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Background: Childhood sexual abuse (CSA) is one type of childhood trauma that has long-term effects on physical and mental health, predisposing to social anxiety., Objective: This study attempted to investigate the characteristics of different subgroups of social anxiety among youths with CSA experiences., Participants and Setting: 83,219 participants were recruited in a cross-sectional study from 63 colleges and universities in Jilin Province, China., Methods: The main variables were measured by a series of self-report questionnaires. Latent profile analysis was used to classify different subgroups of social anxiety, and multiple logistic regression was employed to investigate factors influencing transitions between different subgroups., Results: 3022 (3.63 %) youths who suffered from CSA (46.8 % were male, M age  = 19.57, SD = 1.76) could be divided into four subgroups of social anxiety: low-risk social anxiety (16.4 %), medium-risk social anxiety with high public speaking anxiety (30.3 %), medium-risk social anxiety with no prominent characteristics (22.9 %), and high-risk social anxiety (30.4 %). Shy bladder and bowel and virtual life orientation increased the level of social anxiety from low to medium and high risk. Smoking and drinking were more prevalent in the low- and medium-risk subgroups than in the high-risk subgroup., Conclusions: There was heterogeneity in different subgroups of social anxiety among youths with CSA experiences. Potential targeted prevention and intervention suggestions could be beneficial in mitigating the risk of social anxiety and further preventing the aggravation of risk between subgroups., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Men who have sex with men (MSM) with history of childhood sexual abuse (CSA) are at high risk for HIV acquisition. One reason is posttraumatic responses compromise ability to accurately appraise risk for danger/vulnerability. Health behavior change models and related interventions assume risk perception can be changed in an enduring manner. Given paucity of studies examining how risk perception changes or sustains over time post-intervention, this underlying assumption is not confirmed. Among this particularly high-risk group who struggle with perceiving risk due to trauma-related cognitions, it may be accuracy of risk perception is fluid. The study primarily aimed to examine accuracy of HIV risk perception over time post-HIV prevention behavioral intervention. Leveraging data from a larger RCT, N = 190 MSM in Boston, MA and Miami, FL USA completed a psychosocial baseline assessment, an intervention aimed to increase awareness of personal HIV risk level, then four follow-up assessments three months apart for a year. Linear mixed effect models were used to examine the degree to which accuracy of HIV risk perception (vs. traditional construct of risk perception with no information about accuracy) predicts sex risk behavior over time delineated by between-person (trait level) and within-person (state level) effects. Majority (92%) of participants fluctuated in HIV risk accuracy over time post-intervention. Within-person risk accuracy (one's accuracy at any given timepoint) predicted sex risk behavior (condomless sex not protected by adherent PrEP) over time, but not between-person (one's average of accuracy). Findings have implications for intervention and counseling related to specific HIV prevention strategies., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Online forums provide a conduit for anonymous communication within deviant subcultures, such as online paedophiles. This helps to build virtual communities of support., Objective: This study explores the experience of paedophiles in the criminal justice system as reported by those who experienced it on such a forum. By analysing and understanding the experiences disclosed by these individuals, we may be able to design more targeted prevention strategies and treatment options., Participants and Setting: Data are from one online forum discussion thread that includes 595 online forum posts by 212 unique usernames ranging over 11 years from 2012 to 2023. This forum claims to be an anonymous "therapeutic community" for paedophiles and does not allow the sharing of media (e.g., videos or images)., Methods: This study uses an inductive approach to analyse the posts and discover the perspective and concerns of users who have experienced or are faced with prosecution and punishment., Results: Seven main themes emerged from the posts on this thread: support and praise, techniques of neutralisation, life in prison, anxiety and mental health, relationships, therapy, and difficulties post-prison., Conclusions: The forum provided an important source of support among a virtual community of people who shared similar sexual interest in children and feel rejected and demonised by mainstream society. The thread functioned like an "echo chamber" that reinforced a positive view of users' deviant interest. Individuals who had been prosecuted for their offending were returning to the forum, which may encourage reoffending. Parole boards and probation officers may need to consider limiting or restricting access to the Internet, particularly the Tor network, when setting release conditions. Implications for treatment focus on challenging the justifications and excuses used by paedophiles., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The study aimed to investigate the potential link between a history of childhood sexual abuse (CSA) and the experience of technology-facilitated sexual violence on dating apps (TFSV), considering distinct motivations for app usage among CSA survivors., Objective: To explore the association between CSA and TFSV on dating apps, while also examining the potential moderating role of motivations for app usage and differences based on sexual orientation., Participants and Setting: The study utilized an online survey among 534 dating app users in Israel., Methods: Participants completed an online survey assessing history of CSA, experiences of TFSV on dating apps, and motivations for app usage., Results: The study found that individuals with a history of CSA experienced more TFSV on dating apps. Survivors of CSA showed lower motivation for love and higher motivation for self-worth validation, ease of communication, and thrill of excitement. Differences between heterosexual and LGBTQ+ participants were observed, with LGBTQ+ individuals reporting higher levels of CSA prevalence and TFSV on dating apps. Motivations for app usage and sexual orientation were found to moderate the association between CSA history and TFSV on dating apps. Among LGBTQ+ participants, those who experienced CSA had a higher likelihood of encountering TFSV on dating apps, regardless of their motivations. Heterosexual individuals with a history of CSA were more prone to TFSV on dating apps if they had a strong motivation for love., Conclusions: This study shed light on unique vulnerabilities among individuals with a history of CSA, including increased susceptibility to TFSV on dating apps., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: There is evidence youth in foster care may be vulnerable to commercial and sexual exploitation of children (CSEC) in the U.S. Youth in care may show vulnerabilities such as running away, identifying as sexual/gender minorities, or exhibiting complex behavioral and mental health needs. However, the nature and nuances of the relationship between CSEC and foster care placements has been largely unexamined., Objectives: This review explores the literature on trafficking among foster care youth to establish what is known about risk factors, vulnerable populations, and leverage points for prevention and intervention., Methods: This scoping review was conducted using PRISMA-ScR guidelines. Eight databases were searched, and the screening process resulted in 16 final articles in the analysis., Results: Sixteen articles were screened into the current study. In reviewing the content, a few distinct themes emerged. First, the articles focused on three different populations of CSEC youth. Second, there was variability in the definitions of CSEC used by scholars. Third, there was a range of terms used to describe youth who were trafficked. Finally, there were broad differences in study methodology. This included the data sources used and the array of outcomes explored (e.g. substance use, mental health diagnoses, housing stability)., Conclusions: It is important for scholars to use common language and definitions when studying the sex trafficking of minors. Developing national databases and improving state and federal data sharing is needed to inform prevalence estimates and explore various pathways to youth experiencing CSEC., (Copyright © 2024. Published by Elsevier Ltd.)

