidsorgpraktisyns, sielkundiges, versorgers, ouers, en opvoerders is bekommerd oor die konsep van multimedia-geïnduseerde seksualisering en beskou hulle dit as ‘n kwessie wat aangespreek moet word. Al is hierdie internasionale verslae vrygestel, bly inligting beperk rakende die oorsake, gevolge en die toekomstige bestuur van seksualisering. Literatuur dui aan dat kinders se verbeterde toegang tot en blootstelling aan verskillende media modaliteite op die voorgrond van seksualisering kan wees. Die blootstelling aan seksuele materiaal deur middel van die media is nie nuut vir kinders nie, maar het ontstellende nuwe neigings waar kinders direk in die media geteiken word, kommernis ontwikkel (Gale, 2008). Self-gemotiveerde seksuele eksplorasie en ouderdom-toepaslike blootstelling aan inligting oor seksualiteit, word nie per se beskou as seksualisering nie. Seksualisering verwys na kinders se onvanpaste blootstelling aan volwasse seksualiteit voordat hulle psigologies, emosioneel, of fisies voorbereid is om dit te hanteer; waardeur oormatige klem en waarde geplaas word op seksuele voorkoms of gedrag; en waardeur jong kinders geëvalueer word in terme van fisiese eienskappe (American Psychological Association Task Force on the Sexualisation of Girls, 2010; Bailey, 2011). Onlangse bevindinge dui aan dat die seksualisering van middelkinderjarige meisies toenemend plaasvind op vroeër ouderdomme en kan seksualisering potensiële skadelike effekte inhou. Laasgenoemde word veral nou gekoppel aan hierdie jong bevolkingsgroep se toegang en blootstelling aan seksuele inhoud in die media (Papadopoulos, 2010). 8 Die doel van hierdie sistematiese literatuur studie is om beskikbare navorsing te hersien, te verken, te sintetiseer en op te som rakende die psigologiese effekte van multimedia-geïnduseerde seksualisering van meisies in middel kinderjare. 'n Omvattende oorsig van die literatuur word weergegee oor hierdie verskynsel. Die inligting word opgesom met die doel om by te dra tot die internasionale debatvoering, om aan lesers die nuutste inligting oor hierdie verskynsel te verskaf, om verdere navorsing te motiveer, en om bewustheid te skep oor hierdie verskynsel in ontwikkelende lande soos Suid-Afrika. Die aanvanklike elektroniese soektog het 1934 resultate opgelewer. Nadat studies uitgesluit is op grond daarvan dat dit nie die navorsingsvraag aanspreek nie, nie aan die insluitings kriteria voldoen nie, of aangewys is as swak gehalte navorsing, is 'n finale negentien studies ingesluit. Die finale studies is gepubliseer tussen die jare van 2001 tot 2016 en bestaan uit verskeie metodologieë en navorsingsontwerpe. Data was geanaliseer deur middel van kwalitatiewe inhoudsanalise en het daar twee temas navore gekom. Tema een som die moontlike nadelige psigologiese effekte op wat multimedia-geïnduseerde seksualisering vir kinders kan inhou. Laasgenoemde resultate word bespreek in subtemas van internalisering, liggaamsontenvredenheid, objektifisering, welstand en geslagstereotipering. Tema twee hou verband met die moontlike positiewe effekte van multimedia-geïnduseerde seksualisering. Bevindinge dui aan dat die psigologiese effekte van seksualisering vir middel-kinderjarige meisies meer nadelig is vir hulle welstand. Dit word aanbeveel dat die bogenoemde in aggeneem word deur praktisyns, wat betrokke is by die behandeling van middel-kinderjarige meisies, om sodoende hulle funksionering beter te verstaan. 'n Gebrek aan navorsing in ontwikkelende lande oor hierdie onderwerp is geïdentifiseer. 'n Voorkomende benadering word aanbeveel met betrekking tot die seksualisering van meisies in middelkinderjare. 9 Preface Article format This mini-dissertation is part of the requirements for the completion of the Magister of Artium degree in Clinical Psychology. It has been prepared according to the article format regulations of the North-West University. Journal This manuscript is compiled in accordance with the requirements set by the Journal of Child and Adolescent Mental Health. Please take note that the article is presented according to the authors’ guidelines of the abovementioned journal. The in-text citations as well as the references of Section 1 and 3 is prepared according to the APA (American Psychological Association) publication guidelines. Page numbers For examination purposes, the pages are numbered from the title page and proceed from there onwards. 10 Structure of the Mini-Dissertation The mini-dissertation will be submitted in article format, consistent with the General Regulation A.13.7 of the North-West University and is structured as follows: Section 1: Introduction, a brief literature review, the aim of the study, methodology and ethical considerations. Section 2: Research article: A systematic literature review pertaining to the psychological effects of multimedia induced sexualisation of girls in middle childhood. This article will be submitted for publication in the Journal of Child and Adolescent Mental Health. This section and the reference list at the end of the section were compiled in accordance with the guidelines of the last-mentioned journal. Section 3: Critical reflection about the study. 11 Guidelines for Authors Author guidelines: Journal of Child and Adolescent Mental Health Each issue of the journal contains several different types of contribution: original research papers (including brief reports (<2 000 words); review and systematic report papers (to be limited to 4 000 words, unless by special arrangement); clinical perspectives; book reviews; and editorials. We welcome contributions for all of these sections of the Journal. Editorial policy Submission of a manuscript implies that the material has not previously been published, nor is being considered for publication elsewhere. Submission of a manuscript will be taken to imply transfer of copyright of the material to the publishers, NISC (Pty) Ltd. Contributions are accepted on the understanding that the authors have the authority for publication. 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PhD thesis, Pennsylvania State University, Pennsylvania, USA. Louw J. 1990a. Comorbidity of conduct and anxiety disorders. Southern African Journal of Child and Adolescent Psychiatry 5: 43–51. Louw J, Mkize AC, Naidoo DH. 1990. Cultural disorders. In: Isaacs S (ed.), Psychiatric disorders in South African children. Cape Town: Juta & Co. pp 84–96. McRoy RG, Grotevant HD, White KL. 1988. Openness in adoption: new practices, new issues. 14 New York: Prager Publishers. PRB (Population Reference Bureau). 2002. Untitled fact sheet. Available at http://www.prb.org/content/navigationMenu/Other_ reports /2000–2002/sheet1.html [accessed 22 February 2002]. - Tables and figures: Each table and figure must be numbered with Arabic numerals and must be accompanied by an appropriate stand-alone caption. Tables and figures must be formatted to fit the page vertically with a printed width of 140 mm. Tables may include up to five horizontal lines but no vertical lines. 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We, the supervisors of this study, hereby declare that the article entitled “A systematic literature review pertaining to the psychological effects of multimedia-induced sexualisation of girls in middle childhood”, written by Caryn Koekemoer, does reflect the research regarding the subject matter. The co-authors of the article that forms part of this mini-dissertation, namely Mrs. Heleen Coetzee (supervisor and co-author) and Prof. Esmé van Rensburg (co-supervisor and co-author), hereby give permission to the candidate, Caryn Koekemoer, to include the article as part of a master’s dissertation and that the candidate may submit the article for publication in The Journal of Child and Adolescent Mental Health. The contribution (advisory and supportive) of these two co-authors was kept within reasonable limits, thereby enabling the candidate to submit this mini-dissertation for examination purposes. ____________________ _____________________ Heleen Coetzee Prof. Esmé van Rensburg Supervisor and co-author Co-supervisor and co-author 16 Language and Technical Editing Certificate 17 Turnitin Originality Report 18 SECTION I: INTRODUCTION AND CONTEXTUALIZATION OF THE STUDY Introduction This introduction aims to help the reader better contextualise the problem statement in the manuscript, namely the integration of available research on the psychological effects of multimedia-induced sexualisation of girls in middle childhood. In order to provide the context, this section focuses on the relevant concepts named in the title. Thus, aiming to conceptualise sexualisation by means of multimedia, middle childhood, and factors related to psychological functioning. In recent years, there has been a growing concern about the sexualisation of children, specifically about the effects of media and commercial marketing in this respect (Buckingham, Bragg, Russel, & Willet, 2010). Several academic publications, task force and government reports have argued that the progressive sexualisation of children is harmful. Whether it is Durham’s (2008) best-selling book, The Lolita Effect: The Media Sexualisation of Young Girls and What We Can Do About It, or similarly minded publications (Levin & Kilbourne, 2008; Palmer, 2013) or reports (American Psychological Association [APA] Task Force on the Sexualisation of Girls, 2010; Papadopoulos, 2010; Rush & La Nauze, 2006a, 2006b; Standing Committee on Environment, Communications and the Arts, 2008), had initiated international debate amongst academics and populist commentary. In so doing, Tsaliki (2015) contended that these publications work as cautionary precursors regarding the damage inflicted upon children due to sexualising trends in the media, which may result in stealing from children’s ‘childhood innocence’ and cause girls to engage in self-destructive behaviour. 19 Dialogue associating children with sexuality is bound to elicit discussion. Children are usually made out as being ‘at risk’ or perceived as vulnerable when it comes to sexual topics such as child pornography, sex education, sexual media content or sexualised popular culture (Buckingham et al., 2010; Tsaliki, 2015). Children’s access to sexual information and how or when it should be gained, remains a controversial debate. Although exposure to sexual materials are not new for children, new trends and developments are cause for concern, as young children are currently being directly targeted in the media (Gale, 2008). Different multimedia modalities make it possible for children, who have access or are exposed to these modalities, to engage with media almost anywhere and anytime (Duits, 2010). The increased exposure (voluntary and involuntary) and access to different media modalities will inevitably raise the chances for young girls to be flooded with unwanted and/or age-inappropriate messages and material (APA Task Force, 2010; Mancuso, 2016). Media content has visually become more sexualised compared to previous generations (Bailey, 2011; Gunter, 2014;). Young girls, especially in middle childhood and adolescence, are at risk to unforeseen exposure of sexualised content and imagery as the use of and exposure to different media modalities increases and develops (Bailey, 2011; Duits, 2010). Papadopoulos (2010) is of the opinion that beneath the sexualised content and imagery lays messages about expectations, values and ideals. Girls in middle childhood who might lack the cognitive and social skills to differentiate between themselves and these messages, can internalise the messages, and could this lead to premature sexualisation (Clark, 2013; Papadopoulos, 2010). Although not part of the focus of this study, it is worthwhile to mention that clothing, products, services, and peer- and parental pressure also play a significant role in sexualisation, as frequently mentioned in the literature (APA Task Force, 2010; Bailey, 2011; Brookes & Kelly, 2009; Buckingham et al., 2009; Buckingham, Bragg, Russel, & Willet, 20 2010; Ferguson, Munoz, Contreras, & Velasques, 2011; Goodin, Van Denburg, Murnen, & Smolak, 2011; Papadopoulos, 2010; Rush & La Nauze, 2006a, 2006b; Schick, 2014; Starr & Ferguson, 2012). Conceptualising Sexualisation Healthy sexuality is set apart from sexualisation. Determining what constitutes normal or healthy sexuality is complicated by several variables such as gender, age and health (Benuto, 2009). Nevertheless, according to the National Sexual Violence Resource Centre (2015) of the United States, healthy sexuality means having the knowledge and power to express sexuality in ways that enrich one’s life whilst respecting others; being comfortable with one’s body, accepting one’s own gender identity; understanding the impact of family, cultural, media, and societal messages on thoughts, feelings, values, and behaviours; expressing sexuality in ways that are in line with one’s own values; and knowing the difference between life-enhancing sexual behaviours and those that are harmful to the self and/or others. According to the American Psychological Association Task Force on the Sexualisation of Girls (APA Task Force, 2010), self-motivated sexual exploration and age- appropriate exposure to information about sexuality is not viewed as sexualisation. When combining the APA Task Force’s (2010) and Bailey’s (2011) definitions, sexualisation refers to the inappropriate imposition of adult sexuality onto children and young individuals before they are mentally, emotionally or physically capable of dealing with it; whereby excessive emphasis and value is placed on sexual appeal or behaviour; and young children are evaluated in terms of physical characteristics. Sexualisation also differs from merely being appearance-focused (Stone, Brown, & Jewell, 2015). Being appearance-focused involves self-surveillance and monitoring of one’s appearance, with the aim of being attractive, well-groomed and clean (Smolak, Murnen, & 21 Myers, 2014). Being appearance-focused is different from sexualisation, as sexualisation would specifically focus on behaviours related to being “sexy” (Stone et al., 2015). For example, sexualisation would be associated with behaviours that encourage wearing heavy makeup and/or clothing with the aim of emphasising sexual body parts such as breasts and buttocks (Smolak et al., 2014). Therefore, being appearance-focused means that a child can be attractive, but it does not necessarily equate to being sexualised. Sexualisation has come to be regarded as a significant social problem in numerous countries such as England, the United States of America, Australia, and Scotland. Children are excessively exposed as the inappropriate imposition of sexuality is encouraged and/or emphasised via multimedia. Media-induced sexualisation has raised concern because it can lead to detrimental psychological effects (Duschinsky, 2013; McKenney & Bigler, 2016). Although most evidence points to the detrimental psychological effects of sexualisation, contradictory arguments also stand. Scholars argue that sexualisation can contribute towards social benefits of attractiveness, the development of a positive sexual sense of self, and contribute towards the growing power of girls’ assertiveness and agency (Buckingham et al., 