FRIDAY, Nov. 9 (HealthDay News) -- A new study of Dutch teens finds that few of them frequently engage in risky online activity related to sex, such as sending naked photos to strangers and searching for sex partners, but those who do are more prone to have casual sex in real life.

"There seems to be a relationship between engagement in online and offline sexual risk behavior," said study author Susanne Baumgartner, a graduate student at the University of Amsterdam. "Adolescents who engaged in offline sexual risk behavior were also likely to engage in online sexual risk behavior."

Should parents be worried? Most kids don't engage in risky online activity related to sex, which is a "reason not to worry too much," Baumgartner said. However, there is extra risk for adolescents who "seem to be troubled in their everyday lives."

"Sexting" by teens -- sending naked or partially naked photos to other people via cellphones -- has been reported in the American media in recent months. Some research suggests it's fairly common. Teens also use the Internet to make friends and meet other teenagers.

The authors of the new study wanted to understand how "risky" sexual behavior online (talking with strangers about sex on the Internet, searching for someone to have sex with and sexting to strangers) is related to "risky" sexual behavior offline (having casual sex).

Baumgartner's team surveyed over 1,700 Dutch adolescents aged 12 to 18. Those at highest risk of risky behavior online "were less satisfied with their lives, had higher levels of sensation-seeking . . . and were lower educated," the study authors found.

The researchers suggested that kids at higher risk deserve more attention in terms of preventing risky sexual activity.

Jeff Temple, a psychologist and an assistant professor at the University of Texas Medical Branch who studies teenage sexuality, said the study provides "more evidence that the boundary that separates offline and online lives is becoming increasingly blurred."

He added: "It's important that pediatricians and other health-care providers need to focus on online behaviors as much as offline behaviors as they're beginning to look like one and the same."

Parents should pay attention, too, Temple noted, because if a teen is sexting, he or she may also be engaging in risky sexual activity in the real world.

David Finkelhor, director of the University of New Hampshire's Crimes Against Children Research Center, cautioned that the study has a major limitation for parents in the United States: it looks at Dutch teens, not American teens. Also, he said, "there is not much evidence that the Internet is amplifying risk" -- making it more likely that kids will do risky things in real life.

As for kids at highest risk, Finkelhor said, "We cannot conclude from this that onlykids from low-educated, problem families take risks, just that this is more often the case. I am not sure what the new implications are since we already know that kids from low-educated, problem families need to be targeted for help."

The study appeared online Nov. 5 and in the December print issue of the journal Pediatrics.

More information

For more about teen sexual health, visit the U.S. National Library of Medicine.