Breaking the demand chain for sex from minors would render supply worthless, contributing to the elimination of commercial sexual exploitation of children (CSEC). Using a novel sampling technique, this study reports on actual and potential adult customers of CSEC in two areas in Kathmandu ( n   =  466). Controlling for refusal conversion, age, education, and income, higher scores on a new Love-Fantasy Scale (LFS) were associated with increased odds of purchasing sex from young girls, as were patriarchal norms emphasizing the power of men. Further research is needed to design interventions that include aspects related to sexual fantasy for young girls to combat demand for CSEC., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: The aim of this study is to assess the coping strategies and psychological resilience of parents of children who are victims of sexual abuse., Methods: The study's sample was compiled from parents of sexually abused children admitted to the Child Advocacy Centre for forensic interviews in a Northern Turkish province (N = 75). Data were collected from May to September 2022. A cross-sectional design was used to assess psychological resilience and coping skills. The Introductory Information Questionnaire, the Strategies for Coping with Family Stressors Scale, and the Psychological Resilience Scale for Adults were administered verbally during individual interviews. The study was approved by the institutional ethics committee., Results: According to the results, the psychological resilience and coping skills of parents played a significant role, particularly concerning touch-based abuse, a single occurrence of abuse, and the absence of family violence. Moreover, there was a positive correlation between coping skills with stressors and psychological resilience (p < 0.05)., Conclusion: In conclusion, empowering parents of children exposed to abuse proves crucial for reducing the traumatic impact on the victimized child. Further research, identifying risk factors for both the child and the family, and strategizing follow-up, educational, and counseling initiatives can enhance the provision of holistic health services in this context., Implications to Practice: This study emphasizes the need to restructure issues of not only trauma in children who are victims of sexual abuse but also coping skills and psychological resilience in parents within nursing approaches aimed at children who are victims of sexual abuse., Competing Interests: Declaration of competing interest The authors declare no conflict of interest. The study did not receive any financial support or relationships that may pose potential conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Disclosing ongoing child sexual abuse (CSA) to a mandated reporter should facilitate youth safety. Unfortunately, youth may continue to experience abuse after disclosure, although little research has examined this phenomenon., Objective: We aimed to understand when and why the child protection process fails after youth disclose to a mandated reporter., Participants and Setting: Hotline support specialists completed an online survey about 124 anonymous hotline chats with youth whose abuse continued after a prior disclosure to a mandated reporter., Methods: We thematically analyzed support specialists' open-ended descriptions of information disclosed by the victim in their chat., Results: In most cases (71 %), the abuse was seemingly not reported or not investigated. Mandated reporters' belief of the victim and minimization of abuse affected reporting decisions. Some mandated reporters tried to address the abuse directly with the perpetrators, endangering victims. Rarely, mandated reporters did not report to respect the victim's wishes. In 24 % of cases, the victim described an investigation that did not result in protection. Victims indicated that investigators "sided to the perpetrator" or said there was not enough evidence. Some victims recanted, often in fear. In 6 % of cases, formal actions were taken but did not provide long-term protection. Victims described temporary cessation of abuse that resumed because their guardian(s) allowed the perpetrator to access them., Conclusions: Disclosing to a mandated reporter can engender traumatic experiences without resulting in long-term safety. Professionals need additional training to increase their knowledge of CSA and respond in ways that prioritize physical and emotional safety., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Competing Interests: E. D. Gaier reports Luminopia, Inc. (scientific advisor, equity, patent), Stoke Therapeutics Inc. (consultant), and Neurofieldz (consultant). The remaining authors report no conflicts of interest.

Background: Child sexual abuse is a universal social challenge and the victims of childhood sexual abuse suffer a range of short and long term psychological, social, behavioral and physical problems that vary in different cultures. The study was carried out to explore the perceived impacts of childhood sexual abuse in Pakistan, because no such study was conducted in Pakistan earlier., Methods: Interpretative phenomenological analysis was used to analyze the data. A snowball sampling technique was used to approach the sample of current study. The sample of the study comprised ten female survivors of childhood sexual abuse of age ranged between 18 and 22 years (M age = 20.10 years) with the education ranging from matric to BSc. Out of these participants, four were married and six were unmarried and belonged to different cities of Punjab, Pakistan. Data were collected via a semi-structured interview schedule and all interviews were verbatim transcribed., Results: A rigorous iterative process of data analysis resulted in three super-ordinate themes and ten sub-ordinate themes: Experiencing Abuse (emotional trauma, and physical distress), Psycho-social Distress (low self-esteem, negative self-concept, psychological pain, social suffering, and retaliation vs. forgiveness), and Sexual Difficulties (passive role, emotionally aloof, aversion from hetero-sexuality and avoidance)., Conclusion: It was concluded that childhood sexual abuse is an intense experience that has short- and long-term negative impacts on the lives of female survivors and engulfs their lives as a whole. The study has implications for psychiatrists, psychologists, family counselors, social scientists, educationists, and parents., (© 2024. The Author(s).)

Objective: to describe the feelings expressed by health professionals when caring for child and adolescent victims of sexual violence from the theoretical perspective of Symbolic Interactionism., Method: qualitative research carried out with 30 female health professionals. An instrument was used consisting of closed questions for sociodemographic data and a script with open questions for interviews. The data was organized and analyzed using Nvivo software version 12, according to Bardin's proposal, from the perspective of Symbolic Interactionism in the work of Charles Morris. The project was approved by the Research Ethics Committee., Results: five thematic categories emerged, revealing feelings of empathy, fear, indignation, suffering, and consternation. These feelings remained in the interviewees' memories, making caring for child and adolescent victims of sexual violence a moving and difficult experience that deeply marks the life of the health professional., Conclusion: there is a need to adopt strategies to support the mental health of professionals who work in services that provide general care to children and adolescents, considering that there is a possibility that they will provide care to child and adolescent victims of sexual violence in compliance with pre-existing public policies., Highlights: (1) Feelings stem from individual impressions in line with social interaction. (2) Caring for child and adolescent victims has a negative impact on professionals' emotions. (3) Service managers need to pay attention to the health of professionals who assist victims.