2009; Buckingham et al., 2010; Jackson & Vares, 2015; Starr & Ferguson, 2012). Considering the different opinions and views on sexualisation, it is evident that sexualisation can be viewed from two different perspectives; one being positive and the other negative. For this study, focus will be placed on summarising and integrating the detrimental psychological effects of sexualisation via multimedia. Positive effects will also briefly be discussed. Defining Middle Childhood Mash and Wolfe (2013) state that children in middle childhood range from 6 to 12 years of age, and that this is a critical developmental stage for learning, as children are 22 cognitively and psychologically very receptive to external influences. As children develop into middle childhood, the changes taking place in their cognitive, psychological, and social development contribute to important developments in the way they think about themselves and the world (Wild, 2012). Masten and Cicchetti (2010) highlight that problems in childhood could predict widespread difficulties in adulthood due to cascade effects. Several authors place emphasis on the importance of balanced development during middle childhood, as this serves as a foundation for further development (Dunn & Craig, 2013; Louw & Louw, 2014; Papalia & Martorell, 2014; Santrock, 2011). In children aged 7 to 12 years, approximately, cognitive development is in the stage of concrete operations (Piaget, 1932). This means that the children are mature enough to use logical thought or operations (i.e. rules), but can only apply logic to physical objects. Therefore, they can solve problems in a logical fashion, but are typically not able to think abstractly or hypothetically. Hence, children in middle childhood will not necessarily be able to fully understand underlying messages conveyed through the media. Psychosexually, children in this age group will function in the latency phase. During the latency phase, their conscience (morality principle) starts to develop, and they are likely to acquire new social values from interacting with same-sex peers and adults (Freud, 1905). In this phase, children begin to behave in morally acceptable ways and imitate or adopt (observational learning or modelling) the values of their parents, teachers, sport heroes, pop stars, or caregivers, as well as other important role models -including models portrayed in the media (Bandura, 1986). Concrete cognitive processes, with certain developmental thinking errors, are thus at work as children observe models portrayed in the media and learn new behaviour. In addition to the above processes taking place in middle childhood, Erikson’s (1959) psychosocial theory states that development consists of a sequence of stages, each defined by a unique challenge or crisis. From the age of 6 years to adolescence, children need to learn 23 basic skills and work with others (industry versus inferiority), and develop a lasting, integrated sense of self (identity versus identity confusion). Succeeding in early developmental tasks becomes the scaffold upon which later competencies and emerging developmental tasks develop, thus reaching competence in a developmental stage is crucial to beget future competence (Masten & Cicchetti, 2010; Obradovic & Hipwell, 2010). If developmental stages and phases are taken into consideration, it is clear that girls in middle childhood are susceptible to external influences such as models portrayed in the media, and that this could have an effect on their psychological functioning. Nevertheless, in order to judge what is regarded as detrimental to a child’s psychological functioning, one needs to be sensitive to each child’s stage of development, and take each child’s unique methods of coping and ways of compensating for difficulties into consideration (Mash & Wolfe, 2013). Understanding Psychological Effects Psychological functioning and psychosocial impact could be described as the result of an effect on an individuals’ social and/or psychological functioning, that is frequently caused by environmental and/or biological factors (De Oliveira, Buchrain, Vizzotto, Elkis, & Cordeir, 2013). Preedy and Watson (2010) state that a person’s psychological functioning refers to an individuals’ behaviour, emotion, social skills, and overall mental health. It also includes his or her ability to achieve his or her goals within him- or herself and the external environment. The media contributes towards the way young girls see themselves and the world (Brooks, 2008). Sexualisation could have an effect on a young girls’ psychological functioning in that it can affect emotions, cognitions, mental health, social skills, and, evidently, their behaviour (Papadopoulos, 2010). As the aforementioned could be influenced 24 by multimedia, it is worth exploring the possible psychological effects it might have on girls in middle childhood. Research states that middle childhood is a particularly important time for the development of the self-concept, and that experiences during this period can have a major impact on children’s self-esteem (APA Task Force, 2010; Wild, 2012). Research findings indicate that the current body ideal for women and young girls are unrealistically thin, and increasingly “sexy” (Murnen & Seabrook, 2012). The idealised pictures painted of women are ever-present to such an extent that advertisements in a variety of magazines depict young girls and women as sex objects (Stankiewicz & Rosselli, 2008). Some journalists, child advocacy organisations, parents, and psychologists have become alarmed, arguing that the sexualisation of girls is a vast and increasing phenomenon that can be harmful to girls (Bloom, 2004; Dalton, 2005; Lamb & Brown, 2006; Levy, 2005; Papadopoulos, 2010). With the latter in mind, research links sexualisation with psychological effects, such as mental health problems in girls and women, ranging from eating disorders, to low self-esteem, depression, sexual promiscuity, and anxiety (APA Task Force, 2010; Cook & Kaiser, 2004; Kehily, 2012). The Digital Transformation of Childhood: The Impact of Multimedia Children growing up in the twenty first century have entered a digital revolution. This current information age has its own unique challenges (Brown & Bobkowski, 2011; Levitin, 2015). With the surfeit of media modalities that children are exposed to on a daily basis, it is possible to view the latest news or download the most popular song almost anywhere and anytime (APA Task Force, 2010; Duits, 2010). Older forms of media such as television, radio, movies and magazines all have to adapt to the presence of newer media forms such as social networking sites, expansion of the 25 Internet, MP4 players, and “smart” mobile phones (Brown & Bobkowski, 2011). Together with this fast-changing environment, the focus of the content and context of multimedia has also adapted to newer social environments (Crabtree, 2012; Evans, 2012; Taylor, 2010). According to the book So Sexy So Soon: The New Sexualised Childhood and What Parents Can Do to Protect Their Kids (Levin & Kilbourne, 2008), children are being prematurely induced into inappropriate forms of sexual behaviour, particularly as a result of their exposure to media and commercial marketing. The concern here relates partly to children’s exposure to media material and content designed for older audiences, for example sexualised music videos; and partly to material explicitly targeting children, for example “tween” magazines, clothing and toys (Machia & Lamb, 2009; Rush and La Nauze, 2006b; Vandenbosch, Vervloessem, & Eggermont, 2013). The digital transformation of childhood inevitably primes children to use more media- related mediums (Bailey, 2011). Marketing and advertising induces this pressure on children as well as their parents (Rush & La Nauze, 2006a). According to Rush and La Nauze (2006a), parents are becoming more and more likely to buy non-essential items for their children to engage in media, because they desire: 1) to be seen by other parents as good providers for their children; 2) to let their children have the same possessions and opportunities as their peers; or 3) to prevent their children from being excluded, teased or bullied by their peers. Thus, parents also conform to social pressure which further results in promoting their children to use different media mediums more frequently (Ferguson et al., 2011). Children display enhanced autonomy and independence in their consumer behaviour, as they are able to request specific items for themselves and thereby may influence family purchasing decisions (Crabtree, 2012). A term coined “Pester Power” postulates that children are increasingly contributing towards the way parents spend their money (Bailey, 2011). For 26 example, Tiggeman and Slater (2014) recently pointed out that advertisers will target the ‘tween’ market in an attempt to use “Pester Power” to influence the purchasing decisions of their parents. Although it is difficult to quantify the influence children actually have on parental or family purchasing, literature does appear to indicate that most contemporary children have significant power regarding the purchase of items made by their parents for their own use (Buckingham et al., 2009). Despite seemingly providing consumers with own choice, personal empowerment and knowledge, different forms of multimedia such as television, music, movies, advertisement, cartoons and animation, magazines, Internet and video/computer games all have to compete for their fair share of children’s time and attention (Evans, 2012). Using topics with sexual images and content is an important part of getting the competitive edge in a very competitive environment, and inevitably contributes towards multimedia-induced sexualisation (APA Task Force, 2010). Children’s lives are becoming increasingly media-saturated as they incorporate reading child-magazines, watching more television, utilising the Internet, using mobile- and smartphones and playing video games within their daily lives (Childwise, 2011). According to Rideout (2015) in the Common-Sense Census, young children in the USA aged 8 to 12 years were found to consume up to 6 hours of media per day, and McDonough (2009) found that over 28 hours are spent per week on combined media-usage. Concurrently, increasingly more books, child-oriented magazines, music, films, television programmes, games and other products are created specifically to address children (Buckingham et al., 2009). This growing access to media is expanding as various forms of media are rapidly converging. For example, children utilising mobile phones do not simply use it to make calls or send messages, but also have access to the Internet to download games, watch videos, interact on social media platforms, and listen to music. If this is the case, making use of different media modalities 27 will inevitably expose children to an increased volume of unnecessary, sexualised advertisement and marketing (Buckingham et al., 2009). Popular girls’ magazines such as Barbie Magazine, Total Girl, Dolly Girl and Disney Girl specifically target girls between the ages of 5 and 12 years. The content of these magazines mostly revolves around beauty, fashion, celebrities, romance, fictional content, food, and book reviews. In an analysis performed by Rush and La Nauze (2006a), it was found that over half of the content of these magazines contained sexualising material. Brookes and Kelly (2009) concluded in an analysis specifically aimed at Dolly Magazine that consumer-media culture is limited in scope because it is dominated by images of young, slim and attractive females. As stated in the report by Rush and La Nauze (2006a), Phillip Adams coined the metaphor “corporate paedophilia” in an attempt to describe how advertising and marketing either seek to present children in sexually suggestive ways, or to sell products to children using overt forms of adult sexuality. Vares, Jackson and Gill (2011) also indicated that the content of television programmes are becoming more sexualised in nature, highlighting physical attractiveness and promoting ways in which young girls learn from and imitate the behaviours of film and cartoon characters. Bailey (2011) argues that society has become more sexualised, and with the increasing number of media modalities available, young girls receive sexualised messages through (sometimes unforeseen) exposure to sexualised content and imagery. Behind the sexualised content and imagery lays messages about expectations, values and ideals, which can lead to the internalisation thereof and can contribute towards sexualisation (Papadopoulos, 2010). Levin and Kilbourne (2008) state that many girls, from younger ages than before, seem to be preoccupied with appearing sexually attractive. The latter is a consequence of how females are presented in the media, informing young girls’ perception of how females ought to appear. 28 As girls increasingly engage with the media, whether supervised or unsupervised, they are inevitably more at risk to the exposure of age-inappropriate sexual content (Lumby & Albury, 2010). The degree of their exposure to such content and their reaction thereto can, however, be influenced by their social and cognitive abilities, age, individual preferences, peer networks, parental involvement, family relations, access to particular technologies, and pubertal timing (Brown, Halpern, & L’Engle, 2005; Buckingham et al., 2009; Vares et al., 2011). Young girls are not necessarily passive recipients of media models, but often imitate them and use them as resources in their construction of identities, values, and behavioural habits (Schick, 2014). This type of media poses as a powerful influence in the processes of self-formation for young people. Thus, a girl in middle childhood can be understood as an artefact of consumption as she seeks to develop and/or fashion a sense of self (Brookes & Kelly, 2009). The specific media modalities to which girls in middle childhood are exposed will be discussed in relation to how these modalities contribute to the sexualisation of girls. The effect of the different media vehicles. The different media modalities will be discussed in relation to television, magazines, Internet, advertising material, video-computer games and music. Television. The Australian Bureau of Statistics (2003) found that watching television is the most popular activity that many children participate in when it comes to media consumption, as it occupies a considerable portion of children’s leisure time. Although there are specific channels and programmes developed for children, children are also likely to view programmes that are not intended for them. Regardless of viewing programmes that are not intended for children, a concern raised 29 by Bailey (2011) is that programmes that have been traditionally viewed by families, such as reality and talent shows, have started to push the boundaries of acceptability by including increasingly sexualised content. In a survey conducted by Bailey, 41 per cent of parents stated that they had seen unsuitable or inappropriate programmes or advertisements for children on television before 9 p.m. due to the sexual content of these programmes. Television tends to depict women and girls in a sexualised manner, for example, they are being provocatively dressed, or somebody making sexual comments or remarks aimed at females (Papadopoulos, 2010; Shewmaker, 2015). As documented by the APA Task Force (2010) an analysis conducted on different prime- time American programmes had observed that women’s bodies were frequently objectified and often alluded to by insulting insinuations about their sexuality and lack of intellect. Researchers (Lamb & Brown, 2006; Levin, 2005) have expressed their concern regarding the sexual content of recent television programmes and movies for children. Others have also indicated that Disney’s female characters, e.g. The Little Mermaid and Pocahontas, display more cleavage, less clothing, and are presented as sexually more aesthetic (APA Task Force, 2010). Young girls spend a great deal at home, therefore, social learning from television can be expected to be particularly important for sexualisation (Shewmaker, 2015). The APA Task Force (2010) therefore emphasise that massive exposure to television among girls in middle childhood can create the potential for unwarranted sexual exposure and portrayals sexualising girls and teaching them that women are rendered to being sexual objects. 