The Journal of Sex Research

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Emotional Outcomes of Casual Sexual

Relationships and Experiences: A Systematic
Review

Rose Wesche , Shannon E. Claxton & Emily A. Waterman

To cite this article: Rose Wesche , Shannon E. Claxton & Emily A. Waterman (2020): Emotional
Outcomes of Casual Sexual Relationships and Experiences: A Systematic Review, The Journal of
Sex Research, DOI: 10.1080/00224499.2020.1821163

To link to this article: https://doi.org/10.1080/00224499.2020.1821163

Published online: 29 Sep 2020.

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THE JOURNAL OF SEX RESEARCH
https://doi.org/10.1080/00224499.2020.1821163

Emotional Outcomes of Casual Sexual Relationships and Experiences: A Systematic

Review
a
Rose Wesche , Shannon E. Claxtonb, and Emily A. Watermanc
a
Department of Human Development and Family Science, Virginia Polytechnic Institute and State University; bDepartment of Psychology,
Morningside College; cNebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska- Lincoln

ABSTRACT
Casual sexual relationships and experiences (CSREs) are common and emotionally significant occurrences.
Given the uncommitted, often emotionally complicated nature of CSREs, researchers have asked whether
these experiences may have positive and/or negative emotional consequences. We reviewed 71 quanti­
tative articles examining emotional outcomes of CSREs, including subjective emotional reactions (e.g.,
excitement, regret) and emotional health (e.g., depression, self-esteem). Overall, people evaluated their
CSREs more positively than negatively. In contrast, CSREs were associated with short-term declines in
emotional health in most studies examining changes in emotional health within a year of CSRE involve­
ment. Emotional outcomes of CSREs differed across people and situations. Women and individuals with
less permissive attitudes toward CSREs experienced worse emotional outcomes of CSREs. Alcohol use
prior to CSREs, not being sexually satisfied, and not knowing a partner well were also associated with
worse emotional outcomes. These findings suggest directions for prevention/intervention related to
CSREs. For example, skill-building related to sexual decision-making may help individuals decide whether,
and under what circumstances, CSREs are likely to result in positive or negative emotional outcomes. In
addition, the limitations of extant research suggest directions for future inquiry (e.g., examining whether
verbal and nonverbal consent practices predict emotional outcomes of CSREs).

Casual sexual relationships and experiences (CSREs) are com­ Several theories support the hypothesis that engaging in
mon and emotionally significant occurrences for adolescents CSREs can lead to negative emotional consequences. For
and adults. CSREs are defined by sexual involvement without example, attachment theory proposes that people evolved to
expectation of a future romantic relationship, although there is form lasting intimate relationships (Fraley & Shaver, 2000).
variability in the length of CSREs, the emotional closeness of Because CSREs are often fleeting and may not be characterized
CSRE partners, and the types of sexual behaviors CSRE partners by emotional intimacy, they may not fulfill people’s attachment
engage in (Claxton & van Dulmen, 2013; Lewis et al., 2012). By needs. Sexual script theory proposes that sexual experiences
young adulthood (between ages 18–29), CSREs are common. often follow learned, predictable patterns called scripts (Frith &
Between 60% and 80% of college students have had a CSRE in Kitzinger, 2001). CSRE scripts are characterized by a lack of
their lifetime (Garcia, Reiber, Massey, & Merriwether, 2012; communication between partners, which can also be found in
Kuperberg & Padgett, 2016). In samples of young adults that new or unstable romantic relationships (e.g., Dailey et al., 2016;
are diverse in educational status (Furman & Collibee, 2014; Reese-Weber, 2015); this lack of communication can lead to
Lyons et al., 2013), sexual identity (Barrios & Lundquist, 2012), confusion and hurt feelings (Beres, 2010; Karlsen & Træen,
and/or race/ethnicity (Kuperberg & Padgett, 2016), the majority 2013; Littleton et al., 2009).
(between 51% and 70% of aggregated samples) have had a CSRE, However, researchers have also noted reasons why CSREs
although there is variation across demographic groups, and not may be neutral or positive experiences. Developmental research­
all young adults are represented in research. These experiences ers focusing on CSREs in adolescence and adulthood have noted
fall into various categories; one-night stands, booty calls, hook­ that these sexual experiences may serve a developmental purpose
ups, and friends with benefits are all common types of CSREs by enabling individuals to engage in sexual behavior while bal­
(Bisson & Levine, 2009; Owen & Fincham, 2011a; Wentland & ancing competing demands of school, work, and/or family com­
Reissing, 2011). Scholars have questioned whether CSREs’ fre­ mitments (Shulman & Connolly, 2013).
quent absence of commitment and emotional intimacy makes Other theories guide understanding of how characteristics of
them emotionally unfulfilling or even detrimental to emotional people and experiences may lead to different emotional out­
health (Bachtel, 2013; Freitas, 2013). In order to address this comes of CSREs. Many of these theories relate to gender differ­
question, a body of research has emerged examining emotional ences. Evolutionary psychologists suggest that CSREs may be
outcomes of CSREs. In the present article, we review the quanti­ less compatible with women’s evolutionary mating strategies,
tative literature on this topic. which require long-term commitment from a sexual partner

CONTACT Rose Wesche [email protected] Department of Human Development and Family Science, Virginia Polytechnic Institute and State University,
Blacksburg, VA 24061
© 2020 The Society for the Scientific Study of Sexuality
2 R. WESCHE ET AL.