Background: The internet has become a place of increased risk of abuse, including sexual abuse, for young people (YP). One potential risk factor to online abuse and exploitation is the ability to mentalise. We developed the i-Minds app, a mentalisation-based digital health intervention (DHI) for YP who have experienced technology assisted sexual abuse (TASA), which we tested in a clinical feasibility trial. Nested within the trial was a qualitative implementation study with clinicians who referred to the trial., Objective: To explore the barriers and enablers to the future integration of i-Minds into clinical practice., Participants and Setting: Twelve HCPs were recruited from across two trial recruitment sites (Manchester and Edinburgh)., Methods: Semi-structured interviews were informed by Normalisation Process Theory (NPT). Framework analysis was used; transcripts were coded deductively to NPT constructs., Results: Practitioners were positive about the need for, and added value of, the i-Minds app over existing interventions, including other DHIs. While they felt confident with the app, concerns remained around the safety of using the app without practitioner support. i-Minds promoted changes in practitioners' work and impacted online behaviour of YP. There was an identified need for further training and organisational support., Conclusions: Practitioners are aware of TASA but have limited knowledge, skills and tools to work with TASA in clinical practice with YP. There is a need for awareness raising and education about TASA and DHI. i-Minds offers a theory-informed DHI for working with YP exposed to TASA that is acceptable to practitioners and YP., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Parental support has been suggested to mitigate mental and physical consequences following childhood sexual abuse (CSA). However, many CSA survivors experience parental rejection post-CSA., Objective: We aimed to understand the impact of abuse-specific parental acceptance on post-traumatic stress disorder (PTSD) and physical pain in Burundian CSA-survivors. We further assessed the significance of parental acceptance among known risk factors for predicting PTSD., Methods, Participants, and Settings: Participants (N = 131, 80.9 % female, mean age 16.21 years) were recruited via primary health care centers for survivors of sexual violence which survivors approached post-CSA. Survivors reported on PTSD symptoms, daytime/nighttime pain, and adverse childhood experiences in semi-structured interviews. Parental acceptance levels were categorized (acceptance, no acceptance, no contact) for mothers and fathers separately. Kruskal-Wallis tests assessed group differences. Conditional random forests (CRF) evaluated the significance of parental acceptance in predicting PTSD symptom severity., Results: No significant differences regarding PTSD symptoms and physical pain between levels of maternal acceptance were obtained. Pairwise comparisons revealed significant differences in PTSD symptom severity between paternal acceptance and no acceptance (d = 1.04) and paternal acceptance and no contact (d = 0.81). The CRF identified paternal acceptance as important variable for the prediction of PTSD symptom severity. Even though results were less conclusive, medium effect sizes hint at less pain perception within the paternal acceptance group., Conclusions: The results highlight paternal acceptance as a potential risk or protective factor regarding psychological and possibly physical well-being in the aftermath of CSA, even in the context of other known risk factors., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: A relatively understudied but growing body of research indicates that individuals with a history of childhood trauma exhibit altered reward processing in adulthood. Research to date has focused on adversity broadly, with studies typically finding evidence of blunted response to rewards in adults with a history of childhood trauma., Objective: Given the role of reward processing in risk for psychopathology and the particularly pathogenic nature of sexual abuse (SA), the present study sought to assess whether adults with a history of severe childhood SA exhibit altered neurophysiological response to rewards., Participants and Setting: Female adults (N = 105) were included from two study sites that used the same measures of childhood trauma (Childhood Trauma Questionnaire, CTQ), reward processing (Doors Task), and psychopathology (SCID)., Methods: Based on participants' CTQ and SCID responses, three groups were created: Severe SA (n = 36), Clinical Match (with comparable lifetime psychopathology but no-to-minimal SA history; n = 35), and Healthy Controls (n = 34). Group differences in RewP amplitude were assessed., Results: The Severe SA group exhibited larger reward positivity (RewP) amplitude to monetary rewards than the Clinical Match and Healthy Control groups (partial ƞ 2  = 0.06, p = .047). This effect remained after covarying for severity of other forms of childhood trauma., Conclusions: Our study found that severe SA in childhood was related to a heightened response to reward in adulthood. Furthermore, this was not attributable to the severity of other forms of early trauma or comorbid psychopathology. Future studies are needed to identify how heightened reward processing following severe childhood SA may be implicated in the onset and course of psychopathology., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The paper examined how dissociation is experienced and manifested in the drawings and narratives of female survivors of childhood sexual abuse (CSA) diagnosed with dissociative identity disorder. Fifteen Israeli women filled out a self-report questionnaire consisting of demographics, traumatic events, and dissociation severity. Then, they were asked to draw a dissociation experience and provide a narrative. The results indicated that experiencing CSA was highly correlated with indicators such as the level of fragmentation, the figurative style, as well as with the narrative. Two main themes emerged: a constant movement between internal and external worlds, and distorted perceptions of time and space., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Emotional congruence with children (ECWC) is a psychologically meaningful risk factor for sexual offending against children (SOC). Based on previous research and theory, three models have been proposed to explain ECWC: Blockage, Sexual Domain, and Psychological Immaturity. Using structural equation modelling in a routine correctional sample of men adjudicated for sexual offences ( n = 983), we found little support for all three of these models. Instead, we found that atypical sexual interests, alone, best explained ECWC, with a moderate relationship to ECWC. Using the predictors associated with each of the three models of ECWC, we identified three classes of men with a history of SOC who are high in ECWC using latent class analyses ( n = 377). These three classes generally did not replicate the three models of ECWC. We instead propose three subgroups of men with histories of SOC who are high in ECWC, characterized respectively by: relationship deficits; youth and loneliness; and high sexual and general criminality. High levels of ECWC are predictive of a higher risk of sexual recidivism, regardless of class association; however, these subgroups are differentially at risk for some types of recidivism. Our findings suggest that ECWC is a multi-faceted construct, which is still not