30 Magazines. The escalation of popular girls’ magazines such as Barbie Magazine, Total Girl and Disney Girl, targets girls mostly between the ages of 5 and 12 years. Rush and La Nauze (2006a) analysed these magazines and identified that material containing sexual content related to beauty, fashion, celebrities, or romance. Brookes and Kelly (2009) found in their analysis of Dolly Magazine that there was a limited range of body shapes and that the ‘ideally thin’ and ‘toned’ body was ever present in girls depicted in their featured photos. Papadopoulos (2010) also highlighted that girls featured in these magazines were often dressed to draw attention to sexual features that they not yet possessed, whilst at times also posing in provocative ways. The production and purchasing of magazines aimed at young children has dramatically increased (APA Task Force, 2010). A dominant theme found by researchers analysing the content of such magazines, is that of presenting oneself as sexually desirable to gain the attention of males (Brookes & Kelly, 2009; Machia & Lamb, 2009; Papadopoulos, 2010). It was also documented that attracting boys’ attention by looking “hot” or “sexy” was the main topic of advertisements, articles, cover lines and photographs posted in such magazines (Brookes & Kelly, 2009; Machia & Lamb, 2009). Rush and La Nauze (2006a) are of the opinion that magazines aimed at this age group reflects the increasing commercialisation that girls are exposed to. The emphasis on physical attractiveness reinforces the ‘ideal image’ that girls are lured to, encouraging them to display themselves as sexually desirable in order to gain males’ attention (Papadopoulos, 2010). The latter statement in itself equates the role of magazines’ contribution to sexualisation. 31 Internet. Young girls use the Internet frequently and have easier access to it compared to previous years (Tiggeman & Slater, 2013). It was found that 99 per cent of 8- to 17-year-olds in the UK have access to the Internet, and around a third of 8-to 11-year- olds were mostly using the Internet on their own (Papadopoulos, 2010). According to Papadopoulos (2010), online advertisements exceed television advertisements, which in effect contribute to greater and easier access to sexualised content online, as well as more exposure to sexualised marketing imagery and messages. Bailey (2011) pointed out concerns with regard to the easy access to age-restricted and adult material online, especially to pornographic sites. According to the APA Task Force (2010), girls in middle childhood were the most frequent users of the Internet in the USA. Most of these girls were also found to be registered on popular social networking sites, but a matter of concern was their naivety to the way in which they presented themselves, unknowing of the risks that this might entail (Bailey, 2011; Šribar, 2013). Social networking sites allow children to create online identities. What extends this to an example of sexualisation taking place is the fact that some girls present themselves solely in sexualised ways, dressing provocatively, and posting notices of their sexual availability (APA Task Force, 2010; Gabriel, 2014; Papadopoulos, 2010). Via the Internet, young girls have access to and/or are exposed to age- inappropriate sexual content and sexually loaded advertisements, whether it be purposefully pursued or accidentally encountered (Bailey, 2011). Advertisement/ advertising material through media modalities. Advertising is a lucrative industry that infiltrates countries world-wide. Advertisements can be seen on the television, in movies, in magazines, on the 32 Internet, on billboards, etc. More sophisticated techniques are utilised by advertisers to target children (Rush & La Nauze, 2006a). Children are recognised as a valuable group to target because they can influence parents’ purchases (‘Pester Power’) and often have their own money to spend (Buckingham et al., 2009). There has been a dramatic increase in sexualised images featured in advertising (Coy, 2009). In an analysis conducted over a 40-year period of young children appearing in advertisements, O’Donohue, Gold and McKay (1997) found that 85 per cent of these advertisements focused on girls, and that the depiction of sexualised girls increased over time. Girls often appeared alongside sexualised adult women, and were portrayed in either matching clothes or seductive poses. The sexualised images that are portrayed in advertising can contribute towards the sexualisation of young girls. Bailey (2011) states that within certain advertisements, women and girls are often depicted in highly sexualised ways, which in effect pressurises young girls to conform to certain body shapes, sexualised aesthetics, and particular gender roles. The APA Task Force (2010) documented that within certain advertisements and commercials, women are portrayed in a state of undress - that is, in a sexually provocative manner, they are presented in sexually exploitative ways; and they are often depicted as sexual objects. Rush and La Nauze (2006a) highlight that children aged eight and under, have a less developed understanding of the intent of advertising compared to older children. The latter may result in affecting the young child’s perception and understanding of him or herself. Although adolescent children have a better understanding of persuasive intent, they, on the other hand, are entering a vulnerable period of self-consciousness (Segall, 2003), making it very difficult for them to reject 33 cultural underpinnings in advertisements, creating desirability of sexualisation (Rush and La Nauze, 2006b). Video/computer games. It was found that 87 per cent of young children in the USA play video games, and that the average girl spends an average of 40 minutes per day playing online or home system games (APA Task Force, 2010). Haninger and Thompson (2004) found that of 80 “teen”-rated games, 27 per cent of these games contain sexual themes (noticeable cleavage, large breasts, or provocative clothing) and that the games depict female characters as partially nude or engaging in sexual behaviours. Papadopoulos (2010) states that playing games on the Internet is the most common way in which children aged 8 to 11 engage with the Internet. Some games can be educational and of social value; however, they also appear to encourage young girls to present themselves in more mature ways physically, and place an emphasis on physical appearance (Papadopoulos, 2010). On the website, www.missbimbo.com, girls can create virtual characters that are encouraged to make use of plastic surgery and dieting in order to achieve the ‘perfect figure’ to compete for the ‘coolest and most popular bimbo in the world’. As no thorough method is used to verify the girl’s age, any girl can participate in playing this game. Many computer- and video games are becoming increasingly graphic and realistic, and feature sexualised graphics or content (Papadopoulos, 2010). Therefore, girls engaging in these games, especially without supervision, can become highly susceptible towards the development of sexualisation. 34 Music videos and music performances. Papadopoulos (2010) states that young children can listen up to 1.5 and 2.5 hours of music each day, and are therefore potentially influenced by the lyrics and music videos. There are no restrictions for children to purchase or download music or music videos. What is of concern is that most recent popular hip-hop music videos contain highly sexual imagery, especially that of women being displayed in provocative and revealing clothing while dancing in sexual ways (Bailey, 2011). Vandenbosch et al. (2013) found that women are frequently depicted in music videos as sexual objects, whereby focus is placed on their body parts in order to emphasise sexual attractiveness. Donze (2011) contends that information about female sexuality is not only conveyed through music videos, but also through the changing personas of the artists themselves. Andsager and Roe (2003) found in their analysis of the 20 years before 2003 that sex and sexualised appearance are used as a ‘metamorphosis’. They indicate that teen artists would use their sexuality to establish a more mature version of their former selves as they transgress from a teenage icon to adult musician. This process can be illustrated by artists such as Miley Cyrus (Hannah Montana), Britney Spears, Christina Aguilera, and Madonna. These ‘metamorphic’ transformations exemplify that by changing into a successful sexual object, one could be perceived as more mature and successful. Exposure to high sexually charged media material, such as that contained in some music videos, in combination with underlying messages in advertising that sexiness is highly desirable, can lead children to mimic these sexual behaviours, and evidently lead them to adopt a sexualised appearance (Dagbovie-Mullins, 2013; Jackson & Goddard, 2015; Rush & La Nauze, 2006a). 35 Young girls are likely to be objectified and sexualised through a variety of media modalities such as television, magazines, the Internet, advertisement, video- or computer games, and music and music videos. Through these media modalities, girls are presented with underlying messages and models that they use to fashion their own behaviours, self-concepts, and identities (Schick, 2014). A number of factors such as age and level of cognitive and emotional development would influence the way in which girls in middle childhood respond to sexualisation. However, important to consider is the cumulative effect that exposure to sexualised images and messages will have over time. When it comes to internalising media messages, there is a body of research that attests to the fact that children in middle childhood have not yet developed the cognitive skills to cope with persuasive media messages (APA Task Force, 2010; Papadopoulos, 2010). Rationale for the Study In Westernised countries, whereby certain parts of South Africa’s (SA) metropolitan areas can be included, sexualisation can primarily be understood as a mainstream, commercial phenomenon that is apparent in the entire cultural field. Levy (2005) furthers this argument by stating that young girls growing up in Westernised countries do this against a backdrop of promiscuous culture. According to Gill (2007), the latter represents a ‘new femininity’ for some scholars, whereby hypersexual forms of sexual expression are now expected, emphasised or being made aware of. Thus, a variety of ideas about sexuality, sexualised aesthetics, and sexualised modes of communication create the framework for sexualisation in culture and media. Papadopoulos (2010) further states that young children that are exposed to such explicit sexualised content may not yet have developed the maturity to rationalise and put what they see into context. 36 In contrast to the abovementioned dangers of sexualisation, feminism, homosexual politics and other sexual movements have introduced an explosion of other ways of conceptualising sexualisation, and have, thus, affiliated and generated new sexual knowledge (Holland & Thomson, 2010). Critics commenting on the detrimental effects of sexualisation argue that no consideration is given to sexualisation, or even objectification, as being self- controlled, intrinsically positive, empowering or lust enhancing, and that there is no focus on a female’s sexual agency, control, or assertiveness (Lerum & Dworkin, 2009; Vanwesenbeeck, 2009; Vares et al., 2011). Although the media contributes to the sexualisation of girls, commentators argue that knowledge around female sexual power, sexual health and sexual emancipation can also be a positive result of sexualisation (Albury, 2013). The main contention is that sexualisation is associated with risks, as well as with opportunities (Vanwesenbeeck, 2009), and that any productive study will have to consider both. As no study with regard to this topic could be found within the context of developing countries, a synthesis and integration of the available research done internationally could be valuable to add to international debate, and hopefully inform further research that is more directed and focused on issues associated with this phenomenon. This may also contribute to a better understanding of its psychological effects on children in middle childhood and why and/or how multimedia may contribute towards sexualisation. In addition, this research can create awareness of the phenomenon and facilitate the development of pro-active intervention strategies and psycho-educational programmes for parents aimed at managing the phenomenon in the context of developing countries. 37 Aim of the Study The aim of this study will be to: • systematically review, synthesize, and summarize recent literature pertaining to the psychological effects of multimedia-induced sexualisation of girls in middle childhood. In light of the aim stated above, the central research question that this study sought to answer was: What are the psychological effect/s of multimedia-induced sexualisation of girls in middle childhood as found in current literature? Methodology Research Method and Design A systematic literature review will be done to provide a synthesis of the available literature that “aims at answering a clear targeted research question” (Hannes et al., 2007, p. 749). The systematic literature review attempts to answer a research question through an unbiased study of all the empirical studies and literature that address it (Strech & Sofear, 2012). The available literature will be retrieved by the researcher to determine if it is relevant, while excluding literature that is irrelevant. The specific purpose for using this method to conduct research is to comprehensively scrutinise, compare, describe, summarise, and synthesise published findings about the phenomenon. This summarised and integrated information is found to be very valuable, for example, for psychologists in practice to help conceptualise their clients and plan their treatment regimes. Therefore, the reviewer will attempt to present these findings in a way that not only answers the specific research question, but also will save other scientists or practitioners the time to obtain and evaluate these studies themselves (Rew, 2010). 