(Reiber & Garcia, 2010). Researchers adopting a feminist per­ research on emotional outcomes of CSREs has produced
spective argue that women are more likely to experience negative mixed findings (Claxton & van Dulmen, 2013; Garcia et al.,
emotional outcomes of CSREs than men are due to the gendered 2015; Vrangalova, 2015a). This mixed evidence may not be
context in which sex occurs (Allison & Risman, 2013; Kelly, surprising given that research is diverse in types of CSREs
2012). CSREs take place in the context of a sexual double examined, sample composition, outcomes, and methodological
standard in which men are socially rewarded for sex and techniques. Each of these factors may explain differences in
women are socially sanctioned (England & Bearak, 2014; research results regarding emotional outcomes of CSREs.
Farvid & Braun, 2018). Script theory complements this perspec­ It is important to understand emotional outcomes of CSREs
tive, noting that sexual scripts are gendered, and women are in order to facilitate healthy relationship choices and positive
discouraged from communicating their sexual or relationship emotional outcomes of sexual behavior. Knowledge, attitudes,
needs with CSRE partners (Backstrom et al., 2012; Karlsen & norms, and contextual constraints all shape behavior, and all
Træen, 2013; Littleton et al., 2009). However, not all theorists these domains are targets of interventions aimed to improve
propose that women experience worse emotional outcomes of sexual health. For example, relationship education aims to
CSREs than men. Some feminist scholars propose that CSREs build knowledge and skills for making healthy choices about
can be positive experiences for women because they signify relationships and sex (Hawkins, 2017; Simpson et al., 2018).
women asserting their sexuality and defying restrictive standards Understanding whether, and under what circumstances,
of women’s sexual expression (Kalish & Kimmel, 2011). CSREs are related to positive and/or negative emotional out­
Self-determination theory and sexual motivation theory comes will inform the inclusion of CSRE-specific material in
may also explain variability in emotional outcomes of CSREs relationship education programs. Knowledge of emotional out­
(Cooper et al., 1998; Deci & Ryan, 2000). Both theories propose comes of CSREs can also inform prevention programs, targeted
that people experience diverse motives for sex. CSREs are more primarily at college students, that aim to change norms and
likely to lead to positive outcomes for people with certain contextual factors (e.g., party environments) that contribute to
motives. According to self-determination theory, autonomous physically and emotionally risky sexual experiences (e.g., Patrick
motives, in which people feel in control over their decision to et al., 2014; Testa et al., 2020). Understanding the emotional
engage in CSREs, may promote positive outcomes (Townsend outcomes of CSREs can also inform clinical practice, both for
et al., 2019; Vrangalova, 2015a). Controlled motives (in which adolescent and adult patients, by helping clinicians learn how
people engage in CSREs due to external reasons) and amotiva­ these experiences may contribute to patients’ emotional health.
tion (“it just happened”) may promote negative outcomes. In this article, we systematically review quantitative research
Some sexual experiences that may indicate controlled motives on the emotional outcomes of CSREs. Choosing to limit the
or amotivation are having sex due to peer pressure, having sex review to quantitative articles allowed us to focus more clearly
at a young age, having sex under the influence of alcohol or on methodological issues that are specific to quantitative stu­
drugs, and having sex despite negative attitudes toward it. dies, such as measurement and study design. A meta-synthesis
According to sexual motivation theory, individuals have sex of qualitative studies of CSREs has summarized many of the
for self-focused and other-focused reasons. CSREs are more emotional issues that arise from CSREs (Rodrigue & Fernet,
likely to satisfy self-focused motives like pleasure, compared to 2016). The purpose of our review is to better understand the
other-focused motives like emotional intimacy (e.g., Uecker associations between CSREs and emotional outcomes such as
et al., 2015). overall positive/negative evaluations (a subjective emotional
In order to determine whether CSREs are associated with reaction) and depressive symptoms (an example of emotional
positive and/or negative emotional outcomes, researchers health). We addressed the following research questions:
have addressed a wide range of emotional outcomes of
CSREs. A useful distinction is that some research addresses (1) What subjective emotional reactions do individuals
subjective emotional reactions, whereas other research experience following CSREs?
addresses emotional health (Vasilenko et al., 2014). (2) Is involvement in CSREs associated with emotional
Subjective emotional reactions are the emotions that indivi­ health?
duals report feeling as a result of their CSREs, such as excite­ (3) To better understand interpersonal and situational var­
ment, satisfaction, regret, embarrassment, or feeling used. iation in the emotional outcomes of CSREs, we had two
Emotional health includes indicators of overall emotional questions. (3a) Among CSRE-experienced individuals,
functioning, including psychological distress (i.e., depressive what characteristics of individuals and situations are
symptoms, loneliness), self-esteem, and general affect. associated with subjective emotional reactions? (3b)
Whereas subjective emotional reactions offer evidence of What characteristics of individuals and situations mod­
how individuals believe their CSREs affected them, emotional erate associations between CSREs and emotional
health is a broader indicator of well-being that does not health?
directly measure perceptions of the effects of CSREs. Both
subjective reactions and emotional health are important
Method
aspects of how CSREs may influence well-being.
A comprehensive review of research on emotional out­ We systematically searched PsycINFO and Web of Science to
comes of CSREs can clarify whether, for whom, and under identify articles that were published in English-language, peer-
what circumstances CSREs are associated with positive or reviewed journals between 1997 and September 2019. In order to
negative emotional outcomes. Scholars have noted that be included, articles had to measure CSREs, defined broadly as
 THE JOURNAL OF SEX RESEARCH 3

any type of sexual encounter with partners participants did not review criteria. A list of the articles identified is included in
consider to be romantic partners. We excluded studies that Table 1.
focused on infidelity and extradyadic involvement because the
emotional consequences of these CSREs may be shaped by
Results
participants’ romantic relationships. We also excluded qualita­
tive articles, given our aim was to review quantitative literature. The articles included in this review primarily sampled popu­
To be included, articles also had to measure emotions related to lations of adolescents (n = 13) and young adults, including
CSREs. We defined these emotions broadly, including subjective college students (n = 48) and young adults mixed in educa­
emotional reactions (e.g., positive and negative evaluations of tional status (n = 3). A minority (n = 7) included samples of
CSREs, regret, excitement) and emotional health (e.g., psycho­ adults with a wide range of ages. The analyses included
logical well-being, self-esteem, and affect). Although this review cross-sectional (n = 44) and longitudinal (n = 27)
focuses on emotional health as an outcome of CSREs, we approaches. Longitudinal studies ranged from two to 84
included longitudinal studies in which emotional health pre­ data collection occasions, covering periods of 2 months to
dicted later CSRE involvement because we were interested in 7 years. Studies relied on retrospective reports of CSREs that
understanding the quality of evidence regarding a causal asso­ included past day, month, college semester, year, or any
ciation between CSREs and emotional health. Including these CSRE within a participant’s lifetime. Fifty-one articles expli­
articles in our review helps to determine the temporal ordering citly noted one or more theories that guided research ques­
between CSREs and emotional health. We searched for combi­ tions or interpretation of findings. Among the most
nations of CSRE terms (hook* up, hookup, casual sex, friends commonly referenced were theories related to evolution
with benefits, booty call, one-night stand) and emotional out­ (evolutionary theory, life history theory, sexual strategies
comes (mental health, depress*, internalizing, self-esteem, emo­ theory; n = 15), social comparison (social learning theory,
tion*, distress, consequences, anxiety, enjoy*, excite*, feel*). social role theory, and social comparison theory; n = 8), and
Following this search, we conducted forward searches (finding cognitive constructions of the self (self-determination the­
articles that cited identified articles) and backward searches ory; n = 5).
(searching the reference lists of identified articles) to identify
additional relevant research. We first screened the abstracts of
Subjective Emotional Reactions
articles for relevance (i.e., does this article appear to measure
sexual behavior and/or emotional outcomes); we then assessed We identified 34 articles that assessed participants’ subjective
the full-text of relevant articles to determine eligibility. We emotional reactions to their CSREs. This research included
followed PRISMA search guidelines (Moher et al., 2009); questions about a range of feelings about past CSREs, including
Figure 1 describes the search results. In total, 71 articles met general positive and negative feelings, emotional satisfaction,
Identification

Records identified through database Additional records identified

searching through other sources
(n = 2,577) (n = 20)

Records after duplicates removed

(n = 2,097)
Screening

Records screened Records excluded

(n = 2,097) (n = 1,920)
Eligibility

Full-text articles assessed Full-text articles excluded

for eligibility (n = 106)
(n = 177)
Included

Studies included in review

(n = 71)

Figure 1. PRISMA flow diagram.

 4

Table 1. Articles examining emotional outcomes of CSREs.

Citation Sample Emotional variable(s) assessed Cross-sectional or longitudinal Moderators/predictors explored
SUBJECTIVE EMOTIONAL REACTIONS
Bachtel (2013) US college students (N = 210) Regret, negative emotional Cross-sectional
reactions
Bendixen et al. (2017) US and Norwegian college students (N = 466) Regret Cross-sectional Gender, religiosity, sociosexuality
Campbell (2008) British television viewers (N = 1,743) Positive and negative “morning Cross-sectional Gender
after” emotions
R. WESCHE ET AL.