well understood., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Most research examining the consumption of online child sexual abuse material (CSAM) has focused on offenders' demographic and psychological characteristics. While such research may assist in the development of therapeutic interventions with known offenders, it has little to offer the development of interventions for the vast majority of offenders who are never caught., Objective: To learn more about the offending strategies of CSAM offenders, in order to inform prevention efforts to deter, disrupt, and divert individuals from their pursuit of CSAM., Participants & Setting: Seventy-five male CSAM offenders, who were living in the community and were voluntarily participating in a treatment programme., Methods: Participants completed a detailed self-report questionnaire focussing on their pathways to offending and their online behaviour., Results: Most participants reported that they did not initially seek out CSAM but that they first encountered it inadvertently or became curious after viewing legal pornography. Their involvement in CSAM subsequently progressed over time and their offending generally became more serious. The most notable feature of participants' online behaviour was the relative lack of sophisticated technical expertise. Opportunity and other situational factors emerged as mediators of offending frequency. Offending patterns were affected by participants' psychological states (e.g., depression, anger, stress), offline relationships and commitments (e.g., arguments with spouse, loss of job), and online experiences (e.g., blocked sites, viruses, warning messages)., Conclusions: Findings suggest that many offenders are receptive to change and may be potentially diverted from their offending pathway., Competing Interests: Declaration of competing interest The authors declare that there are no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Adult appraisals of their childhood sexual experiences as abusive are associated with increased risk for long-term psychological problems. Factors that underlie whether adults appraise their childhood sexual experiences as abusive remain unknown., Objective: To determine factors associated with adult cognitive appraisals of childhood sexual abuse., Participants and Setting: Participants were 1196 adults ages 19-41 (M = 29.23, SD = 3.84) with documented cases of childhood maltreatment (sexual abuse, physical abuse, and neglect) during the years 1967-1971 and demographically matched controls who were followed-up and interviewed in adulthood., Methods: Using a prospective cohort design, participants were asked to recall whether they had any sexual experiences in childhood, and if so, the frequency of abuse, age at the onset of abuse, relationship to perpetrator, and whether they appraised the experiences as sexually abusive., Results: Over half of the sample (52%) reported childhood sexual experiences, yet only 44% considered those experiences sexually abusive. Participants with documented cases of child sexual abuse and neglect were more likely to appraise their childhood sexual experiences as abusive compared to controls. Participants who reported more severe abuse, more frequent abuse, younger age at the onset of abuse, and intrafamilial and both intra- and extrafamilial abuse (vs. extrafamilial abuse) were more likely to consider their experiences abusive. Compared to males and Black participants, females and White participants were more likely to appraise their experiences as abusive., Conclusions: Understanding factors that determine adult cognitive appraisals of childhood sexual experiences as abusive can inform clinical interventions for maltreated populations., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Childhood sexual abuse (CSA) is a global problem that is preventable. Sexual grooming behaviors have been deemed an integral part of CSA for the purpose of avoiding detection and preventing disclosure. Many of these behaviors are reported more often by adults who experienced CSA as compared to those that did not (Jeglic et al., 2023). Such behaviors form important targets for prevention efforts, as well as the investigation and prosecution of CSA. Consequently, it is important to identify the prevalence rates of sexual grooming behaviors., Objective: The aim of the present study was to identify the prevalence of sexual grooming as reported by adult survivors of CSA., Participants and Setting: A large sample of adults who reported a history of CSA (n = 1045) completed the study online via Prolific., Methods: Participants completed an anonymous self-report survey which included the Sexual Grooming Scale - Victim Version (Winters & Jeglic, 2022)., Results: Overall, 99% of participants endorsed experiencing at least one sexual grooming behavior, with an average of 14.25 sexual grooming behaviors out of a possible 42 (range = 0-36) reported per survivor. Participants endorsed behaviors across all five stages of the sexual grooming process: victim selection, gaining access and isolation, trust development, desensitization, and post-abuse maintenance. The most frequently reported sexual grooming behaviors included the perpetrator selecting a child who was compliant/trusting (68%) or had low self-esteem (61%); arranging activities alone with the child (57%); presenting themselves as nice/charming/likeable (70%); showing the child large amounts of attention (56%) or affection (54%); and using seemingly innocent touch (51%)., Conclusions: Sexual grooming is prevalent based on reports from adult survivors of CSA. These findings will be discussed as they pertain to the prevention, detection, and prosecution of CSA., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Online child sexual abuse (OCSA) is a growing social concern. However, its manifestations among children with disabilities (CWDs), who face an increased risk of sexual abuse, remain largely unexamined., Objective: This study aims to fill this gap by examining professionals' perspectives of the OCSA of CWDs through their work at the 105 Hotline, an Israeli national call center that accepts queries and reports of the cyber victimization of minors., Methods: A mixed methods research design was employed. A quantitative analysis was performed on 114 case files involving the OCSA of CWDs, followed by a thematic content analysis of 23 follow-up files by social workers., Results: The quantitative findings revealed various characteristics of the survivors, their families, and OCSA. The qualitative analysis revealed that professionals indicate multiple interrelated risk factors for the OCSA of CWDs on three levels: child, related to the child's characteristics and disability traits; family, referring to familial complexities, parenting challenges, and socio-economic position; and relational, referring to the online abusive relationships between the perpetrator and the survivor. Furthermore, the online platform comprised characteristics that enhanced the risk of OCSA of CWDs., Conclusions: The understanding that the OCSA of CWDs as a compounded risk that encompasses personal and environmental risk dimensions is necessary and should guide all professionals' decisions and actions. There is also an urgent need for governmental and community efforts to develop measures, policies, and support systems to reduce OCSA risks for CWDs. Moreover, knowledge and interventions should be developed for professionals and parents of CWDs to improve the identification and response