38 In order to appropriately identify available literature, the research will follow five distinct, standardised phases, namely: • Phase 1: Search for keywords and search criteria in databases • Phase 2: A critical appraisal of compliance to keywords, inclusion and exclusion criteria • Phase 3: Critical appraisal of quality of selected studies • Phase 4: Data extraction from final group of selected articles • Phase 5: Data analysis Phase 1: Search for keywords in databases. In the systematic reviewing of literature, the following keywords will be used to do the initial search: Sexualisation, sexualisation of girls, middle childhood, multimedia sexualisation, and psychological effects. The search criteria will also include words such as: Healthy sexuality, sexual emphasis or awareness in media, sexual objectification, developmental stages, multimedia and sexualisation, behavioural effects of sexualisation, emotional effects of sexualisation, and social skills. The above search terms will be used to consult the following databases: EbscoHost, Academic Search Premier, ScienceDirect, ePublications, SAE publication, Google Scholar, JSTOR, PsycArticles and PsychINFO. Parameters are intentionally set at the start of a review process to inform which articles, data, and opinions will be included and/or excluded in the summary analysis of the review (Zumsteg, Cooper, & Noon, 2012). The inclusion criteria relate to data that must be relevant to the research question, and the exclusion criteria will exclude studies that are 39 known to be out of the scope of the review. The Boolean operators AND, OR, and NOT will be applied to appropriately combine the specified key words. Phase 2: A critical appraisal of compliance to keywords, inclusion and exclusion criteria. The researcher and primary study leader will independently review titles and abstracts of all initially selected studies in order to decide which ones should be included for further analysis. A third reviewer (an independent researcher with experience in systematic reviews) will be invited to resolve disagreements when necessary, and to help ensure that eligibility criteria are applied in an unbiased way. Phase 3: Critical appraisal of quality of selected studies. Selected full text articles, based on titles and abstracts, will be assessed independently by the reviewer and supervisor. Quality Criteria Checklist (QCC) instruments of the Critical Appraisal Skills Programme (Critical Appraisal Skills Programme, 2006) will be utilised to critically appraise qualitative and theoretical literature studies. The QCC instruments of the American Dietetic Association (ADA, 2003) will be utilised to critically appraise quantitative studies and review reports. This will ensure that each study has a sound scientific base, has been properly designed, and has been appropriately executed. Articles selected during this process will make up the final group that will be reviewed and synthesised. Phase 4: Data extraction. The following data will be extracted from the final group and plotted in a table: • Author(s) • Title of study 40 • Year of publication • Type of publication (journal, article, book chapter, etc.) • Research design • Sample method and sample size • Sample description • Data collection and data analysis technique • Findings on psychological effects of sexualisation • Recommendations and/or guidelines regarding further research and practice Phase 5: Data analysis. Qualitative content analysis (QCA) will be independently conducted by the researcher and her supervisor to synthesise the findings. Mayring (2000) describes QCA as a methodological analysis of texts that strictly follows stepwise content analytical rules. It is an inductive approach that allows themes to emerge from the data rather than being based on preconceived categories. Emerging themes will, however, be discussed in relation to sexualisation as described in scientific literature. Validity and Reliability Validity and reliability will be promoted by following the steps in the research process in a deliberate, well-planned, and reflective way. The whole process will be carefully planned, recorded and documented according to the protocol for systematic reviews. The use of two independent reviewers with a co-reviewer (co-supervisor) will ensure rigour and enhance the trustworthiness of the study. Care will be taken to be thorough and critical, and to continuously reflect on the process. 41 Ethical Considerations Authors of a systematic review have certain important responsibilities. They should follow the general conventions of publication ethics and guidelines. Contributors should be properly acknowledged, the potential conflict of interests must be declared and the review must not contain plagiarised material (Wagner & Wiffen, 2011). For the research to take place, ethical approval was obtained from the Ethics Committee of the North-West University, Potchefstroom Campus (NWU-00373-15-S1). Informed consent does not apply to this study. Preparation for this systematic review will be undertaken in a responsible manner to ensure integrity and avoid misconduct. Avoiding duplication of research will also be attended to. There is no other study like this one that has been conducted elsewhere in South Africa, as journals do not want to publish work that has been, or will be, published elsewhere (Wagner & Wiffen, 2011). Repeated publication of positive findings and repression of negative findings (and vice versa) may also have subtler psychological effects on readers, leading to a misplaced confidence or bias. Plagiarism will be avoided at all times. It is not only unethical but also illegal. The researcher will commit to describing others’ research in her own words, with appropriate citation, and will not use their words in this publication unless the origin of the word is clear, i.e., their words will be presented in quotation marks. Thus, the researcher will not represent another person’s work as her own. Flagging suspected plagiarism or fraudulent research will also be done. Systematic reviews sometimes reveal apparent plagiarism of whole articles (republished by a completely new set of authors). In such cases, it is good practice for the researcher to alert the publishers of both articles to point out the similarity and suggest that they should investigate this. Transparency will be ensured by declaring any conflict of interest of the researcher, or the researcher’s supervisors; private interests (competing interest); and the responsibilities to scientific and publishing activities. The researcher will ensure accuracy by 42 extracting data accurately, and will not modify the results or literature in any way. Thus, the researcher has planned for accurate data extraction by ensuring that data is extracted by the researcher and her supervisor and reviewed by the co-supervisors. Sound scientific databases will be explored, and a well-documented record of all the databases researched as well as all researched results obtained will be kept. Due to the method of the research and it not being empirical of nature, no participants are physically required and therefore no person will be caused harm in a physical, psychological or legal manner. The foreseen benefits of this study will include increased insight into the phenomenon of the multimedia-induced sexualisation of girls and the psychological effects thereof. Thus, the benefits of this study outweigh the risks, as there are methods put in place to counter foreseeable risks. 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Caryn Koekemoer, Heleen Coetzee, and Esmé van Rensburg Correspondence: * Caryn Koekemoer Klinkenberg Street Potchefstroom caryn.koekemoer@gmail.com Heleen Coetzee School for Psychosocial Behavioural Sciences North-West University Potchefstroom 10933824@nwu.ac.za Esmé van Rensburg School for Psychosocial Behavioural Sciences North-West University Potchefstroom 10194118@nwu.ac.za 54 Running title: MULTIMEDIA-INDUCED SEXUALISATION Abstract Objective- The aim of this study was to systematically review, explore, synthesise and integrate available literature pertaining to the psychological effects of multimedia- induced sexualisation of girls in middle childhood. Method- A systematic review was conducted through a comprehensive electronic search. Nineteen studies were identified for inclusion in the review. Data were analysed by means of qualitative content analysis. Results- Two themes were identified, namely: 1) detrimental psychological effects of sexualisation and 2) positive psychological effects of sexualisation. Findings appeared to indicate that the psychological effects on girls in middle childhood resulting from sexualisation, such as internalisation, mental health problems, objectification and gender stereotyping, were more detrimental than beneficial to their well-being. A paucity of research on the topic in developing countries was also found, and as such a precautionary approach pertaining to sexualisation of girls in middle childhood was recommended. Conclusion- A thorough understanding of this phenomenon is valuable, as it can inform a preventative and pro-active management approach. It can especially help to inform policy in this regard, and help therapists by informing their developmental conceptualisation and treatment of girls in middle childhood. 55 MULTIMEDIA-INDUCED SEXUALISATION A systematic literature review pertaining to the psychological effects of multimedia- induced sexualisation of girls in middle childhood. Keywords: sexualisation, sexualisation of girls, middle childhood, multimedia sexualisation, psychological effects Introduction Media reports issued in America, Australia, England, and Scotland have recently sparked an international debate regarding the sexualisation of young children on a global scale. This has been identified as an issue of concern, and is currently a topic of academic and populist commentary, as well as an emerging issue of policy debate (Bragg, 2012). Although exposure to sexual materials is not new for children, a recent disturbing trend shows that, for the first time, young children are being directly targeted in the media (Gale, 2008). It is important to distinguish between healthy sexuality and sexualisation. Healthy sexuality consists of having the knowledge and power to express sexuality in ways that enriches one’s life whilst respecting others; being comfortable with one’s body; accepting one’s own gender identity; understanding the impact of family, cultural, media, and societal messages on sexually related thoughts, feelings, values, and behaviours; expressing sexuality in ways that are in line with one’s own values; and knowing the difference between life- enhancing sexual behaviours and those that are harmful to the self and/or others (National Sexual Violence Resource Centre, 2015; Sexuality Information and Education Council of the United States, 2004). In contrast, sexualisation can be described as making something sexual in character or quality, to make the sexual visible, or to become aware of sexuality and then become sexualised at an inappropriately accelerated rate as a consequence of encounters with 56 MULTIMEDIA-INDUCED SEXUALISATION ‘sexualised’ media (Bailey, 2011; Collins English Dictionary, 2014; Jackson & Vares, 2015; Kehily, 2012). The American Psychological Association Task Force on the Sexualisation of Girls (APA Task Force: 2010, p. 1) and Bailey (2011, p. 115) further define sexualisation as “the inappropriate imposition of adult sexuality onto children and young individuals before they are mentally, emotionally or physically capable of dealing with it; whereby excessive emphasis and value is placed on sexual appeal or behaviour; and whereby young children are evaluated in terms of physical characteristics”. According to the APA Task Force, self- motivated sexual exploration and age-appropriate exposure to information about sexuality is not viewed as sexualisation. Sexualisation also differs from merely being focused on one’s appearance in order to be presented as well-groomed or neat (Smolak, Murnen, & Myers, 2014; Stone, Brown, & Jewell, 2015). Children’s lives are becoming increasingly media-saturated as they incorporate different multimedia within their daily lives as a result of the information age in which they are growing up (Childwise, 2011; Levitin, 2015). Consequently, different forms of sexualised multimedia pertaining to television, music, movies, advertisement, cartoons, animation, child-magazines, Internet, and video/computer games may all contribute towards sexualisation (APA Task Force, 2010). In a television show, ‘Toddlers and Tiaras’ featuring child beauty pageants, 5-year-old girls wear fake teeth, hair extensions, make-up, and are encouraged to ‘flirt’ onstage by batting their long, false eyelashes (Cookson, 2001). Not only do shows like these normalise certain sexualised behaviours, but it also dictates the production of products to reinforce such behaviours. In another example, Bratz toy-doll manufacturers are currently producing dolls wearing black leather mini-skirts, feather boas, tight, high boots, ‘made-up’ faces, and low-cut tops; and they market them to 8- to 12-year- old girls (La Ferla, 2003). Thongs sized for 7- to 10-year-old girls are also currently being 57 MULTIMEDIA-INDUCED SEXUALISATION sold, some even printed with slogans such as “eye candy” and “porn star” (Brooks, 2008; Williams, 2010; Womack, 2007;). Some products advertised through different media modalities for girls appear to be promoting a ‘made up’ appearance, which can contribute towards sexualisation. The developmental stage of each unique child will determine the extent to which they will be effected by exposure of sexualised multimedia messages. A number of authors emphasise the importance of balanced development during childhood, as this will serve as a foundation for further development (Dunn & Craig, 2013; Louw & Louw, 2014; Masten & Cicchetti, 2010; Papalia & Martorell, 2014; Santrock, 2011). From a developmental perspective, Mash and Wolfe (2013) state that girls in middle childhood, ranging from the ages of 6 to 12 years, are cognitively as well as psychologically very receptive to external influences. As children develop into middle childhood, the expected changes taking place in their cognitive, psychological and social development may contribute to important developments in the way they think about themselves and the world around them (Wild, 2012). Children in middle childhood find themselves functioning in the latency phase, whereby their superego (morality principle) is starting to develop. Concrete cognitive processes, with certain developmental thinking errors, are at work as children observe models portrayed in the media (Anderson et al., 2010). These children are likely to acquire new social values and behaviours from interacting, observing, or imitating peers