De Jong et al. (2018) Female US college students (N = 203) Satisfaction with CSRE, positive and Longitudinal 5 weekly surveys Motives
negative emotions
DeLuca et al. (2015) College-attending and non-college-attending US young Satisfaction with CSRE Longitudinal 5 daily surveys; Gender, college status, peer approval, peer communication
adults (N = 246) 1-month follow-up
Eshbaugh and Gute (2008) Female US college students (N = 152) Regret Cross-sectional
Fielder and Carey (2010a) Female US college students (N = 118) Enjoyment, regret Cross-sectional
Fisher et al. (2012) Canadian college students (N = 200) Sexual regret Cross-sectional Gender, alcohol use
Galperin et al. (2013) Heterosexual and homosexual men and women (Ns from Regret Cross-sectional Gender, sexual orientation
200– 24,230 in three studies)
Gusarova et al. (2012) Canadian college students (N = 281) Perception that CSRE was positive Cross-sectional Gender, reasons for entering a friends with benefits
or negative experience relationship
Kennair et al. (2016) Heterosexual Norwegian college students (N = 263) Regret Cross-sectional Gender, sociosexuality, worry, physical gratification
Kennair et al. (2018) US and Norwegian college students (N = 218) Regret Cross-sectional Gender, worry, disgust, sexual competence, sexual
pressure, sexual initiative, physical gratification
LaBrie et al. (2014) US college students (N = 828) Contentment/satisfaction Cross-sectional Partner familiarity, alcohol use
Lewis et al. (2012) US college students (N = 1,468) Positive and negative emotional Cross-sectional Gender, hooking up attitudes, partner type, sexual
reactions behavior type, alcohol use
Lyons et al. (2014) US adolescents (N = 239) Regret Longitudinal Four waves with Gender
12–24-month follow-ups
Mark et al. (2015) US adults (N = 6,955) Sexual and emotional satisfaction Cross-sectional Gender, sexual orientation
Montes et al. (2017) US college students (N = 589) Negative consequences of CSREs Cross-sectional Friends’ attitudes, own attitudes, motives
Montes et al. (2016)a US college students (N = 271) Negative consequences of CSREs, Cross-sectional Motives
negative affect
Napper et al. (2016)a US college students (N = 607) Negative consequences of CSREs, Cross-sectional Gender, unprotected sex
psychological distress
Owen and Fincham (2011a)a US college students (N = 500) Positive and negative emotional Cross-sectional Gender, hope for future relationship, sexual behavior type,
reactions, psychological distress condom use, alcohol use
a
Owen and Fincham (2011b) US college students (N = 889) Positive and negative emotional Cross-sectional Gender, hope for future relationship
reactions, psychological distress
Owen et al. (2010)a US college students (N = 832) Positive and negative emotional Cross-sectional Gender, attitudes toward hooking up, alcohol use
reactions, psychological well-
being
Paul and Hayes (2002) US college students (N = 187) Feelings during a typical hookup Cross-sectional Gender
(e.g., proud, regretful)
Snapp et al. (2015) US college students (N = 250) Positive and negative emotional Cross-sectional Gender, motives, sexual self-concept, relationship with
reactions, overall satisfaction partner
with the hookup
Strokoff et al. (2015)a US college students (N = 879) Positive and negative emotional Cross-sectional Gender, sexual behavior type
reactions, depressive symptoms,
loneliness
Townsend and Wasserman US college students (N = 696) Worry-vulnerability Cross-sectional Gender
(2011)
Townsend et al. (2015) US college students (N = 194) Worry-vulnerability Cross-sectional Gender, sexual attitudes
Uecker and Martinez (2017) College students (N = 13,028) Regret Cross-sectional Gender, relationship with partner, sexual behavior type
Uecker et al. (2015) US college students (N = 1,219) Regret Cross-sectional Gender, race/ethnicity
Vasilenko et al. (2012) US college students (N = 209) Positive and negative short-term Longitudinal 14 daily surveys Gender
emotional reactions
(Continued)
Table 1. (Continued).
Citation Sample Emotional variable(s) assessed Cross-sectional or longitudinal Moderators/predictors explored
Victor (2012) US college students (N = 172) Positive and negative emotional Cross-sectional Actual/ideal self-discrepancy, actual/ought self-
reactions discrepancy
Wesche et al. (2018) College-attending and non-college-attending US young Positive and negative emotional Cross-sectional Gender, relationship with partner, sexual behavior type,
adults (N = 192) reactions college status
Wesche, Lefkowitz et al. US college students (N = 269) Positive and negative short-term Cross-sectional Relationship with partner, sexual behavior type
(2017) emotional reactions
Zimmer-Gembeck et al. Australian women recruited through university (N = 364) Positive and negative emotional Cross-sectional Sexual subjectivity, romantic satisfaction, perceived
(2015) reactions negative influence of alcohol/drugs on sex, condom use
EMOTIONAL HEALTH
Bancroft et al. (2003) Gay-identified men who have sex with men (N = 589) Depression proneness, anxiety Cross-sectional
Bersamin et al. (2014) US college students (N = 3,907) Psychological well-being, Cross-sectional Gender
psychological distress
a
Black et al. (2019) College students (N = 377) Anxiety Longitudinal 2-month follow-up Post-event processing, positive and negative reactions,
level of intoxication
Carrotte et al. (2016) Australian music festival attendees (N = 1,345) Poor mental health Cross-sectional
Deutsch and Slutske (2015) Mono- and dizygotic twins in the US (N = 357 twin pairs) Depressive symptoms, suicidal Longitudinal 6-year follow-up Gender
ideation
Dubé et al. (2017a) Canadian high school students (N = 2,601) Psychological distress, self-esteem, Longitudinal 6-month follow-up Gender
suicidal ideation
Dubé et al. (2017b) Canadian high school students (N = 2,304) Psychological distress, self-esteem, Longitudinal 6-month follow-up Gender, sexual behavior type
suicidal ideation
Eisenberg et al. (2009) Young adults (N = 1,311) Self-esteem, depressive symptoms, Cross-sectional
suicidal ideation
Fielder and Carey (2010b) US college students (N = 140) Self-esteem, depressive symptoms Longitudinal 10-week follow-up Gender, sexual behavior type
Fielder et al. (2013) Female US college students (N = 483) Self-esteem, depressive symptoms Longitudinal 9 monthly surveys
Fielder et al. (2014) Female US college students (N = 483) Depressive symptoms Longitudinal 13 monthly surveys
Furman and Collibee (2014) US young adults (N = 185) Internalizing symptoms, self- Longitudinal Follow-ups at 2.5, 4, Gender
esteem and 5.5 years
Gonçalves et al. (2017) Brazilian adolescents (N = 737) Depressive symptoms Longitudinal Follow-ups at 4 and
7 years
Grello et al. (2006) US college students (N = 382) Depressive symptoms Cross-sectional Gender
Grello et al. (2003) US adolescents (N = 2,344) Depressive symptoms Longitudinal 1-year follow-up
Lin et al. (2017) Men seeking HIV test in Taiwan (N = 850) Depressive symptoms, suicidal Cross-sectional Condom use
ideation
Manning et al. (2005) US high school students (N = 7,470) Self-esteem Cross-sectional/longitudinalb Gender, age
1.5-year follow-up
Manning et al. (2014) US adolescents (N = 324) Depressive symptoms, self-esteem Longitudinal 6-year follow-up
Manthos et al. (2014) College students (N = 339) Depressive symptoms, loneliness Longitudinal 10-week follow-up Reasons for CSREs
Mendle et al. (2013) US adolescent sibling pairs (N = 1,551 pairs) Depressive symptoms, clinical Cross-sectional Age
depression
Monahan and Lee (2008) US adolescents (N = 6,602) Depressive symptoms Longitudinal Follow-ups at
1–2 years and 6 years
Owen et al. (2013) US college students (N = 308) Loneliness, depressive symptoms Cross-sectional Relationship with partner
Owen et al. (2011) US college students (N = 394) Depressive symptoms, loneliness Longitudinal 4-month follow-up Initial depressive symptoms, loneliness, sexual behavior
type
Parsons et al. (2003) HIV+ men who have sex with men (N = 367) Anxiety, depressive symptoms, Cross-sectional Sex without a condom, sexual behavior type
loneliness
Paul et al. (2000) US college students (N = 555) Self-esteem Cross-sectional Gender
Sandberg-Thoma and Kamp US adolescents and young adults (N = 12,401) Suicidal ideation, depressive Longitudinal 6-year follow-up Gender
Dush (2014) symptoms
THE JOURNAL OF SEX RESEARCH