to this overlooked phenomenon., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Over the last two decades, several studies have examined the extent and expression of child sexual abuse (CSA) in religious institutions. In 2021, following new Vatican guidelines and under intense public pressure, the Portuguese Episcopal Conference commissioned a study on CSA in Portugal by members of the Portuguese Catholic Church (PCC) and others associated with it (from 1950 to 2022)., Objective and Methods: The study draws on a web-based survey and a respondent driven sample. The questionnaire included categorical questions about victims, abusers, types of abuse, and open-ended questions. We characterized victims and abusers and developed a social cartography of abuse using Correspondence Analysis. Victims' narratives are also part of the model of analysis., Results: We validated 512 of CSA by members of the PCC. Boys were more frequently abused (57.2 % vs. 42.2 %); male abusers predominate (96.7 %); most victims were abused more than once (57 %); the average age of victims when the first abuse occurred was 11.2 years. More invasive forms of abuse predominate (80 % manipulation of sexual organs or penetration; only 20 % had no body touching). There are patterns of abuse, and space plays a pivotal role in understanding the forms that CSA takes within Catholic environments. The richness of individual narratives was an unexpected outcome that enables us to better understand the organisational and symbolical power structures in which abuse takes place., Conclusion: Given the characteristics of our sample, these cases are the tip of the iceberg, with CSA within the PCC likely involved thousands of children. Further research should strive to consider victims' narratives., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The darknet hosts an increasing number of hidden services dedicated to the distribution of child sexual abuse material (CSAM). Given that by contributing CSAM to the forum members subject themselves to criminal prosecution, questions regarding the motivation for members contributing to darknet CSAM forums arise., Objective: Building on insights gained from research into clearnet communities, here we examine the extent to which social incentives generated by the online CSAM community may explain members' posting behavior on darknet CSAM forums., Participants and Setting: We analyze digital forensic artifacts on the online behavior of members of a darknet CSAM forum that was shut down by law enforcement agencies in July 2015., Methods: We apply group-based trajectory modelling (GBTM), social network analysis, and mixed-effect survival models., Results: Applying GBTM three posting trajectories can be distinguished. Social network analyses finds the reply network to be more centralized than predicted by chance. Mixed-effect survival models show positive associations between the length of members' first post and the time since members' first registration on the forum and subsequent posting. Contrarily, the number of replies received appears to mitigate subsequent posting., Conclusions: Findings show posting activity on the forum to be concentrated in a minority of forum members who show posting trajectories that are both frequent and persistent. Results further suggest persistence in posting is motivated by social identity and, to a lesser extent, differential association processes., Competing Interests: Declaration of competing interest The authors report there are no competing interests to declare., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: Adolescents who have been sexually abused commonly experience trauma symptoms, and many are referred for trauma-based treatment. However, they sometimes spend considerable time on waitlists before beginning treatment. This study examines the course of trauma symptoms among adolescents who have been sexually abused and are waiting for treatment, and the extent to which self-blame for the abuse predicts trauma symptoms at the beginning of treatment., Method: Participants were 127 adolescents (89.0% female, M age  = 13.61 years; 53.2% identified as Hispanic) at a Children's Advocacy Center in the southern United States. All had reported being sexually abused. Participants reported on their trauma symptoms and self-blame appraisals at a screening assessment (T1), and trauma symptoms were re-assessed at the beginning of treatment (T2)., Results: The mean level of trauma symptoms declined over time for the total sample. Regression analyses indicated that greater self-blame for the abuse at T1 was associated with higher levels of trauma symptoms at T2, even when controlling for T1 trauma symptoms and other correlates of T2 trauma symptoms. Higher levels of trauma symptoms at T1 and adolescent sex (female) were also associated with higher levels of trauma symptoms at T2., Conclusions: Findings suggest that assessing for self-blame for sexual abuse may be important in triage and treatment planning for youth with trauma symptoms after experiencing sexual abuse.

Objectives: US veterans report more adverse childhood experiences (ACEs) than nonveterans, and a greater number of ACEs has been linked to substance use disorders (SUDs). To date, however, no study has examined whether specific ACEs may be linked to SUDs in this population in a sex-related fashion., Methods: We analyzed data from the National Health and Resilience in Veterans Study, a nationally representative survey of 4069 US veterans. ACEs, current alcohol use disorder (AUD), and current drug use disorder (DUD) were assessed using validated self-report measures., Results: Being raised in a household with people with SUDs was independently associated with current AUD. Childhood sexual abuse and having an incarcerated family member were independently associated with current DUD. Sex moderated associations with specific ACEs. Specifically, female veterans who had experienced physical neglect in childhood or were raised with a mentally ill family member in the home were more likely to endorse current AUD and DUD, whereas male veterans who experienced sexual abuse in childhood or who were raised in a home with someone who used substances were more likely to endorse current AUD and DUD., Conclusions: Results underscore the importance of targeted and sex-sensitive interventions in addressing potentially unresolved childhood traumas as part of treatment efforts for SUDs in veterans., Competing Interests: The authors declare no conflicts of interest, and there was no funding for this manuscript. Dr Potenza has consulted for Opiant Therapeutics, Game Day Data, Baria-Tek, and the Addiction Policy Forum; has been involved in a patent application with Yale University and Novartis; has received research support from the Mohegan Sun Casino, Children and Screens, and the Connecticut Council on Problem Gambling; has participated in surveys, mailings, or telephone consultations related to drug addiction, impulse-control disorders, or other health topics; has consulted for and/or advised gambling and legal entities on issues related to impulse control, Internet use, and addictive disorders; has performed grant reviews for research-funding agencies; has edited journals and journal sections; has given academic lectures in grand rounds, CME events, and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts. The other authors do not report disclosures. This manuscript was not posted on a preprint server., (Copyright © 2024 American Society of Addiction Medicine.)