and models such as parents, teachers, sport heroes and pop stars (Bandura, 1986; Freud, 1905). From the age of 6 years to adolescence, children need to learn basic psycho-social skills, like working with others and comparing themselves against them (industry versus inferiority), and the development of a lasting, integrated sense of self (identity versus identity confusion) (Erikson, 1959). The abovementioned outline of developmental tasks and challenges give a 58 MULTIMEDIA-INDUCED SEXUALISATION clear indication of the possible vulnerability and susceptibility of girls in middle childhood to the psychological effects of media influences. Psychological functioning and impact can be understood as a combination of environmental and/or biological factors influencing an individual’s social and/or psychological functioning (De Oliveira, Buchrain, Vizzotto, Elkis, & Cordeir, 2013) and relates to the ability to achieve his or her goals within him- or herself and the external environment (Preedy & Watson, 2010). Psychological functioning includes an individual’s thoughts, behaviour, emotions, social skills, well-being, and overall mental health (APA Task Force, 2010; Mash & Wolfe, 2013; Papalia & Martorell, 2014). Sexualisation can influence emotions, cognitions, mental health, social skills, and, evidently, young girls’ behaviour, as the media contributes towards the way they see themselves and the world (Brooks, 2008). Children in middle childhood are greatly influenced by multimedia (Bailey, 2011; Coy, 2009; Papadopoulos, 2010), and it is therefore important to explore what the psychological effects of multimedia-induced sexualisation of girls in middle childhood are. Research indicates that the contemporary body ideal for women is unrealistically thin, and increasingly “sexy” (Murnen & Seabrook, 2012). The cumulative presentation of idealised pictures painted of women are ever-present, and can have a direct impact on how girls in middle childhood view themselves (Kehily, 2012). Middle childhood is a particularly important developmental stage, especially with regard to the development of the self-concept. Experiences during this phase can have a major impact on children’s self-esteem (APA Task Force, 2010; Wild, 2012). Some journalists, child advocacy organisations, parents, and psychologists argue that the sexualisation of girls is a vast and an increasing phenomenon that can be harmful to girls 59 MULTIMEDIA-INDUCED SEXUALISATION (Bloom, 2004; Dalton, 2005; Lamb & Brown, 2006; Levy, 2005). With the latter in mind, research links sexualisation to various mental health problems among girls and women, including psychiatric disorders and psychological problems such as eating disorders, low self- esteem, depression, sexual promiscuity, and anxiety (APA Task Force, 2010; Bailey; 2011; Cook & Kaiser, 2004; Kehily, 2012; McKenney & Bigler, 2016; Papadopoulos, 2010; Taylor, 2010). Although there is a strong argument for the detrimental psychological effects of sexualisation in the media, there are also contrasting views. These views motivate that female sexual power, sexual health, and sexual emancipation can be seen as a positive result of sexualisation. The contrary argument holds that sexualisation or even objectification can be self-controlled, intrinsically positive, empowering, or lust enhancing, which in effect contributes to a female person’s sexual agency, control, and assertiveness (Holland & Thomson, 2010; Lerum & Dworkin, 2009; Reid, 2014; Vanwesenbeeck, 2009). Research has found that, not only individuals, but also communities, society’s representation, and culture as a whole are influenced by the prevalence of sexualisation in the media (Kehily, 2012). The context wherein sexualisation takes place is thus a very important variable that needs to be taken into consideration. In Westernised societies, in which certain parts of developing countries’ metropolitan areas can be included, sexualisation can primarily be understood as a mainstream, commercial phenomenon. Levy (2005) furthers this argument by stating that young girls growing up in Westernised countries do this against the backdrop of a “raunch culture”. According to Gill (2007), the latter represents a ‘new femininity’ for some scholars, whereby hypersexual forms of sexual expression are now expected and/or emphasised. 60 MULTIMEDIA-INDUCED SEXUALISATION Developing countries receives immense media input from Westernised societies, as most media emanates from countries such as the United States and United Kingdom. Westernised media contains more explicit, sexualised media, and girls are more likely to be exposed to sexual content (Attwood, 2009). Children from the developing countries would engage with these sexualised media portrayals, and are rendered vulnerable due to their societal and cultural position (Mathews, Loots, Sikweyiya, & Jewkes, 2012). Sexualisation taking place through Western media may increase their vulnerability. The current study was motivated by an apparent lack of information, as no studies on this topic could be found within the context of developing counties. As a result, this study aimed to explore, compare, synthesise, and integrate the available research that has been done on the topic internationally. In conducting this research, the aim was to produce a comprehensive outline of literature on a phenomenon that is currently taking place worldwide. The reason for integrating this information was to add to international debate, inform readers regarding most recent evidence on this phenomenon, pro-actively inform further research, and create an awareness of this phenomenon within developing countries. This may also contribute to a better understanding of the psychological effects that children might be exposed to due to multimedia-induced sexualisation. Aim of the Study The aim of the study was to explore, systematically review, synthesise, and summarise current available research pertaining to the psychological effects of multimedia-induced sexualisation of girls in middle childhood. In light of the aim stated above, the central research question that this study sought to answer was: What are the psychological effects of multimedia-induced sexualisation of girls in middle childhood as found in current literature? 61 MULTIMEDIA-INDUCED SEXUALISATION Method A systematic review was done to identify and describe the best methodologically sound evidence of literature that is relevant to the specific topic of this proposed study. The purpose of using this method to conduct research is to comprehensively explore, describe, synthesise, and summarise published findings about the phenomenon under scrutiny. A function, namely Onesearch, provides within a single search the results from different search engines and databases. The databases searched and search engines utilised for this study included JSTOR, SAePublication, EBSCOhost, Google Scholar, Sabinet Reference, Scopus, Web of Science, Academic Search Premier, ScienceDirect, PsycArticles and Psych INFO. The following key words were used in combination with Boolean operators (AND, OR, NOT) to do the initial search in consultation with a librarian at the NWU: 1) sexualisation OR sexuali?ation OR “premature sexuali?ation” OR “sexual maturation” OR “sexual appeal” OR sexual objectification OR sexuali?ed behaviour OR sexuali?e OR “sexualized aesthetics” OR “sexual emphasis” OR sexual awareness OR “hypersexuali?ation” OR “sexiness” OR sexual socialisation NOT healthy sexuality NOT sexual abuse NOT sexual orientation NOT “early sexual debut” 2) middle childhood OR young childhood OR early childhood OR youngster OR youth OR “young girl” OR “preteen” OR “girlhood” OR young female OR young individual OR early adolescents OR preschool girls OR primary school girls OR “pre-adolescent” OR “young girl” OR “tween” NOT adolescents NOT adult women NOT boys NOT males NOT men 3) psychological effects OR psychosocial effects OR psychosocial effect OR psychological influence OR “psychological impact” OR “influence on personality” OR “social effect” OR “psychological consequences” OR behavioural effects OR “long term effects” 62 MULTIMEDIA-INDUCED SEXUALISATION 4) multimedia OR digital media OR “audio-visual media” OR mass media OR media OR “multimedia” OR media exposure A systematic review requires that a researcher make use of inclusion and exclusion criteria to help ascertain which studies are relevant to the review (Bryman, 2012; Milner, 2015). As such, the following inclusion criteria were used in the present study: - Academic publications between 2001 and 2016, which included higher degree dissertations and full-text journal articles. - Grey literature published between 2001 and 2016. This included technical and research reports, working papers, conference proceedings, and other documents that are not normally subject to editorial control or peer review. - Studies that focused on middle childhood and/or early adolescence. - Studies that focused on sexualisation and childhood. - Reviews and peer commentator papers. - Archival original documents and collections. - Publications which had originated from any country or language, but with an available abstract in either English or Afrikaans (A South-African language). The following exclusion criteria were used: - Publications that preceded the year 2001. - Non-accredited scientific articles. - Data representing males/boys. - Data not related to the sexualisation of females. - Duplicate reports of the same study. - Studies in a language other than, and without an abstract in either English or Afrikaans. 63 MULTIMEDIA-INDUCED SEXUALISATION Due to the fast changing pace of technology and multimedia, it was considered that studies on multimedia and sexualisation which precede the year 2001 might be outdated and therefore not produce a true reflection of the current phenomenon under study. At first, the search produced a total of 1934 results of potential studies (that contained the keywords somewhere within the text). The researcher screened 1934 titles for relevance, whereby 1691 studies were excluded due to inapplicability to the review question. Therefore, after screening and elimination, 243 studies remained. The researcher and first co-author independently reviewed the remaining 243 titles and abstracts to select those to be included for further analysis. Of the remaining 243 studies, 213 studies were excluded due to their not meeting the inclusion criteria or being irrelevant to the research question (Petticrew & Roberts, 2006). Next, the remaining 30 full text studies were independently critically appraised by both researcher and first co-author, following the Quality Criteria Checklists (QCC) of the Critical Appraisal Skills Programme (CASP, 2006) and the American Dietetic Association (ADA, 2003: See appendix). It was planned that the second co-author (a third reviewer) with experience in systematic reviews would be approached to resolve disagreements on which articles to include and exclude. This planned procedure would also have been helpful to ensure that eligibility criteria were applied in an unbiased way. The third reviewer was, however, not required, as no disagreements escalated to this degree. By using the appropriate appraisal instruments, 11 of the 30 studies were further excluded from the final group of studies, as, according to the appraisal instruments, they were identified as poor quality research. A total of 19 studies remained in the final group of studies to be explored, reviewed, and analysed in order to answer the research question. The whole process of selecting the final 19 studies included in the study is reflected in Figure 1. 64 MULTIMEDIA-INDUCED SEXUALISATION Data were extracted from the final group of 19 studies and plotted in a table, (see Table 1). Qualitative content analysis (QCA) was independently conducted by the researcher and one of the co-authors to explore and synthesise the findings. Finally, based on the methodological steps of a systematic review, emerging themes were synthesised and discussed in the results section of this paper (Higgins & Green, 2011; Milner, 2015; Petticrew & Roberts, 2006). Ethical approval to conduct the research was obtained from the North-West University (NWU-00373-15-S1). In addition to adhering to the research protocol, the authors applied the guidelines provided by Wagner and Wiffen (2011) to ensure accuracy and transparency, as well as avoid duplication, fabrication, falsification, and plagiarism. Validity and reliability were promoted by subsequently following the steps in the research process in a thoughtful and reflective way. The use of two reviewers and a third independent reviewer further ensured rigour and enhanced the trustworthiness of the study. Results The final 19 studies included 6 quantitative and 4 qualitative studies, 1 theoretical article, and 8 review reports. The studies varied in sociocultural contexts and location, with sample sizes ranging between 15 and 815. The review reports did not necessarily volunteer sample sizes, but placed focus primarily on the sexualisation of girls in middle childhood. Most of the identified studies focused mainly on how sexualisation is promoted and give a clear indication that the generation of empirical knowledge and evidence regarding the psychological effects of media-induced sexualisation of girls in middle childhood is still lacking or in its beginning phase. Two main themes with their sub-themes, however, arose from the current review; namely, 1) detrimental psychological effects of multimedia-induced sexualisation, and 2) positive psychological effects of multimedia-induced sexualisation. 