Schwartz et al. (2011) US college students (N = 9,515) Well-being Cross-sectional Gender

Siebenbruner (2015) Female US college students (N = 255) Depressive symptoms, anxiety, self- Cross-sectional Sexual behavior type
esteem
5

(Continued)
6 R. WESCHE ET AL.

regret, embarrassment, and feelings of concern and vulnerabil­

Gender role beliefs, peer approval, sexual assertiveness,

ity. In each study measuring positive and negative feelings,

sexual pleasure, negative perceptions of others who

participants reported more positive than negative feelings

Gender, relationship length, sexual behavior type

Moderators/predictors explored about their most recent CSREs. Because of the diversity of
measures of emotional reactions, this finding has different

Longitudinal 6 periods of 14 daily Perceived short-term consequences of sex

interpretations across studies. In each study where authors
tested the difference between positive and negative feelings,
participants reported significantly more positive than negative
feelings (Campbell, 2008; Owen & Fincham, 2011a, 2011b). In
each study that measured positive and negative feelings but did

engage in casual sex

Gender, sociosexuality
not statistically test for differences, the means of positive feel­
ings were higher than means of negative feelings (Fielder &
Gender, motives

Carey, 201a; Owen et al., 2011; Snapp et al., 2015; Wesche et al.,
2018; Wesche, Lefkowitz et al., 2017; Woerner & Abbey, 2017).
Motives

Furthermore, in each study that assessed scale scores of sub­

jective emotional reactions, the average response was higher
than the scale midpoint for positive reactions and lower than
Longitudinal 12 monthly surveys
Cross-sectional or longitudinal

Depressive symptoms, anxiety, self- Longitudinal 9-month follow-up

Depressive symptoms, anxiety, self- Longitudinal 3-month follow-up

across one college semester;

the scale midpoint for negative reactions (Eshbaugh & Gute,

These articles also examined emotional health outcomes. bAlthough this paper used data from a longitudinal study, it did not measure change in self-esteem.
Longitudinal 4-year follow-up
Longitudinal 7-year follow-up

Depressive symptoms, anxiety, self- Longitudinal weekly surveys

2008; Fielder & Carey, 2010a; Gusarova et al., 2012; Kennair

et al., 2016, 2018; Lyons et al., 2014; Lewis et al., 2012; Owen &
9-month follow up

Fincham, 2011a, 2011b; Wesche et al., 2018).

Although individuals reported more positive feelings than
Cross-sectional

Cross-sectional

negative feelings about their most recent CSREs, many indivi­

surveys

duals reported having ever felt negatively about a CSRE.

Between 25% and 78% of participants had ever regretted
a CSRE or had a negative CSRE (Bachtel, 2013; Eshbaugh &
Depressive symptoms, self-esteem

Gute, 2008; Fisher et al., 2012; Gusarova et al., 2012), with most
Emotional variable(s) assessed

Tendency to suppress emotions

studies on this topic finding that over half of participants had

Positive and negative affect

Positive and negative affect

Positive and negative affect

Positive and negative affect
esteem, life satisfaction

esteem, life satisfaction

ever regretted a CSRE (Bachtel, 2013; Eshbaugh & Gute, 2008;

Fisher et al., 2012).
Despite positive subjective emotional reactions to CSREs,
CSREs were associated with less positive emotional outcomes
than sexual behavior in the context of romantic relationships.
esteem

Individuals rated CSREs as less emotionally satisfying than

romantic relationships (Mark et al., 2015). Individuals felt
less positively and more negatively about sexual behavior
with casual partners, compared to sexual behavior with roman­
tic partners, in studies of Australian (Zimmer-Gembeck et al.,
2015) and American college students (Victor, 2012). This find­
ing was not simply due to between-person confounding fac­
tors – for example, that individuals who were predisposed to
Female US college students (N = 477)
Israeli high school students (N = 144)

positive feelings were more likely to be in romantic relation­

Sample

ships. In one study, individuals had less positive/more negative

US college students (N = 284)
US college students (N = 364)

US college students (N = 528)

US college students (N = 666)

US college students (N = 371)

US college students (N = 585)

Israeli adolescents (N = 144)

feelings about their sexual experiences at times when they had

casual partners versus times when they had romantic partners
(Vasilenko et al., 2012).

Emotional Health
Feelings about past sexual encounters provide useful evidence
of the emotional impact of CSREs. However, these feelings may
Vrangalova and Ong (2014)

Woerner and Abbey (2017)

or may not translate into emotional health outcomes such as

Vasilenko and Lefkowitz
Townsend et al. (2019)

psychological distress (including depressive symptoms, anxi­

Shulman et al. (2019)
Shulman et al. (2017)

Wesche et al. (2019)

Table 1. (Continued).

Vrangalova (2015b)
Vrangalova (2015a)

ety, and/or suicidal ideation), affect, and self-esteem. Studies

examining associations between CSRE involvement and emo­
tional health have used diverse methodological approaches,
(2018)
Citation

including cross-sectional, longitudinal, and sibling designs.

These strategies answer different questions, each of which
a
 THE JOURNAL OF SEX RESEARCH 7