In contrast to adults, there is considerably less research on childhood or adolescent exposure to sexual harassment (CAESH), its lasting psychological correlates, and whether such experiences should be included in definitions of childhood sexual abuse. The current study examined the prevalence and symptomatic sequels of unwanted flirting, being "checked out" sexually, unwanted sexual attention, sexual comments, propositions, and related noncontact behaviors that occurred before age 18, as well as the multivariate relationship between CAESH and contact child sexual abuse (C-CSA) in a diverse online sample of 528 individuals. CAESH was very common, with over 95% of women and 64% of men reporting at least one experience of noncontact sexual harassment before age 18. When childhood sexual abuse was operationalized as the presence of either C-CSA or a total CAESH score of 18 or higher (corresponding to an average score of "3-5 times" prior to age 18), the prevalence was 67% for women and 26% for men, more than three times higher than C-CSA alone. This expanded definition was associated with significantly more anxiety, depression, and posttraumatic stress relative to C-CSA alone. These results suggest that CAESH is a significant source of symptoms in adults and support the emerging perspective that childhood sexual abuse may be best understood as including both contact and noncontact events., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Studies indicated that people tend to consider female-perpetrated sexual abuse (FPSA) less serious and damaging than male-perpetrated abuse (MPSA) and the possible roles of gender stereotypes on attitudes to minimize FPSA. This study aimed to explore the role of gender stereotypes and sexuality myths on the attitudes toward FPSA among professionals. A secondary aim was to explore the role of training and experience with child sexual abuse (CSA) cases on the attitudes toward FPSA. The sample consisted of Turkish professionals ( N  = 502), including mental health/social, health, and justice workers. The participants were recruited via a face-to-face online survey. The results of one-way ANOVAs showed that females and mental health/social workers were more likely to consider FPSA as a serious problem and believe the negative impact of abuse. A five-step hierarchical multiple regression analysis demonstrated that the experience with FPSA cases, belief in gender stereotypes, and myths about female sexuality accounted for 21.7% of the variance in the attitudes toward FPSA. Although the level of professional minimization of FPSA is above average, the influential roles of gender stereotypes and sexual myths on the attitudes toward FPSA exist among professionals. Our findings supported the necessity of additional training addressing gender stereotypes and sexual myths. Future studies should also be conducted with different populations and other influential possible factors on the attitudes toward FPSA., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Young people with special educational needs (SEN), such as intellectual disability and/or autism, are particularly vulnerable to child sexual exploitation and abuse (CSEA). This mixed-methods systematic literature review consolidates findings in respect to how young people with SEN are currently being taught about CSEA in the UK, incorporating empirical and practice-based findings to counteract publication bias. Key databases were searched, and relevant organizations were contacted regarding studies published between 2015 and 2022 (inclusive). Thirteen articles met the inclusion criteria. Of these, 10 adopted a qualitative methodology, and three a mixed-methods approach. The thematic synthesis of the qualitative studies identified the following themes: (a) beliefs and stereotypes about CSEA, vulnerability. and risk have led to young people with SEN being misinformed and misunderstood, and (b) anxiety about the topic of sex and abuse creates polarized views regarding CSEA education in adult guardians of young people with SEN. Themes are discussed in the context of societal biases in respect to vulnerability and risk, and these biases are considered to have a negative effect on how young people with SEN are supported. The findings of this review encourage providers of CSEA awareness education to be mindful of not endorsing harmful stereotypes, and to involve parent-carers as much as possible. This review additionally encourages services and organizations to increase focus on practitioner reflexivity and regular training to counteract potential biases in respect to gender, vulnerability, and risk., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Technology-facilitated sexual abuse refers to the use of information and communication technologies to facilitate both virtual and in-person sexual crimes. Research on this topic has focused on rates, risk factors, and consequences. This scoping review aims to understand whether and how forensic psychological procedures are adapted to assess adolescent victims and how Internet-based information might be useful as complementary data. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extensions for Scoping Reviews guidelines, searches were conducted in April 2023 in five electronic databases to include Portuguese, Spanish, or English quantitative, qualitative, or mixed-method peer-reviewed studies. Of the 2523 studies, six were considered eligible. Identified procedures include forensic interviews following the National Institute for Child Health and Human Development Protocol, and risk and trauma assessments. While discussing technology's role in abuse during interviews was informative, confronting adolescents with evidence of their abuse had adverse effects on their testimony and recovery. The assessment tools often had a narrow focus or overlooked the abuse unless explicitly disclosed, implied a referral, or when safeguarding concerns were raised. Clinical, forensic, and criminal implications are elaborated., (© 2024 The Authors. Behavioral Sciences & The Law published by John Wiley & Sons Ltd.)

Research on male survivors of childhood sexual abuse is notably deficient when it comes to addressing their sexual concerns, such as experiences of sexual distress, negative thoughts, and feelings related to their sexuality. Dissociation, a known consequence of childhood sexual abuse, could be associated with higher sexual concerns through identity cohesion. Precisely, dissociation can potentially be related to lower identity cohesion (e.g., not knowing what you want or need). In return, lower identity cohesion may be related to higher sexual concerns by impeding the capacity to know and accept oneself, which tends to promote a positive and healthy sexuality. This study aimed to examine the role of identity cohesion in the link between dissociation and sexual concerns in 105 men consulting for their history of childhood sexual abuse. Men completed questionnaires assessing dissociation, sexual concerns, and identity cohesion at admission in a community setting. Results of a path analysis revealed an indirect association between dissociation and higher sexual concerns through lower identity cohesion. The model explained 27.6% of the variance in sexual concerns. This study highlights the relevance of interventions targeting dissociative symptoms to improve identity cohesion and sexual health in male survivors of childhood sexual abuse.