65 MULTIMEDIA-INDUCED SEXUALISATION Detrimental effects will be discussed under the sub-headings of internalisation, body satisfaction, self-concept, and the effect on young girls’ mental health, objectification, and gender stereotyping. Positive psychological effects will then be discussed without specific sub-headings, as no specific sub-headings were produced. Theme 1: Detrimental Psychological Effects of Multimedia-Induced Sexualisation Detrimental psychological effects identified from the current review included internalisation, body dissatisfaction, self-concept, and the effect on the young girls’ mental health, objectification, and gender stereotyping. Internalisation Internalisation refers to the process whereby an individual conforms to social norms and uses those internalised norms to act as guiding principles that inform their views, decisions and behaviour (APA Task Force, 2010; McKenney & Bigler, 2016). This current review has found significant evidence that demonstrates the correlation between the internalised ‘thin body ideal’ imposed by media images and body dissatisfaction. Internalisation of unrealistic body ideals has shown to be the main predictor of body dissatisfaction (APA Task Force, 2010). McKenney and Bigler (2016) concluded that girls in middle childhood who presented with higher levels of internalised sexualisation were more likely to wear sexualised clothes, and displayed higher levels of body surveillance and body shame compared to girls with lower levels of internalised sexualisation. As another result of sexualisation, body dissatisfaction alters confidence in one’s own body, which in effect leads to a host of negative 66 MULTIMEDIA-INDUCED SEXUALISATION emotional consequences including feelings of shame, inadequacy, anxiety and self-disgust (APA Task Force, 2010; Papadopoulos, 2010; Rush & La Nauze, 2006a, 2006b). Murnen, Smolak, Mills and Good (2003) described body dissatisfaction as the discrepancy between one’s actual body and the ideal body presented in contemporary media. The issue of body image overlaps with young girls being put under pressure to equate their own bodies with slender and so-called ‘sexy’ bodies (Buckingham et al., 2009). The APA Task Force (2010) found that many girls from the age of 6 years were dissatisfied with their body appearance and weight, and that nearly a third of 7- to 11-year-olds wanted to change some aspect of their bodies. Another study also demonstrated that appearance dissatisfaction in 5- to 8-year-old girls predicted a subsequent lowered overall self-esteem one year later (Dohnt & Tiggemann, 2006). Body dissatisfaction could impede the development of a healthy body image. Contemporary media appears to promote and reinforce an idealised notion of a particular body image (Easterbrook, Wright, Dittmar, & Banerjee, 2014). Thus, repeated exposure to unrealistic media images and messages can lead young girls to internalise harmful messages about their value as human beings, and, in the process, could detrimentally affect their mental health (Stone et al., 2015). Body dissatisfaction, self-concept, and the effect on young girls’ mental health In addition to internalising potentially harmful media images, the analysis of literature in this study found that the sexualisation of young girls can lead to a range of damaging consequences for their mental health, such as depression, eating disorders, lowered self- esteem, and lowered well-being (APA Task Force, 2010; Bailey, 2011; Buckingham et al., 2010; Easterbrook et al., 2014; Papadopoulos, 2010; Rush & La Nauze, 2006a, 2006b). Papadopoulos (2010) in particular had found that internalising conventional ideas about the 67 MULTIMEDIA-INDUCED SEXUALISATION idealised girl portrayed in contemporary media could lead girls to question their self-worth, and as such they have a higher propensity to become depressed. They are also more likely to suppress their feelings about their bodies in the process. In a longitudinal study conducted by Stice, Spangler and Agras (2001), it was concluded that body dissatisfaction, eating disorders, and depression were strong predictors for young girls developing major depressive disorder. Young girls exposed to idealised women in advertisements were also found to have scored higher on depression (Bailey, 2011). Furthermore, frequent exposure to contemporary movies, television, and music videos that feature these idealised images relate strongly to stress, guilt, shame, insecurity, and lowered self-esteem (Brookes & Kelly, 2009; Papadopoulos, 2010). The Australian Standing Committee on Environment, Communications and the Arts (SCECA: 2008) has also stated that sexualisation tends to result in low self-esteem and problems with self-image and emotional development. Numerous studies were also found link sexualisation with eating disorders (APA Task Force, 2010; Bailey, 2011; Papadopoulos, 2010). The eating disorders were linked with advertisements and television programmes featuring slim models, and girls’ own inaccurate estimation of their body sizes (Papadopoulos, 2010). Another link was also found between dieting practices and the consumption of fashion and beauty magazines. DeLeel, Hughes, Miller, Hipwell and Theodore (2009) surveyed almost six hundred 9- to 10-year-old girls, and found that 11 per cent of 9-year-old girls and 7 per cent of 10-year-old girls scored within the ‘anorexic range’ as part of their study. It was found that over a third of all girls had selected ‘ideal’ figures that were disproportionate to their own bodies. DeLeel et al. concluded that young girls demonstrated a higher drive for thinness, a negative perception of their bodies, and higher levels of perfectionism; which in turn made them a high-risk group for the development of eating disorders. 68 MULTIMEDIA-INDUCED SEXUALISATION Over-all, numerous researchers observed a vicious cycle where dissatisfaction with one’s own body leads to more Internet use, and more Internet use in turn leads to more body dissatisfaction (Bailey, 2011; Papadopoulos, 2010). It therefore appears that striving for consumer culture ideals can have detrimental effects on young girls’ well-being (Brookes & Kelly, 2009). Easterbrook et al. (2014) confirmed this by finding that the consequences of striving for consumer culture ideals related to lowered well-being among children aged 8 to 15 years, as they constantly strive to emulate unrealistic societal ideals. Objectification Self-objectification refers to the process where a girl would adopt an observer’s perspective of her physical self and view herself primarily as an object to be scrutinised on the basis of her appearance (Starr & Ferguson, 2012; Tiggeman & Slater, 2014). Sexual objectification in turn refers to where a girl is solely portrayed as a sexual object comprising a collection of sexual and physical attributes, rather than as a person (Schick, 2014). This current review has found that, according to research, self-objectification leads to the constant monitoring of one’s own appearance, which contributes towards heightened levels of anxiety, shame, and a depressed mood (Rush & La Nauze, 2006a; Starr & Ferguson, 2012; Tiggeman & Slater, 2014). Goodin, Van Denburg, Murnen, and Smolak (2011) and SCECA (2008) argued that the overabundance of sexual images and messages conveyed in the media has encouraged girls to view themselves as sexual objects, and to primarily base their personal value on their physical attractiveness and sexual availability or willingness. The integration of various sources in this study showed that one of the detrimental effects of self-objectification is the fragmentation that it causes to one’s consciousness. For example, constant attention placed on physical appearance consumes cognitive resources that could otherwise have been invested on other mental and physical activities (APA Task Force, 69 MULTIMEDIA-INDUCED SEXUALISATION 2010; Rush & La Nauze, 2006a). Furthermore, self-objectification could result in the notion that girls in middle childhood dressed in sexualised clothing are viewed as less intelligent and capable than the same girls dressed in more childlike clothing (Graff, Murnen, & Smolak, 2012). It is thus concluded that such perceptions might fragment a young girl’s development in ways that might limit, rather than foster, her life opportunities in domains that is not related to her appearance. This review also found that sexualisation of young girls frequently contributed to another detrimental psychological effect, namely gender stereotyping (Bailey, 2011). Content analysis of television advertisements and images in contemporary media indicated that females are commonly portrayed in highly gender-specific ways whereby they portray gender stereotypical roles, and girls in particular are frequently portrayed as passive (Buckingham et al., 2009). This research implies that these gender stereotypical portrayals can influence young girls’ expectations about appropriate gender behaviour, such as the notion that girls should be submissive to male figures (Schick, 2014). Stereotypical gender images portrayed in the media can therefore contribute towards a distorted body image by presenting unrealistic standards of female appearance and thinness (Papadopoulos, 2010; Stone, Brown, & Jewell, 2015). The APA Task Force (2010) argues that the frequent exposure promulgated by media images and messages that sexualise girls may affect how girls conceptualise femininity. This plays an intricate role in how girls construct their identities based on the attitudes and beliefs they adopt and internalise from these media sources, thereby ingraining a more constrained and stereotypical notion of female gender roles (APA Task Force, 2010; Stone et al., 2015). Theme 2: Positive Psychological Effects of Multimedia-Induced Sexualisation When considering the potentially beneficial effects of multimedia-induced 70 MULTIMEDIA-INDUCED SEXUALISATION sexualisation of young girls, in contrast to theme 1, SCECA (2008) states that children can also learn from their engagement with contemporary media such as television and the Internet, as this enables them to explore and express ideas connected to their sexual (and, in effect, psychological) development. Many young girls have, for example, been found to also utilise media to create alternative images (compared to stereotyped sexualised images) that reflect their exploratory nature on issues such as sexuality, body image, self-esteem, and emotional relationships (SCECA, 2008; Tsaliki, 2011). Some feminists further argue that sexualisation is a manifestation of girls’ self- assertion and agency (Buckingham et al., 2009; Vares, Jackson, & Gill, 2011). Starr and Ferguson (2012) state in their article that sometimes girls can enjoy sexualisation, because it contributes towards social benefits of attractiveness. Furthermore, it can also contribute towards the development of a positive sexual sense of self (Jackson & Vares, 2015). Some researchers also suggest that contemporary media can be a valuable source of ‘sexual learning’ that can contribute towards the enhancement of sexual development and knowledge (Buckingham et al., 2010; Papadopoulos, 2010; Tsaliki, 2015). Finally, Buckingham et al. (2010) argue that exposure to risk is an important part of healthy development, and that children should experience these risks in order to be able to learn from them. Inappropriate content is said to provide valuable opportunities to learn and form identity while exploring different cultural avenues (Buckingham, et al., 2010; Jackson & Vares, 2015). Discussion and Recommendations Girls in middle childhood can be seen as a vulnerable population with regard to contemporary multimedia influences. Not only are they developmentally very susceptible to external messages during this phase of development, but they are also saturated and being 71 MULTIMEDIA-INDUCED SEXUALISATION directly targeted by different media modalities (APA Task Force, 2010; Papadopoulos, 2010). With the increased number of modalities, it is inevitable that girls in middle childhood will be exposed to multimedia-induced sexualised images, content, and messages on a daily basis. Underneath these sexualised content and images lay messages about expectations, values, and ideals, which can easily be internalised by these girls and have an unavoidable impact on their functioning on numerous levels, especially psychologically. Cultivation theory argues that consistent exposure to similar themes over time lead those exposed to adopt a particular perspective of the world that coincides with the images they have been viewing (Gerbner et al., 1994). This also correlates with Bandura’s (1986) social cognitive theory that states that girls in middle childhood would learn social behaviour by observing and imitating models. Schick (2014) echoes this notion in stating that youthful users are not passive recipients of contemporary media, but often imitate what they observe from it. Therefore, girls in middle childhood would use these models and messages portrayed in the media as resources to co-construct their identities, values, and behavioural habits. This systematic review aimed to explore the psychological effects related to the sexualisation of girls in middle childhood. In the process, both positive and detrimental effects were identified from the literature. Evidence with regards to the detrimental effects of sexualisation were found to be geared towards the likelihood of girls experiencing and/or developing unrealistic internalisation, body dissatisfaction, depression, eating disorders, lowered self-esteem, self-and sexual objectification, cognitive fragmentation, gender stereotyping and lowered well-being (APA Task Force, 2010; Bailey, 2011; Brookes & Kelly, 2009; Buckingham et al., 2009; Goodin et al., 2011; McKenney & Bigler, 2016; Papadopoulos, 2010; Rush & La Nauze, 2006a, 2006b; Schick, 2014). In contrast, positive effects steered towards experiencing and/or developing a positive sexual sense of self, self- 72 MULTIMEDIA-INDUCED SEXUALISATION assertion, agency, and sexual knowledge (Buckingham et al., 2009; Buckingham, et al., 2010; Jackson & Vares, 2015; SCECA, 2008; Starr & Ferguson, 2012; Tsaliki, 2015). It is clear from the review that the number of detrimental psychological effects of the sexualisation of girls in middle childhood appears to exceed the amount of positive effects based on the literature that was reviewed. Furthermore, the positive effects that were identified appears to be mostly based on opinion rather than on empirical evidence/ knowledge, as no empirical research done provided clear evidence on the positive effects that sexualisation might entail for girls in middle childhood. A number of factors would appear to influence the extent to which young girls respond to sexualisation. Some of the most significant factors are the girl’s age, the extent of exposure, the frequency and type of media use, and her level of cognitive and emotional development (Buckingham et al., 2009; Papadopoulos, 2010; Vares et al., 2011). However, regardless of girls’ level of development, when it comes to internalising media messages research strongly appears to indicate that girls in this developmental stage have not yet necessarily developed the cognitive skills to cope effectively with persuasive media messages (APA Task Force, 2010; Papadopoulos, 2010). Other factors such as the socio-cultural environment, family norms, personality variables, and education could also play a role, but have not been included in most of the studies. Nevertheless, the effects and implications of sexualising girls in middle childhood should not be underestimated. Twelve of the nineteen studies included in this systematic review had recommended that further and, ideally, large-scale longitudinal research be conducted on this phenomenon. It is recommended that further research should focus on the bidirectional relationship of consumer culture and well-being of the child, while taking account of the full range of 73 MULTIMEDIA-INDUCED SEXUALISATION influences. It is further recommended that future research should focus on the impact of parental factors, and potential short- and long-term consequences. As most of the research focused on young girls, it is also recommended that research be conducted on how sexualisation might influence or effect young boys. Developing countries such as South Africa receive and engage with contemporary media produced in countries where most of the evidence for this study was gathered. However, it remains difficult to establish how this phenomenon is impacting within the context of developing countries, as no studies pertaining to this topic that had been produced in developing countries could be found or identified. Thus, it is strongly recommended that research