provides different evidence of an association between CSREs Monahan & Lee, 2008; Sandberg-Thoma & Kamp Dush,
and emotional health. 2014). One exception was a study by Shulman et al. (2019),
We identified 12 studies that used cross-sectional who found that Israeli adolescents who engaged in CSREs had
approaches to compare the emotional health of individuals more negative affect 4 years later, compared to adolescents
who engaged in CSREs to those who did not have CSREs. who did not have CSREs. Taken together, these findings
The results of these studies were mixed. Although some studies suggest that CSREs may not be associated with long-term
indicated that individuals who had CSREs were more psycho­ changes in emotional health. Furthermore, some evidence
logically distressed than individuals who had never had CSREs suggests that CSRE involvement is not associated with even
(Bersamin et al., 2014; Lin et al., 2017; Mendle et al., 2013), in short-term decreases in emotional health; two studies found
the majority of studies there was no statistically significant that emotional health did not change during weeks or months
main effect of having had a CSRE on psychological distress following CSRE involvement (Vrangalova, 2015a; Vrangalova
(Bancroft et al., 2003; Carrotte et al., 2016; Eisenberg et al., & Ong, 2014).
2009; Grello et al., 2006; Owen et al., 2011; Schwartz et al., 2011; In addition to longitudinal research, twin and sibling studies
Siebenbruner, 2015). Results for self-esteem were also mixed, have provided evidence of a link between CSRE involvement
with some studies showing that CRSEs were associated with and emotional health. Such studies examined sibling or twin
lower self-esteem (Bersamin et al., 2014; Manning et al., 2005; pairs who were discordant on CSRE involvement, thereby
Paul et al., 2000) and other studies finding no statistically minimizing the likelihood that differences between CSRE-
significant association (Eisenberg et al., 2009; Siebenbruner, involved and non-CSRE-involved individuals were due to
2015). genetic or familial differences. We identified two studies
In addition to cross-sectional research, we identified 19 using such designs. Deutsch and Slutske (2015) found that
longitudinal studies that examined how CSREs were associated CSRE involvement in adolescence was not associated with
with changes in emotional health. Longitudinal studies young adult emotional health in a sample of twins, whereas
improve on cross-sectional studies because they can establish Mendle et al. (2013) found in a cross-sectional analysis that
the temporal ordering of associations between CSREs and CSRE involvement was associated with worse emotional health
emotional health. These studies indicated that there were pre­ in a sample of adolescent siblings. Together, these two studies
existing differences in emotional health between people who are consistent with other findings that CSRE involvement is
did and did not engage in CSREs, with people who engaged in associated with short-term, but not long-term, declines in
CSREs reporting worse emotional health than people who did emotional health.
not engage in CSREs (Grello et al., 2003; Monahan & Lee,
2008). However, it is unclear whether these preexisting differ­
Predictors of Emotional Outcomes of CSREs
ences explain associations between CSRE involvement and
emotional health. Depressive symptoms and/or self-esteem The mixed findings on main effects of CSRE involvement on
were associated with increased likelihood of future CSRE invol­ subjective emotional reactions and emotional health suggest
vement in five studies (Dubé et al., 2017a; Fielder & Carey, potential moderating factors. Researchers have examined how
2010b; Fielder et al., 2013; Manthos et al., 2014; Sandberg- characteristics of individuals and sexual experiences are asso­
Thoma & Kamp Dush, 2014). However, not all evidence indi­ ciated with emotional outcomes of CSREs. These predictors/
cated that emotional health predicted future CSRE involve­ moderators include demographic characteristics, psychosocial
ment (Furman & Collibee, 2014), and two studies indicated factors, sexual behavior type, safer sex, alcohol use, and rela­
that anxiety (Vrangalova, 2015b) and emotional suppression tionship to partner.
(Shulman et al., 2017) were associated with a lower likelihood
of future CSRE involvement. Demographic Factors
Preexisting differences between CSRE-involved and non- Gender was the most frequently explored predictor of emo­
CSRE-involved individuals do not preclude the possibility tional outcomes of CSREs, with researchers hypothesizing that
that CSRE involvement is associated with subsequent changes women experience more negative emotional outcomes than
in emotional health. Overall, studies investigating this asso­ men. We identified 38 studies that included gender, either as
ciation indicated that CSRE involvement may be associated a predictor of subjective emotional reactions among CSRE-
with declines in short-term, but not long-term, emotional experienced individuals or as a moderator of associations
health. Studies measuring changes in emotional health within between CSRE involvement and emotional health. Regarding
a year of CSRE involvement typically found that individuals subjective emotional reactions, the majority of studies indi­
who had CSREs experienced subsequent declines in emo­ cated that women felt worse than men about their CSREs.
tional health, either compared to peers who did not have Women reported more worry, disgust, and regret about their
CSREs (Dubé et al., 2017b; Fielder & Carey, 2010b; CSREs than men did (Bendixen et al., 2017; Fisher et al., 2012;
Vrangalova, 2015b) or compared to themselves at times Galperin et al., 2013; Kennair et al., 2016, 2018; Lyons et al.,
when they did not have CSREs (Fielder et al., 2014; Furman 2014; Lewis et al., 2012; Paul & Hayes, 2002; Townsend &
& Collibee, 2014; Vasilenko & Lefkowitz, 2018; Wesche et al., Wasserman, 2011; Townsend et al., 2015; Uecker & Martinez,
2019). In contrast, studies measuring changes over the course 2017). Women also reported their CSREs as being more nega­
of 1 year or more found that CSRE involvement was not tive and less emotionally satisfying than men did (Campbell,
associated with declines in emotional health (Furman & 2008; Gusarova et al., 2012; Mark et al., 2015; Owen et al., 2010;
Collibee, 2014; Gonçalves et al., 2017; Manning et al., 2014; Owen & Fincham, 2011a, 2011b; Snapp et al., 2015; Strokoff
8 R. WESCHE ET AL.

et al., 2015; Wesche et al., 2018). Although the preponderance 2016; Deutsch & Slutske, 2015; Eisenberg et al., 2009; Grello
of evidence suggested that women experienced worse subjec­ et al., 2006; Owen et al., 2011; Schwartz et al., 2011;
tive emotional reactions to CSREs than men, some studies Siebenbruner, 2015; Vrangalova, 2015a; Vrangalova & Ong,
found that gender was not associated with regret (Uecker 2014). Of two studies using adult samples, one found a main
et al., 2015), negative evaluations (Napper et al., 2016), or effect of CSRE involvement on emotional health (Lin et al.,
satisfaction (DeLuca et al., 2015) following CSREs. 2017) and one did not (Carrotte et al., 2016). In summary,
Additionally, in one study women were more likely than men across all age groups the findings were evenly split between
to experience self-affirmation, a positive subjective emotional those that found an association and those that did not.
reaction, after a CSRE (Vasilenko et al., 2012). In addition to gender and age, other demographic charac­
Regarding emotional health, findings about gender differ­ teristics may influence emotional outcomes of CSREs.
ences were more mixed. Some studies indicated that CSREs Although most studies evaluating emotional outcomes of
were associated with more psychological distress for women, CSREs used samples of predominantly White, heterosexual
whereas men with CSREs had comparable (Dubé et al., 2017b) college students, emotional outcomes of CSREs may differ for
or lower levels of psychological distress (Fielder & Carey, other groups. College students evaluated their CSREs more
2010b; Grello et al., 2006; Strokoff et al., 2015) than men who negatively than non-college-attending young adults (DeLuca
had not engaged in CSREs. However, not all studies indicated et al., 2015; Wesche et al., 2018). Asian individuals were more
that gender moderated associations between CSRE involve­ likely to regret CSREs than White individuals (Uecker et al.,
ment and psychological distress; in some studies, engaging in 2015). Findings regarding sexual orientation were mixed. Mark
CSREs was associated with more psychological distress for et al. (2015) found that heterosexual and lesbian individuals
both men and women (Bersamin et al., 2014; Furman & were less emotionally satisfied with their CSREs than gay
Collibee, 2014). In other studies, men experienced more psy­ individuals. In contrast, Galperin et al. (2013) found that het­
chological distress following CSREs than women did (Schwartz erosexual women reported more regret of their CSREs than
et al., 2011; Townsend et al., 2019; Vrangalova, 2015b). lesbian and bisexual women; however, there were not sexual
Furthermore, studies that found no main effect of CSRE invol­ orientation differences for mens’ regret of CSREs.
vement on psychological distress did not find moderation by
gender (Deutsch & Slutske, 2015; Furman & Collibee, 2014; Psychosocial Constructs
Sandberg-Thoma & Kamp Dush, 2014; Vrangalova & Ong, Seventeen articles explored various psychosocial constructs
2014). In contrast to research on psychological distress, (e.g., attitudes, beliefs, and motives) as predictors of emotional
which indicated that women involved in CSREs fare worse outcomes of CSREs. Broadly, this research suggested that indi­
than men, studies in which CSREs were associated with lower viduals with more positive attitudes toward sexuality generally,
self-esteem found that gender did not moderate this associa­ and CSREs specifically, tended to have better emotional out­
tion (Manning et al., 2005; Paul et al., 2000). comes. Individuals with more permissive attitudes about
Given that emotional health outcomes of sexual behavior CSREs, and those who perceived their friends to have more
differ by age (Vasilenko et al., 2016; Meier, 2007; Wesche, permissive attitudes about CSREs, had more positive and less
Kreager et al., 2017), the association of CSREs with emotional negative subjective emotional reactions than other individuals
outcomes may also differ by age. Mendle et al. (2013) found (De Jong et al., 2018; Lewis et al., 2012; Montes et al., 2017;
that associations between CSREs and emotional health were Owen et al., 2010; Townsend & Wasserman, 2011; Woerner &
stronger for younger adolescents; however, Manning et al. Abbey, 2017). Similarly, individuals with more permissive
(2005) found that associations between CSREs and emotional sociosexuality (willingness to engage in sex outside of
health did not differ by age. In addition to these two studies a committed relationship) were less likely to regret CSREs
that examined age as a predictor of emotional health, we were and had less depression and anxiety after CSREs than indivi­
able to categorize articles examining associations between duals with less permissive sociosexuality (Bendixen et al., 2017;
CSREs and emotional health based on the age of their samples. Kennair et al., 2016; Vrangalova & Ong, 2014). More religious
Based on this distinction, there were not clear patterns of age individuals were also more likely to regret having CSREs
differences in associations between CSREs and emotional (Bendixen et al., 2017), which may be due to many religions’
health. negative attitudes toward premarital sex.
Eight studies of adolescents measured whether CSRE invol­ Individuals tended to have better emotional outcomes of
vement was associated with concurrent or subsequent emo­ CSREs if their motives and expectations for CSREs aligned
tional health. Of these, four found a significant main effect of with the typical features of CSREs (i.e., sexually pleasurable,
CSRE involvement on emotional health (Dubé et al., 2017b; but not emotionally intimate). Self-focused approach motives
Manning et al., 2005; Mendle et al., 2013; Shulman et al., 2019) such as pleasure, fun, and self-affirmation were linked to more
and four did not (Gonçalves et al., 2017; Manning et al., 2014; positive and less negative subjective emotional reactions (De
Monahan & Lee, 2008; Sandberg-Thoma & Kamp Dush, 2014). Jong et al., 2018; Montes et al., 2017; Snapp et al., 2015).
Of 17 studies using young adult samples (including college and Relationship-focused motives such as entering a CSRE with
non-college samples), eight found a main effect of CSRE invol­ the goal of forming a romantic relationship were associated
vement on emotional health (Bersamin et al., 2014; Fielder & with more negative emotional reactions in studies of both
Carey, 2010b; Fielder et al., 2014; Furman & Collibee, 2014; Canadian and American college students (Gusarova et al.,
Paul et al., 2000; Vasilenko & Lefkowitz, 2018; Vrangalova, 2012; Montes et al., 2016). Individuals with avoidant motives
2015b; Wesche et al., 2019) and nine did not (Carrotte et al., such as coping or conformity also tended to experience more
 THE JOURNAL OF SEX RESEARCH 9