This qualitative study consisted of in-depth, retrospective interviews with participants over the age of 18 who experienced child sexual abuse. Through narrative analysis, study findings shed light on three overall findings: the perception of memories, the perception of grooming, and the perception of the lived lives of child sexual abuse survivors. Findings suggest that the narratives elicited from the participants included current views but also past experiences and anticipation about the future, including individual and societal levels of meaning. These narratives are furthermore entangled and inexorably linked - temporally, culturally, generationally, materially, and emotionally - and the results are thus presented from a holistic perspective. Study findings help explain the complex dimensions concerning the lived experiences of child sexual abuse. As such, this research speaks to the field of social and health care practitioners working with children and families facing the complex phenomenon of child sexual abuse., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Although clergy-perpetrated child sexual abuse (CSA) implies severe traumatic repercussions for the victims, they may also experience posttraumatic growth (PTG) deriving from the need to deal with the trauma suffered. This PTG is associated with the processes of recovery, healing, and empowerment., Objective: Applying a mixed methods approach to analyse PTG outcomes and to explore experiences of PTG in survivors of Spanish clergy-perpetrated CSA and its relation with psychosocial, mental and spiritual suffering., Participants: Thirty-one survivors (M = 51.6 years; SD = 12.4) in the quantitative stage of the research, and seven (M = 49.3; SD = 8.9) in the qualitative stage., Methods: A sequential explanatory mixed methods study design was applied using standardized questionnaires and semi-structured interviews. Descriptive, correlation and thematic analyses were conducted. The quantitative and qualitative data were integrated., Results: Positive associations were found between PTG and psychosocial and mental health problems (r = 0.53; p < .01), damage to faith in God (r = 0.43; p < .05) and damage to faith in the Church (r = 0.48; p < .01). Three themes emerged from the qualitative data that explained, expanded, and complemented the quantitative results, highlighting the relationship between damage and growth and the specific meanings of PTG from the perspectives of the survivors., Conclusions: This study shows that survivors may develop PTG in the course of the processes of psychological suffering, spiritual transformation, and meaning-making of traumatic experiences., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Child sexual abuse is an important health problem that disrupts the physical and mental health of children. In order to protect children from abuse, the knowledge and attitude levels of their families need to be increased., Purpose: This study was to determine the knowledge and attitude levels of Syrian refugee parents regarding child sexual abuse who lived in Turkey., Design and Methods: The study was carried out using a cross-sectional, descriptive, relationship-seeking design. A personal information form and the Child Sexual Abuse Knowledge/Attitude Scale for Parents (CSAKAS) were used., Results: In the study, the mean age of the participants was 33.0 ± 8.2; 74.7% were women; 93.7%. It was also found that the mean scores of the participants regarding such sub-dimensions of CSAKAS as myths/facts, belief, information, attitudes, services and reporting information and preventive attitudes differed statistically significantly with respect to their education level, income level, family type, employment status and having a disabled child (p < 0,05)., Conclusion: Based on the results, it could be stated that the parents who were university graduates, who had good levels of perceived income, who had a nuclear family, who were employed and who had disabled children had better levels of knowledge and attitude regarding child sexual abuse, and it could also be stated that the participants had moderate levels of knowledge and attitudes regarding child sexual abuse., Practice Implications: This study shows that pediatric nurses can play an important role in protecting, developing and improving the physical and mental health of children by increasing the knowledge and attitude levels of families in order to prevent child sexual abuse., Competing Interests: Declaration of competing interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 Elsevier Inc. All rights reserved.)

A metasynthesis was performed on 15 qualitative studies to document the experience of revictimization by an intimate partner among women, based on survivors' perspectives on their sustained childhood sexual abuse and intimate partner violence victimization. Results identified two main conceptual categories: (a) Barriers to action: A belief system reflecting learned helplessness that hinders women's abilities to protect themselves and prevent further abuses, and (b) Broken internal compass: Cognitive elements blurring women's risk evaluation capacities and reference points limiting their ability to break the cycle of revictimization. These findings support the need to examine cognitive distortions and false beliefs in intervention practices and suggest valuable guidelines for practitioners. As the responsibility for violence always lies with the perpetrator, this study should not be interpreted as blaming women for their victimization, but instead, as a way to give women a voice about their experiences and give them a sense of power in the prevention of violence., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study examined the role of character evidence and other issues in criminal appeals of child sexual abuse (CSA) convictions. Character evidence includes uncharged acts and character witnesses who testify to another's reputation or opinion and is offered to prove an individual's propensities. Examining 168 appellate court opinions reviewing CSA convictions between 2005 and 2015 in Maricopa County, Arizona, we found that when specific types of evidence were at issue, they were most often character evidence issues (49%). However, appellate courts virtually never reversed convictions ( n = 5), and when defendants did obtain relief, the reduction in charges or in sentences was minor. Of the small number of opinions that were published ( n = 4), all focused on character evidence, including the single case reviewed by the Arizona Supreme Court. However, close examination of the published cases suggested they effected only modest change., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Survivors of child sex trafficking (SCST) experience high rates of adverse health outcomes. Amidst the duration of their victimization, survivors regularly seek healthcare yet fail to be identified. This study sought to utilize artificial intelligence (AI) to identify SCST and describe the elements of their healthcare presentation. An AI-supported keyword search was conducted to identify SCST within the electronic medical records (EMR) of ∼1.5 million patients at a large midwestern pediatric hospital. Descriptive analyses were used to evaluate associated diagnoses and clinical presentation. A sex trafficking-related keyword was identified in .18% of patient charts. Among this cohort, the most common associated diagnostic codes were for Confirmed Sexual/Physical Assault; Trauma and Stress-Related Disorders; Depressive Disorders; Anxiety Disorders; and Suicidal Ideation. Our findings are consistent with the myriad of known adverse physical and psychological outcomes among SCST and illuminate the future potential of AI technology to improve screening and research efforts surrounding all aspects of this vulnerable population., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Children tend to answer yes-no questions with unelaborated "yes" and "no" responses, but the types of details likely omitted from unelaborated answers have not been explored. This study examined 379 4- to 12-year-olds' answers to yes-no questions in forensic interviews about CSA ( N = 11,187), focusing on age differences in elaborated responses. As expected, older children elaborated more frequently than younger children. Our novel categorization of elaboration types revealed that although there were no age differences in children's use of nominal corrections (correcting a label), or in emphatic negations (giving forceful denials), older children were more likely to give narrative elaborations (providing additional narrative information), wh-elaborations (answering implicit wh-questions), and qualified elaborations (avoiding potentially misleading implications of unelaborated "yes" and "no" responses). The results suggest that children's developing understanding of the implied meaning of questions and responses helps to explain age differences in elaborative responses to yes-no questions., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Regardless of compliance to coercion by an alleged perpetrator, child maltreatment is abuse in any form. However, the extent to which coercion is described as an obligation (mandatory compliance) or permission (optional compliance) is legally relevant. The present investigation examined how attorneys question children about coercion and how children describe coercion in courtroom investigations of alleged child sexual abuse, and whether such language influences