pertaining to the sexualisation of girls in middle childhood within the context of developing countries be conducted. Nevertheless, although the state of knowledge on the effects of the media on girls’ development in developing countries is uncertain, it is recommended, according to the available information, that a precautionary approach be adopted. Limitations No studies that had been conducted on this topic within developing countries had been identified. Most literature and evidence is based on populations present in the United States, United Kingdom, and Australia. Therefore, research pertaining to this topic is urgently required in developing countries. This study was limited to articles written in either Afrikaans (a South-African language) or English. However, it was noted that during the initial electronic search, only three possible articles were excluded because of the language being non-English or non-Afrikaans. Additionally, some literature could not be included due to it only being available in book format, and books not being included in the inclusion criteria. Although attempts were made to obtain books, the specific relevant books were not 74 MULTIMEDIA-INDUCED SEXUALISATION available in any South African libraries, and the researcher was constrained by limited time and financial resources. No conflict of interest is to be reported. Conclusion Young girls normally have a natural and healthy interest in their sexuality, but when their development is compromised by sexualisation, it can be detrimental to the healthy developmental process. Girls require time and space to develop their own understanding, rather than being bombarded with constructs and messages that they may not be emotionally or cognitively ready to deal with. However, it is unrealistic to assume that children must be completely prevented from engaging with sexualised images and messages. Instead, it is advised that they be provided with tools in order to better understand and interpret what they see and hear from contemporary media sources. Therefore, by taking a precautionary and pro-active approach, it may alleviate the potentially detrimental effects described in this paper. As recommended by the literature, precautionary steps can be taken by implementing media literacy- and positive body image programmes in schools, and improving caregivers’ and/or parents’ awareness and involvement to enable them to support their children in developing emotional resilience to commercial/social pressures. Lastly, broadcasting agencies’, advertisers’, and marketers’ policies to ‘do no harm’ to children can be revised to improve their responsibility and accountability when communicating to children. 75 MULTIMEDIA-INDUCED SEXUALISATION References American Dietetic Association. (2003). ADA evidence analysis manual: Steps in the ADA evidence analysis process. 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Journal of Sex Research, 46(4), 268-270. doi: 10.1080/00224490903082694 Vares, T., Jackson, S., & Gill, R. (2011). Preteen girls read ‘tween’ popular culture: Diversity, complexity and contradiction. International Journal of Media and Cultural Politics 7(2), 139-154. Retrieved from https://doi.org/10.1386/macp.7.2.139_1 Wagner, E., & Wiffen, P. J. (2011). Ethical issues in preparing and publishing systematic reviews. Journal of Evidence-Based Medicine, 14(2), 130-134. doi: 10.1111/j.1756- 5391.2011.01122.x 83 Wild, L. (2012). Middle childhood. In J. Hardman. (Ed.). Child and adolescent development: A South African socio-cultural perspective (pp.163-202). Cape Town: Oxford University Press. Williams, R. (2010, April 16). Too much, too young? Retailers still selling over-sexualised clothing to kids. The Guardian. Retrieved from https://www.theguardian.com/soc iety/2010/apr/16/children-clothing-survey-bikini-heels Womack, S. (2007, February 20). The generation of ‘damaged’ girls. The Telegraph. Retrieved from http://www.telegraph.co.uk/news/uknews/3347564/The-generation- of-damaged-girls.html 84 SECTION 3 CRITICAL REFLECTION ABOUT THE STUDY Introduction This study set out to summarise the best available research on the psychological effects of multimedia-induced sexualisation of young girls in the form of a systematic review. A number of studies and reports were identified and included from the literature, which simultaneously yielded interesting and concerning results. A critical reflection, along with recommendations for further research, will be discussed in the following sections. Critical Reflection of the Sexualisation of Young Girls When considering societal changes in recent history, few appear to have impacted the lives of human beings as much as the development of multimedia. The present study revealed that, apart from advances made in technology and media, it also seems to entail potential harmful psychological effects on girls in middle childhood. This is because a number of studies revealed that the sexualisation of young girls has started to occur at alarmingly earlier ages, and that this appears to be closely linked with access to technology by this young population group (Papadopoulos, 2010). Furthermore, the apparent shift in societal norms pertaining to what is regarded as “normal” sexual development has simultaneously also changed in recent history, sparking a debate as to what sexual content young girls should be exposed to and at what ages; e.g., in the forms of magazines, movies, television series, and online advertisements, to name but a few. The sexual content displayed in these media modalities further appears to have become more explicit in recent times. Despite the view a person may hold on this debate, the effects of promoting sexualisation by exposure to these various forms of media at early ages among young girls have been 85 undeniable (American Psychological Association Task Force on the Sexualisation of Girls, 2010). Thus, the development of technology along with societal changes occurring in sexual expression have shown to have dramatic effects on the psychological functioning of a girl in middle childhood. The current study has succeeded in its aim to summarise the best current available evidence on the sexualisation of girls in middle childhood. Detrimental and positive psychological effects were discussed, and the detrimental psychological effects were found to exceed the positive effects. Awareness is therefore raised on a phenomenon that is currently taking place. This study also highlighted the paucity of research conducted on this topic within developing countries and yields for attention. Not only were the limitations of this particular study identified, but also limitations within available literature, which will be discussed next. Limitations • When considering the age of young girls included in the present study, the majority of the studies that were included primarily focused on populations of young girls during their middle childhood developmental phase, while only a few focused on young girls during early-adolescence. This made it challenging to provide a precise indication as to when and how sexualisation effects young girls, as it would depend on numerous factors such as age, degree of emotional maturity, intellectual functioning, and their socio-cultural circumstances (Buckingham et al., 2009; Vares, Jackson, & Gill, 2011). For instance, according to Wild (2012), middle childhood ranges from ages 6 to 12 years. This age range varies considerably given the different developmental tasks expected at each age. For example, the degree to which sexualisation would affect a 6-year-old in comparison with a 12-year-old could differ. This made it clear that the present study is more complex than it may appear to be on the surface. 86 • A review of the literature was not only impacted by the aforementioned but also by the fact that some studies had also included research involving young boys. It was very important to ensure that the research results and conclusions based on young boys were excluded, as the present study solely focused on young girls. • The sample characteristics of some of the research had indicated that some parents and/or caregivers had also been included in the research, and their conclusions were thus not being solely based on young girls, but also on the potential anxieties of adults pertaining to the sexualisation of young girls. The latter made the process on reporting accurate results on girls in middle childhood more challenging. Rigorous planning and extraction were therefore implemented by the researcher in an attempt to control for the aforementioned challenges. • The samples of some of the studies were relatively small. This would mean that some of the information would not necessarily apply to developing countries, as it may be over-generalised. • There was a lack of longitudinal studies. Longitudinal studies would have been able to add more rich and thorough information regarding long-term effects of sexualisation. • The review reports that were included in this study were found to be of high quality and value as it was conducted by panels of psychologists and academics, and presented on a national level. However, close inspection of these reports revealed that the teams involved with them had not necessarily conducted empirical research themselves, but rather integrated previous research relevant to their themes. This limitation exposed the reports to possible bias, as most of their conclusions indicated solely the detrimental effects which sexualisation might have on girls during middle childhood. 87 Recommendations for Further Research • Not all research was able to provide clear and thorough evidence on the detrimental and positive effects of sexualisation, as many conclusions were based on assumptions and predictions. The assumptions and predictions had been based on preliminary studies that have been done prior to the studies. This does not indicate that the research conducted would be invalid, but it does highlight the need for further, in- depth, longitudinal, and more specific research pertaining to this topic. • Initially, while extracting themes from the different studies, it was clear that another theme did arise. The theme focused on recommendations to counter and/or manage the sexualisation of girls in middle childhood. However, this theme was excluded based on the premise that it did not answer the research question, and that it may in itself potentially form a research topic for further research. • Had this study not only focused on the psychological effects of sexualisation of girls in middle childhood, other effects could have also been explored and included, as mention of it was also made in the research, for example behavioural effects. Further research on the aforementioned could be of high value in addition to the present study in order to further elaborate on the present topic by investigating other but related topics. • What this study contributes in value is to show that sexualisation is a phenomenon that is taking place in countries all over the world, and that adverse effects can be linked to this phenomenon. Developing countries such as South Africa have made no notion of this thus far, and urgent awareness and research is required within the developing country context. 88 Conclusion Conducting a systematic review allowed the researcher to integrate and summarise the best available research in order to answer the research question (Lodge, 2011). Systematic reviews require that a broad base of knowledge and information be consulted, and, in doing so, challenge and/or limit biased thoughts and notions. This enabled the researcher to answer the research question more thoroughly and in an informed manner, which added value to the study. The current research highlighted various aspects pertaining to the sexualisation of girls in middle childhood, such as that it is occurring at increasingly earlier ages, and that it is influenced by a number of factors. These range from shifting views on what “normal” sexual development should be to which sexual content young girls may be exposed to at which ages. It was found that this would differ between societies, cultures, geographical areas, and the preferences of parents and caregivers. What was found to be undeniable is that sexualisation is globally taking place among young girls and may entail harmful psychological effects on this population. Further research, especially on associated topics, and particularly within the context of developing countries such as South Africa, is advocated. 89 References American Psychological Association (APA), Task Force on the Sexualization of Girls. (2010). Report of the APA Task Force on the Sexualisation of Girls. Retrieved from http://www.apa.org/pi/women/programs/girls/report-full.pdf Buckingham, D., Barwise, P., Cunningham, H., Kehily, M. J., Livingstone, S., Macleod, M., ... & Young, B. (2009). The impact of the commercial world on children’s wellbeing: Report of an independent assessment. United Kingdom: Department of Children, Schools & Families and the Department of Culture, Media & Sport. Retrieved from http://publications.dcsf.gov.uk/default.aspx?PageFunction=productdetails&PageMode =publications&ProductId=DCSF-00669-2009& Lodge, M. (2011). Conducting a systematic review: Finding the evidence. Journal of Evidence-Based Medicine, 4(2), 135-139. doi: 10.1111/j.1756-5391.2011.01130.x Papadopoulos, L. (2010). Sexualisation of young people review, Crown Copyright. Retrieved from http://dera.ioe.ac.uk/10738/1/sexualisation-young-people.pdf Vares, T., Jackson, S., & Gill, R. (2011). Preteen girls read ‘tween’ popular culture: Diversity, complexity and contradiction. International Journal of Media and Cultural Politics 7(2), 139-154. Retrieved from https://doi.org/10.1386/macp.7.2.139_1 Wild, L. (2012). Middle childhood. In J. Hardman. (Ed.). Child and adolescent development: A South African socio-cultural perspective (pp.163-202). Cape Town: Oxford University Press. 