negative subjective emotional reactions (Montes et al., 2017, contact, both in cross-sectional (Owen et al., 2011; Strokoff
2016), and individuals with non-autonomous motives tended et al., 2015; Wesche, Lefkowitz et al., 2017; although see
to have lower self-esteem (Vrangalova, 2015a). Siebenbruner, 2015 for an exception) and longitudinal studies
In addition to attitudes and motivations, it may be that (Fielder & Carey, 2010b). Additionally, Lewis et al. (2012)
subjective emotional reactions to CSREs contribute to subse­ found that having oral sex was associated with higher levels
quent emotional health. One study found that individuals with of positive affect after one’s most recent hookup, whereas
less negative hookup reactions and individuals who ruminated vaginal sex was associated with higher levels of negative affect.
less about their CRSE had less anxiety at follow-up two months Thus, negative emotional outcomes may be more prominent
later (Black et al., 2019). after more intimate sexual contact.

Relationship to Partner Condom Use

The relationships that individuals have with their CSRE part­ In CSREs that involve penetrative sex, failure to use a condom
ners may influence the emotional outcomes of CSREs. We may be associated with worse emotional outcomes. We identi­
identified 10 articles that examined how characteristics of fied five studies that evaluated how condom use was associated
one’s relationship with a CSRE partner were associated with with emotional outcomes of CSREs. Not using condoms with
emotional outcomes. Overall, this research indicated that CSRE partners was associated with worse emotional outcomes
greater partner familiarity was associated with more positive in samples of men who have sex with men (Lin et al., 2017;
emotional outcomes of CSREs. Individuals whose CSRE part­ Parsons et al., 2003). The findings for predominantly hetero­
ners were first-time partners, strangers, or one-time partners sexual samples were mixed, possibly due to the diversity of
reported more negative evaluations of their experiences, com­ samples and research strategies in these studies. In a sample of
pared with individuals with familiar partners in relationships male and female college students who had engaged in a CSRE
characterized by multiple sexual experiences with their partner in the past 3 months, researchers found that having unpro­
(Lewis et al., 2012; Snapp et al., 2015; Uecker & Martinez, 2017; tected sex was associated with greater negative experiences of
Vrangalova, 2015b; LaBrie et al., 2014; Wesche et al., 2018). hooking up (Napper et al., 2016). However, the authors did not
As discussed in the section on psychosocial constructs, evaluate gender differences in this association. Owen and
romantic motives sometimes underlie the decision to enter Fincham (2011b) found that the association between condom
a CSRE. CSREs are unlikely to transition to romantic relation­ use and subjective emotional reactions differed for men and
ships (Owen & Fincham, 2012), which may explain why enter­ women. For women, condom use was associated with fewer
ing a CSRE with the goal of forming a romantic relationship positive and more negative emotional reactions; for men, con­
may lead to negative emotions. However, it appears that tran­ dom use was associated with fewer negative emotional reac­
sitioning to a romantic relationship may lead to positive emo­ tions. Zimmer-Gembeck et al. (2015) found that, among young
tions. Individuals who hoped for a romantic relationship at any Australian women, condom use was not associated with sub­
point during their CSRE, or who discussed the possibility of jective emotional reactions to most recent sexual experience,
a romantic relationship with their CSRE partner, may have and this association was not moderated by relationship status.
more positive subjective emotional reactions, compared to
individuals who did not believe their CSRE would transition Sexual Satisfaction
into a romantic relationship (Owen & Fincham, 2011b). Another characteristic of sexual experiences that may affect
Developing unreciprocated romantic feelings was associated emotional responses to CSREs is sexual satisfaction. Three
with negative subjective emotional reactions in one study studies examined this topic. More sexual satisfaction corre­
(Gusarova et al., 2012). In another study, feeling constrained sponded to more positive and less negative subjective emo­
within one’s CSRE, such as waiting to see if a partner wants tional reactions, as well as more positive and less negative
a romantic relationship, was also associated with negative sub­ affect, in studies of Norwegian and American college students
jective emotional reactions (Owen & Fincham, 2011a). (Kennair et al., 2016, 2018; Woerner & Abbey, 2017).
Once a CSRE ends, the subsequent relationship between
former partners may be associated with emotional outcomes. Alcohol Use
Owen et al. (2013) found that young adults who were no longer Six articles explored how alcohol use moderated the association
friends with their most recent friends with benefits partner between CSRE engagement and subjective emotional reactions.
reported more depressive symptoms and feelings of loneliness Although general alcohol use may not be related to emotional
than peers who maintained some level of friendship with their responses to CSREs (Owen et al., 2010), alcohol use immedi­
former friends with benefits partner. ately prior to a sexual encounter with a CSRE partner may
increase the likelihood of negative subjective emotional reac­
Sexual Behavior Type tions. For example, in a sample of college students who had
We found 10 articles that evaluated how sexual behavior type engaged in a CSRE within the past year, women who reported
moderated the association between CSRE engagement and consuming alcohol before the CSRE were more likely to feel
emotional outcomes. Much of the research in this area focused discontent with the experience (LaBrie et al., 2014). Other
on the difference between penetrative (oral, vaginal, and/or studies identified that both men and women felt more regret,
anal penetration) and non-penetrative contact (kissing and more negative affect, and less positive affect after a CSRE if they
touching). Penetrative contact with CSRE partners was asso­ drank alcohol prior to the experience (Fisher et al., 2012; Lewis
ciated with more negative outcomes than non-penetrative et al., 2012; Owen & Fincham, 2011a). Higher levels of
10 R. WESCHE ET AL.

intoxication during a CSRE were associated with more subse­ well, engaging in penetrative sex, and not using condoms
quent anxiety (Black et al., 2019). (particularly for men who have sex with men; Lin et al., 2017;
Parsons et al., 2003) are all factors that are associated with
worse outcomes when engaging in a CSRE. In contrast, per­
Discussion
missive sexual attitudes and being sexually satisfied are asso­
On average, individuals evaluate their CSREs as positive experi­ ciated with better emotional outcomes (e.g., Montes et al.,
ences. However, many people have experienced regret, negative 2017; Woerner & Abbey, 2017). Women are more likely to
affect, and embarrassment after CSREs. Based on findings of report negative subjective emotional reactions to their CSREs;
longitudinal studies, engaging in CSREs is associated with short- research findings are mixed, however, regarding whether
term declines in emotional health (within a year of having women who have had CSREs experience more psychological
a CSRE) for some individuals; however, the evidence of long- distress than men do.
term detriments to emotional health is sparse. Characteristics of Multiple theoretical perspectives can explain variability in
individuals (being a woman, having negative attitudes about emotional outcomes of CSREs. Self-determination theory pro­
CSREs) and situations (not using condoms, drinking alcohol, poses that individuals feel better about their experiences when
not being sexually satisfied, and not knowing a partner well) they have an intrinsic motivation – one that they control. Not
increase the likelihood and severity of negative emotional out­ knowing a partner well, drinking heavily before a CSRE, or
comes associated with CSREs. The findings of this review suggest engaging in a CSRE when doing so is inconsistent with one’s
directions for incorporating information on CSREs into preven­ beliefs may be signs that a sexual experience is not intrinsically
tion and intervention. Results also highlight limitations of past motivated. Instead, these experiences may have controlled
research on CSREs, suggesting directions for future research. motives like peer or partner pressure, or they may have “just
happened” without the participant intentionally and enthusias­
tically making the decision.
Explaining Contradictory Findings regarding Positive
Regarding gender differences in emotional outcomes of
Evaluations and Negative Emotional Health Outcomes
CSREs, sexual script theory proposes that the scripts of
People rate their CSREs positively, reporting more positive than CSREs, which are often characterized by little communication
negative subjective emotional reactions to their CSREs. Yet, about sexual behaviors and may involve women as sexual gate­
despite overall positive feelings related to CSREs, some CSREs keepers, leave women feeling unsatisfied or disrespected
are associated with short-term declines in emotional health. One (Backstrom et al., 2012; Littleton et al., 2009). A feminist per­
possible explanation for these contradictory findings is that peo­ spective complements script theory, proposing that CSREs
ple’s feelings about their CSREs change between the time when a privilege men’s sexual pleasure over women’s; this phenom­
CSRE occurs and the time when it is reported on a survey. enon, in combination with the sexual double standard, means
Although individuals experience decreases in emotional health in that women tend to feel worse after their CSREs than men do
the weeks or months following a CSRE, these feelings may fade (Heldman & Wade, 2010; Kelly, 2012). Data support each of
over time and even transform into generally positive memories of these explanations. Quantitative research on mediators of asso­
the experience. Many studies assessing subjective emotional reac­ ciations between gender and emotional outcomes of CSREs has
tions to CSREs, such as regret and emotional satisfaction, ask found that sexual enjoyment, feelings of losing a partners’
about lifetime occurrences, most recent occurrences, or occur­ respect, loss of self-respect, partner initiating most sexual
rences within the past year. Given that CSREs are relatively infre­ activity, and being forced or pressured into sex explained
quent (in one study, the median number of past year hookups was gender differences in sexual regret (Uecker & Martinez, 2017).
three for men and one for women [Owen & Fincham, 2011b]), However, it is important to challenge the idea that women
time and intervening events such as relationship changes may always experience negative outcomes of CSREs and men always
color participants' recollections. experience positive outcomes. Women may experience more self-
It is important to acknowledge that associations between affirmation after CSREs than men do (Vasilenko et al., 2012),
CSRE involvement and emotional health are not necessarily which aligns with the feminist idea that having CSREs allows
due to a causal association. If unmeasured confounding factors, women to subvert the sexual double standard. In several studies,
such as a co-occurring romantic breakup, accompany CSRE men experienced regret or decreases in emotional health following
involvement, we may see spurious associations between CSRE CSREs, suggesting that CSREs are not universally positive experi­
involvement and emotional health. Therefore, another poten­ ences for men. In addition, qualitative studies have revealed that
tial explanation for different findings is that CSREs are positive some men express discomfort with the non-relational, no-strings-
experiences, as reflected by subjective emotional outcomes. attached script of CSREs (Epstein et al., 2009; Farvid & Braun,
Studies measuring emotional health do not capture this posi­ 2017).
tivity because they do not assess feelings about CSREs, only When researchers ask about the emotional outcomes of
general emotional health problems. CSREs, they may explicitly or implicitly compare CSREs to tradi­
tional romantic relationships. Although there are distinctions
between these relationship types, our results indicate some impor­
Predicting Emotional Outcomes of CSREs
tant similarities between CSREs and romantic relationships. There
The results of this review indicate that CSREs may be asso­ are positive aspects of CSREs, such as sexual satisfaction, that are
ciated with different outcomes for some people and under also found in romantic relationships (Peck et al., 2005). Factors
certain circumstances. Alcohol use, not knowing a partner that predict negative emotions in CSREs, such as relationship
 THE JOURNAL OF SEX RESEARCH 11