90 APPENDICES Table 1 Data Extraction of Selected Studies Study Aim/focus of the study Methodology Sample Characteristics Measurement Core findings Recommendations Schick, L. (2014). ‘‘Hit Me Baby’’: From Britney Spears to the socialization of sexual objectification of girls in a middle school drama program. Examine how sexually charged media contribute towards the normalising of sexist, abusive, and violent behaviour of women, but also how caretaking adults contribute to these socialization practices in children. Qualitative: Ethnographic 52 Children from 11-14 years of age. Recruited from a revue cast of a middle school in the United States. Observation, video- recording and unstructured interviews. Caretaking adults and sexually charged media can contribute to socialization practices and the normalization of sexist, abusive, and violent behaviour towards children, even within educational activities. Research into adult complicity and the need for intervention into adult behaviour, especially in the context of educational activities. Easterbrook, M.J., Wright, M.L., Dittmar, H. & Banerjee, R. (2014). Consumer culture ideals, extrinsic motivations, and well-being in children. Test predictions based on self-determination theory stating that being extrinsically motivated, which can be influenced by the media, to achieve materialistic and appearance ideals can predict internalisation, which, in effect, can negatively predict children’s well-being. Quantitative: Pilot study and main study. Pilot Study: 65 girls and 85 boys ranging from 8- 11 years of age. Main Study: 80 girls and 80 boys ranging from 8–15 years of age. -Child Depression Inventory. -Materialistic Motives Scale -Short Appearance Motives Scale -Youth Materialism Scale. -Sociocultural Attitudes towards Appearance Scale -Internalisation- General Subscale. -Consumer Culture Ideals Scale. -Life Satisfaction Scale. -Body Esteem Scale. Consequences of striving for consumer culture ideals related to lowered well-being in children aged 8 to 15 years. Evaluate media policy within western consumer cultures. Future research on the bidirectional relationship of consumer culture and well-being is needed. Tiggeman, M. & Slater, A. (2014). Contemporary girlhood: Maternal reports on sexualized behaviour and appearance concern in 4–10- year-old girls. Offer a rich description of young girls sexualized behaviours and appearance concerns in looking at how they engage with teen culture portrayed in the media. Quantitative Correlational 815 mothers of 4–10-year-old girls. - Questionnaire for mothers with one of their daughters in the age range. -Self Objectification Questionnaire -Body Surveillance subscale of the Objectified Body Consciousness Scale. Young girls do engage in ‘grown up’ behaviours but such engagement is not necessarily benign for their development, rather body image and appearance concerns appear to be more negatively associated with young girls’ well- being. Future studies are necessary on parental materialism, parenting styles or parent-child attachment. Research on the development of sexualized behaviour, appearance concerns, and other potential psychological consequences are required. Starr, C. R. & Ferguson, G. M. (2012). Sexy Dolls, Sexy Grade- Schoolers? Media & maternal influences on To produce more evidence on the occurrence of sexualisation through mass-media as well as the interrelated risks and protective factors for girls. Quantitative 60 girls ranging from 6 to 9 years of age and 47 mothers participated. -Child-reported measures (paper dolls). -Mother Reported measures: Daughters media consumption, the Objectified Body Consciousness Scale, Television Young girls compare sexiness with popularity. Overall, media consumption and maternal self- objectification played an important role whereas maternal personal religiosity played a Important areas to research are the prevalence of actual sexualized behaviours among young girls as well as the potential developmental consequences of early sexualisation. 91 young girls’ self- sexualisation. Mediation Scale, Religiosity Likert Scale. buffering role in the process of sexualisation. Brookes, F. & Kelly, P. (2009). Dolly girls: tweenies as artefacts of consumption. Conduct an analysis on resources of consumer media that are presented to girls between the ages of 9 and 14 by an Australian magazine, Dolly which focus on appearances. Theoretical article; Review Dolly Magazine Content Analysis Consumer-media culture is limited in scope in that it is dominated by images of young, slim, and attractive females. Media has a powerful influence in the process of self-formation for young people as they seek to develop/fashion a sense of self. None provided Vares, T., Jackson, S. & Gill, R. (2011). Preteen girls read ‘tween’ popular culture: Diversity, complexity and contradiction. To give tween girls a ‘voice’ regarding the debate about ‘sexualising media’ from which they have been largely excluded. Qualitative; Empirical 71 girls in New Zealand, from age 5-13. Four focus group discussions and video diaries. Girls have a range of interpretative repertoires when engaging with the media. They can express fears about the detrimental effects of media ‘sexualisation’ and also conduct critical deconstructions of media products. To develop an understanding of the ‘sexualisation’ of culture is to incorporate young people’s views and experiences. Tsaliki, L. (2015). Popular culture and moral panics about ‘children at risk’: revisiting the sexualisation of young girls’ debate. To contextualise the sexualisation of girls through advertisement in media by providing a historical account of childhood and previous engagement with popular media and culture. Qualitative 16 different focus groups (4- 5 girls in each group) between the ages of 10– 12 years. Focus Groups Girls exhibit a variety of engagements and practices of popular culture – contrary to prevailing moral panics of sexualisation. Conventional sex education lacks to view media as an opportunity that can contribute to sexual development and knowledge. None given Goodin, S.M., Van Denburg, A., Murnen, S.K., & Smolak, L. (2011). “Putting on” Sexiness: A content analysis of the presence of sexualizing characteristics in girls’ clothing. To study girls’ clothing as a possible socializing influence which may in effect contribute towards the development of self- objectification in preteen girls. Quantitative 15 Popular national stores in the USA Content Analysis Clothing and the advertisement thereof through media can contribute towards the process of sexualisation for girls. Substantial evidence on the presence of sexualisation in girls’ clothing was produced. Further research is needed to explore and investigate the development of self- objectification in young girls. Jackson, S. & Vares, T. (2015). ‘Too many bad role models for us girls’: Girls, female pop celebrities and ‘sexualization’. Contribute to current knowledge about preteen girls’ understanding and negotiation presented in the media of sexually saturated popular culture. Qualitative; Discursive analysis 71 pre-teen girls. Media video diaries about the girls’ everyday engagement with popular culture. Media is to be blamed for the sexualisation of girls in damaging and harmful ways. But it can also contribute towards the development of a positive sexual sense of self. Feminists should not only encourage their own critiques of sexualized media but also consider to engage with young girls in conversations about different, non- commodified meanings of sexuality. 92 McKenney, S.J. & Bigler, R. S. (2016). Internalized sexualization and its relation to sexualized appearance, body surveillance, and body shame among early adolescent girls. To test the hypothesis that internalized sexualisation can be associated with behavioural and psychological consequences, such as making use of sexualized clothing, body surveillance, and body shame. Quantitative 330 girls in the range of 10-15 years. -Internalized Sexualization Scale. -Sexualized appearance coding. -Body Surveillance Subscale and Body Shame Subscale of the Objectified Body Consciousness Scale for Youth. Early adolescent girls with higher levels of internalized sexualization is likely to wear more sexualized clothing and present with higher levels of body surveillance and body shame compared to girls with lower levels of internalized sexualisation. Examine further consequences of internalized sexualization, especially with regards to the development of healthy sexuality. Explore other factors that might contribute towards the internalization of sexualisation. Stone, E. A., Brown, C. S., & Jewell, J. A. (2015). The Sexualized Girl: A within-gender stereotype among elementary school children. Two studies examine whether elementary- aged children endorse a within-gender “sexualized girl stereotype” using developmental intergroup theory. Quantitative Study 1, 208 children ages 6– 11. Study 2, 155 children ages 6- 11. -Demographic and Sexualized Media use Questionnaire. -Stereotypic Evaluations of Sexualized Versus Non-sexualized Girls. -Salience of Adult Sexualisation. -Scale for Adolescents Sexualised girls in accordance with their developmental stage and media exposure are more appearance focused. Sexualized girls are seen as more popular and less athletic, nice, and intelligent than non- sexualized girls. Researchers should fully address the impact of sexualized media messages on the developing child. Bailey, R. (2011). Letting Children Be Children. Report of an Independent Review of the Commercialisati on and Sexualisation of Childhood. The review aimed to assess how children are pressured to grow up at a fast pace and therefor make recommendations on how to address this. Review Report Young children NA Parents should decide what is appropriate for their children and discuss this with them as they develop. An effective way to warrant that broadcasting and advertisements are appropriate for children is to pay attention to the views parents hold rather than to develop complicated definitions of commercialisation and sexualisation. Longitudinal research is recommended to investigate whether there is harm to children and if so, how this harm occurs. Insufficient evidence does not necessarily mean that no harm exists. If parents are concerned, it is their responsibility to adjust to a precautionary approach. American Psychological Association: Report of the APA Task Force on the Sexualisation of Girls-Review. (2010). To study and summarize the best available psychological theory and research whilst incorporating clinical experience with regards to the sexualisation of girls by media and the cultural messages thereof. This will include commenting on the prevalence of these messages and their possible impact on girls. Review Report Young girls NA Exposure to sexualizing and objectifying media can lead to body dissatisfaction, depression, and lowered self-esteem. Self- objectification can diminish cognitive ability and cause shame which may influence achievement levels. Peer relationships can be affected. Perceptions on dating and attitudes toward sexual violence can be influenced. Future studies are required to explore short- and long-term harm and alternative presentations of girlhood. Awareness raising for professionals and the public are required. Education and training focusing on the prevalence and impact are needed. Strategies to combat this problem is recommended. Rush, E. & La Nauze, A. (2006a). Corporate Paedophilia. Sexualisation of Children in Australia. To analyse the sexualisation of children under the age of 12 in relation to three types of cultural material: advertising, girls’ magazines, and television programs. Review Report Girls under the age of 12. Content Analysis Images of sexualised children are becoming increasingly common in advertising and marketing material. Girls particularly who appear 12 years and under, are dressed, posed and made up in the same manner as ‘sexy’ adult models. Such advertising Australian research lack information into the many aspects of the sexualisation of children. More research in this area would enable an informed public debate. 93 and marketing is an abuse of children and public morality. Rush, E. & La Nauze, A. (2006b). Letting Children Be Children. Stopping the Sexualisation of Children in Australia. To place emphasize on the regulation of the sexualisation of children in Australia. Review Report Children under the age of 12. N/A Children’s freedom to develop at their own pace are under threat due to heavily sexualised advertising and marketing. Children are likely to develop freely if government limits the induced sexualising pressure of advertisers and marketers. There is a need for better regulation. Existing codes of practice for advertising, television programming and children’s magazines should be amended due to the rage of risks for children. Papadopoulos, L. (2010). Sexualisation of Young People Review. This review looks at how sexualised media images and messages may be affecting the development of children, influence on cultural norms, and examines the evidence for a link between sexualisation and violence. Review Report Young Children Desk-based review of available data, such as government research and statistics, lobby group publications and academic journals. Unless sexualisation is accepted as harmful, an opportunity will be missed to broaden young people’s beliefs about their self-value; to guide children around sexualisation and objectification; and to create new tools for young people to develop and explore their sexuality in their pace. Further empirical evidence in the form of large scale longitudinal studies that will look in detail at the effects on boys and girls of living in a sexualised culture across their development is needed. Standing Committee on Environment, Communications And the Arts. (2008). Sexualisation of Children in the Contemporary Media. To examine the media sources of sexualisation. To review short- and long-term effects of sexualising and objectifying images and products and the influence on cognitive functioning, physical and mental health, sexuality, attitudes and beliefs. To examine strategies to prevent and/or reduce sexualisation of children in the media. Review Report Young Children N/A Limited work has been done on the sexualisation of young children. Thus, it is difficult to relate particular causes and effects. It is therefore difficult to link particular behaviours to certain products or images. Sexualisation of children in Australia is a concern. To prevent sexualisation is a responsibility that requires action from society. Broadcasters, publishers, advertisers, retailers, and manufacturers should take account of these community concerns. Buckingham, D., Bragg, S., Willet, R., & Russel, R. (2010). Sexualised Goods Aimed at Children: A Report to the Scottish Parliament Equal Opportunities Committee. To provide a clear Understanding of the nature and characteristics of ‘sexualised’ goods, their prevalence and distribution. To assess and explore children’s and parents’ views on this issue. Review Report Young Children N/A Sexual imagery has become more widely available within the culture as a whole, including material that is targeted at, or consumed by children. The evidence about the effects of this – whether positive or negative - is limited and inconclusive. The production and distribution of sexualised goods, or children’s access to them needs to be controlled. An ‘educational’ approach both with parents and children is recommended. Buckingham, D. et al. (2009). The Impact of the Commercial World on Children’s Wellbeing. To gather evidence on the changing nature of children’s commercial engagement; the impact of this on their wellbeing, both beneficial and harmful; and investigate the views of parents and children. Review Report: Independent Assessment Young Children Literature reviews; stakeholder events; consultations and research with children and parents. The sexual content of mainstream media has increased. UK children encounter diverse messages about sex and relationships in the media. Adults and children in Western societies are prone to be dissatisfied with their appearance. The impact of the commercial world on children’s physical and mental wellbeing should be studied thoroughly, taking account of the full range of influences in their lives. 94 Figure 1 Schematic representation of selected studies 95 Critical Appraisals 96 97 98