uncertainty, are similar to the factors that would predict negative of planned behavior aim to improve behavioral control over
emotions in romantic relationships (Knobloch & Knobloch- condom use (Tyson et al., 2014). Similar interventions to
Fedders, 2010). It is important to acknowledge that romantic address behavioral control over sexual experiences may also
relationships are not free of emotional difficulty simply due to improve the emotional outcomes of CSREs.
their relative length, commitment, or emotional intimacy in com­ Findings on gender differences in CSRE outcomes have impli­
parison to CSREs. cations for sexual and relationship education. Practitioners can
use empirical knowledge to improve women’s CSRE experiences.
Emphasis on aligning women’s behaviors with their goals, increas­
Prevention and Education Implications
ing focus on women’s pleasure, and continuing to address the
The results of this review have implications for educators, sexual double standard may be useful in improving both women’s
counselors and program designers who seek to help individuals and men’s decision-making surrounding CSREs and their inter­
navigate CSREs in a healthy manner. Given the high prevalence actions with CSRE partners.
of CSREs, the positive evaluations of them, and the safer sex
precautions that many people take, CSREs are a normative and
Limitations and Strengths
minimally risky component of sexuality for many. However,
negative subjective emotional reactions to CSREs are common, Other authors have noted limitations of the CSRE literature
and some individuals report short-term declines in emotional more broadly, such as the exploratory nature of this research
health following CSREs. In order to increase the positive emo­ and the reliance on heterosexual, predominantly White college
tions associated with CSREs while minimizing emotional risks, samples (Claxton & van Dulmen, 2013; Watson et al., 2017).
it may help to take a skills-based approach that focuses on The studies included in this review are characterized by similar
when/for whom CSREs are emotionally/physically risky. limitations. For example, regarding sampling, 45 of the 71
Because CSREs carry more emotional and physical risks studies included in this review used exclusively college samples.
when alcohol is involved, focusing on preventing alcohol use, The studies also relied on predominantly heterosexual samples;
generally or before CSREs, may improve outcomes associated only three articles addressed emotional outcomes for men who
with them. Alcohol use makes it more likely that people will have sex with men (Bancroft et al., 2003; Lin et al., 2017;
have a CSRE (Fairlie et al., 2018; Grello et al., 2006), increases Parsons et al., 2003), and two studies reported on sexual min­
the likelihood of penetrative contact (LaBrie et al., 2014), and ority women and men (Galperin et al., 2013; Mark et al., 2015).
lowers the likelihood of condom use (Brown & Vanable, 2007; Because the majority of studies focused on American samples,
Cooper, 2002; Kiene et al., 2009; LaBrie et al., 2005). Preventing it is unclear how sociocultural norms related to gender and
alcohol use prior to CSREs may therefore increase condom use sexuality may affect expectations of CSREs, interactions within
and reduce the likelihood of penetrative contact with unfami­ CSREs, and emotional outcomes of CSREs.
liar partners, both of which are also associated with emotional Broad and inconsistent definitions of CSREs limit understand­
outcomes. ing of emotional outcomes. Many definitions of CSREs (e.g.,
People’s subjective emotional reactions to CSREs are better a sexual encounter with someone you were not in a romantic
if their attitudes and motives are consistent with their beha­ relationship with) allow for substantial variation in participants’
vior – for example, when they have more permissive attitudes interpretation. These definitions may obscure differences in emo­
about CSREs and when they are motivated by fun and pleasure, tional outcomes of CSREs according to individuals’ interpretation
rather than forming long-term relationships. Teaching deci­ of what constitutes a CSRE (Wesche et al., 2018).
sion-making skills related to relationship transitions (e.g., Another methodological limitation of the majority of studies
Braithwaite & Fincham, 2007) may encourage individuals to included in this review is a reliance on retrospective data. These
engage in CSREs only when doing so is consistent with their research designs provide an incomplete understanding of how
goals. Personalized normative feedback interventions may also emotional outcomes unfold over time. Recent longitudinal studies
help individuals feel less pressure to engage in CSREs when have provided useful information, for example, documenting that
doing so is inconsistent with their goals (e.g., Chernoff & declines in emotional health following CSREs may fade within
Davison, 2005). People tend to overestimate the prevalence a year. However, longitudinal research with more frequent mea­
and acceptability of CSREs (Lambert et al., 2003). They may surement occasions is needed to understand how emotional out­
be less likely to engage in attitude-inconsistent behaviors if comes of CSREs change within shorter time periods.
they perceive less favorable attitudes among their peers. At This review is limited in that it only included information from
least one intervention has used this approach to address sexual published studies. There is a publication bias in scientific research,
assault in the context of CSREs, finding that college women such that studies finding no statistically significant results are less
who received a personalized normative feedback intervention likely to be published (Dwan et al., 2008, 2013). Thus, our results
reported fewer subsequent CSREs (Testa et al., 2020). may overestimate associations between CSRE involvement and
Factors associated with negative emotional outcomes of emotional outcomes. Furthermore, research cannot demonstrate
CSREs, such as not knowing a partner well, drinking heavily, a causal association between CSREs and emotional health.
having negative attitudes about CSREs, or feeling amotivation – Although there is evidence that individuals tend to experience
like the experience “just happened” – may indicate a lack of increases in psychological distress following CSRE involvement,
agency in decision-making. Interventions designed to increase these longitudinal associations are not sufficient for determining
sexual agency exist, primarily with the goal of decreasing sexual causality. For example, CSREs may also occur shortly following
risk behavior. For example, interventions based on the theory romantic breakups, which are associated with increases in
12 R. WESCHE ET AL.

psychological distress (Monroe et al., 1999). Another non-causal associations with future mental health. Additionally, there is evi­
explanation is that peers’ negative judgments about people who dence that emotional health may predict CSRE engagement.
engage in CSREs could cause increases in psychological distress Research with repeated measurement occasions, such as cross-
(DeLuca et al., 2015). lagged studies, can uncover the extent to which emotional health
Although this review contains limitations, it also has strengths. is a predictor, versus an outcome, of CSREs.
By focusing on the emotional outcomes of CSREs, we expand Research on romantic relationships has utilized a dyadic per­
understanding of the health implications of diverse sexual experi­ spective, allowing researchers to understand how interpersonal
ences, contributing to a holistic understanding of sexual health processes contribute to emotional outcomes (e.g., Pietromonaco
that includes emotions. By including articles examining multiple et al., 2013; Randall et al., 2013). Focusing on interpersonal pro­
types of emotional outcomes, we contribute to an integrated cesses within CSREs may also be useful, although the transitory
understanding of the diverse ways that CSREs are associated and private nature of these experiences poses challenges to collect­
with emotional well-being. By examining studies with diverse ing data from dyads in CSREs. Understanding, even from one
predictors/moderators, sample compositions, and methodological partner’s perspective, how relationship processes like power
techniques, we improve understanding of why studies have imbalances, relationship satisfaction, and relationship commit­
resulted in disparate findings about the emotional outcomes of ment are associated with emotional outcomes of CSREs will
CSREs. improve understanding of CSREs.

Future Directions Conclusion

The results of this review are shaped by the variables examined The results of this review highlight the complex emotional out­
in past research. Future research should examine other vari­ comes of CSRE involvement. Whereas many individuals feel
ables that may explain emotional outcomes of CSREs. For positively about their CSREs, these feelings differ across people
example, future research should explore the roles of sexual and across CSREs. Women, individuals with less positive atti­
communication, verbal and nonverbal consent practices, and tudes toward CSREs, and individuals who drink heavily before
coercion in explaining emotional outcomes of CSREs. The CSREs are at increased risk of experiencing negative emotional
studies included in this review typically did not specify that outcomes. The results of this review do not support the idea that
they were studying wanted sexual relationships and experi­ CSREs are inherently negative and emotionally harmful experi­
ences. Given that the majority of unwanted oral/penetrative ences. Rather than counseling individuals to avoid casual sex due
sexual incidents among young adults occur with a casual sexual to potential negative emotional outcomes, education and pre­
partner (Flack et al., 2007), and that young women identify vention approaches should educate individuals about when and
coercion as a risky aspect of CSREs (Farvid & Braun, 2018), it is for whom CSREs are more emotionally risky in order to improve
likely that some variation in emotional outcomes of CSREs is healthy sexual decision-making surrounding CSREs.
due to unwanted sexual experiences.
Because it is unclear how emotional outcomes of CSREs unfold
over time, additional research is needed to understand how the Disclosure Statement
dynamic nature of CSREs contributes to changes in emotional
The authors declare that they have no conflict of interest.
outcomes. Do subjective emotional reactions fade, stay level, or
grow over time, and do these reactions contribute to changes in
emotional health? Similarly, what factors predict changes in emo­ Funding
tional outcomes of CSREs? For example, women may experience
delayed social consequences of CSREs due to the sexual double This study was funded by the National Institute of Mental Health (grant
standard as they disclose their sexual experiences to others, which numbers T32MH019985 and P30MH052776).
could influence their feelings about their experiences. In addition,
transitions between relationship states – CSREs, romantic part­ Ethical Approval
ners, friends/acquaintances – influence perceptions of past CSREs.
Having romantic feelings toward a CSRE partner is associated This article does not contain any studies with human participants or
with positive subjective emotional reactions (Owen & Fincham, animals performed by any of the authors.
2011a, 2011b), but the majority of CSREs do not develop into
romantic relationships (Eisenberg et al., 2009; Owen & Fincham, ORCID
2011b, 2012; Paul et al., 2000), and individuals report that
unrequited romantic feelings are a source of stress in CSREs Rose Wesche http://orcid.org/0000-0001-9759-0526
(e.g., Gusarova et al., 2012). It is possible that emotional reactions
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