jurors' perceptions of children's testimony. Study 1 assessed 64 transcripts of children's testimonies and revealed that both attorneys and children use coercive language. Problematically, terms of permission were used when describing sexual abuse, potentially implying compliance was optional. Study 2 presented 160 adults with transcript excerpts, varied by coercive language (obligation or permission) and maltreatment type (sexual abuse or punishment). Coercive language influenced perceptions of coercion and whether the adult was to blame. Maltreatment type influenced perceptions of severity, credibility, and verdict. Overall, coercive language and maltreatment type influence perceptions of how the event unfolded., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Adult survivors of childhood sexual abuse (CSA) may experience emotional, social, and psychological difficulties, heightened due to the interpersonal nature of harm. Despite the demonstrated effectiveness of trauma-focused treatments in the West, a culturally specific understanding of the needs of and treatments for survivors in South Asia is still in its infancy. The study aimed to systematically review research findings on the mental health impacts of CSA on adult survivors and current treatment approaches and their efficacy and acceptability in South Asia. Seven databases (Scopus, Ovid, CINAHL, ProQuest, EThOS, Google Scholar, and Dogpile) and five peer-reviewed South Asian journals were searched from inception until March 30, 2023. Searches included participants who were adult survivors of CSA of South Asian origin residing in South Asia. Studies on their mental health, different treatments, and the efficacy and acceptability of these treatments were included. Quality assessment tools were used to appraise the quality of included studies. The results were synthesized narratively. A total of 3,362 records were retrieved, and 24 articles were included in the final review. Twenty studies reported mental health impacts of CSA on adult survivors, four studies reported current treatments offered, and two studies were on recovery. However, no study focused on the efficacy or acceptability of the treatments being delivered. Even though the needs of adult CSA survivors in South Asia have been partly identified, there is very little research into the treatments for them., Competing Interests: DisclosureA conference abstract for a poster presentation of the review findings was published in July 2023: Talwar, S., Osorio, C., Appleton, R., & Billings, J. (2023). Experiences of and Interventions for Adult Survivors of Childhood Sexual abuse in South Asia: A systematic review. European Psychiatry, 66(Suppl 1), S980–S981. https://doi.org/10.1192/j.eurpsy.2023.2085).The findings have been presented at University College London interdisciplinary symposium and have been briefly mentioned in their blog on the University website: https://www.ucl.ac.uk/social-historical-sciences/our-departments/shs-health-mind-and-society/news/colonial-legacies-contemporary-inequities-early. Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The sexual exploitation of children in travel and tourism (SECTT), also referred to as child sex tourism, involves engaging in sexual activity with someone under the age of 18 in the context of travel and/or tourism. Research on the perpetration of SECTT is vastly underdeveloped. The present review considers the operationalization of SECTT, its prevalence, and existing theoretical models. Existing theory on SECTT provides a good overview of environmental factors that contribute to SECTT, but the model is insufficient in fully accounting for individual-level risk factors related to sexual offending against children. The present paper expands an existing theoretical model of SECTT, the ecosystem model, to account for these individual risk factors and considers their interaction with environmental factors. The paper concludes by highlighting different avenues for future research., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Parents are their children's first teachers and there are long-standing calls for their involvement in child sexual abuse prevention. In this rapid systematic review, we asked the following questions: what rationales are used to justify parental involvement in child-focused child sexual abuse (CSA) prevention programs? what approaches are used for parental engagement in child-focused CSA prevention programs? and what are the facilitators and barriers to parental involvement in child-focused CSA prevention programs? We searched CINAHL, Cochrane, ERIC, Medline, PsycInfo, Scopus, and SocINDEX in May 2021. A total of 57 papers met our inclusion criteria, comprised of 50 empirical studies, and 7 program descriptions. Rationales for parental involvement included monitoring and shaping parental attitudes toward CSA program delivery in schools; reinforcing children's learning at home; promoting parent-child communication about CSA prevention; building parent capacity to respond to child disclosures; and supporting program delivery for preschoolers. Types of parental involvement included the following: communication, learning at home, volunteering, decision-making, and collaboration with the community. Barriers to parent involvement included ineffective program engagement modalities, and parental fears and misconceptions., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

There is a growing body of evidence that adolescents, and other children, are responsible for a significant proportion of sexual abuse against children. However, there are substantial differences in how this phenomenon is defined and conceptualized between and within sectors. This scoping review explored the current definitions of harmful sexual behaviors (HSB), and other similar terms, used across a range of stakeholder groups. In all, 141 papers were reviewed from both empirical and gray literature sources, including key policy and practice documents. Included papers needed to list a clear definition for the behavior of interest. There was disagreement and inconsistency across the included papers in their conceptualization of harmful, abusive, or problematic sexual behavior (PSB) in children and adolescents. Although the term HSB has been adopted as an umbrella term or continuum in many policy, practice, and research settings, there is a large variance in behaviors, treatment needs, etiology, and harms present across different types of sexual behavior. Relying solely on one term to describe a wide range of sexual behaviors in children and young people may limit the understanding of this issue and imply similarities between groups that are not present. We suggest that clearly defined subsets of HSB, such as sexual abuse, technology-assisted HSB, and PSB, may give more context to the behavior of concern and may be helpful in informing further research, prevention, and best practice approaches., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Individuals who commit sexual offenses against children have been shown to be distinctive from adult offenders across both individual and crime characteristics. However, an examination of the literature shows that there are gaps in the research related to whether sadism manifests differently between those who target child compared to adult victims. The current study therefore aimed to explore the differences in the characteristics, crime-commission process, and the dimensions of sadism between sadistic crimes of children ( n = 101) compared to those of adults ( n = 433). Sexual sadism was assessed with the Sexual Sadism Scale (SeSaS) and binary logistic regression analysis and multidimensional scale analysis (MDS) were performed to examine differences between these two groups. Our results showed that sadistic fantasies manifested into four dimensions for both adult and child victims. In terms of differences, sadistic sexual offenses involving children appear to be reflective of deviant fantasies related to overlapping paraphilias (e.g., sadism and pedophilia). Conversely, sadistic crimes involving adult victims involve a crime-commission process that involves a greater degree of structure to control their adult victim and decrease their risk of identification. Implications for clinical assessment and police investigations are discussed., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Research examining the association between child sexual abuse and executive functions is limited. Yet, exposure to traumatic situations at a young age has been associated with changes in the prefrontal cortex, which hosts executive functions (Wesarg et al., 2020). These functions are crucial for social adaptation, as they make it possible to inhibit maladaptive behavior and respond flexibly to the demands of the environment. As middle childhood is a sensitive period for the development of self-regulatory abilities, exploring executive functioning in school-age children could provide potential intervention targets (Dajani & Uddin, 2015)., Objective: Using multiple informants, this study compared executive functioning of sexually abused children to that of non-sexually victimized children and examined whether the differences were moderated by sex., Methods: The sample consisted of 225, 6-to-12 years old children with a history of child sexual abuse (CSA) and 97 children without a history of CSA. Children completed two executive functioning tasks measuring cognitive flexibility and inhibition. Parents and teachers completed questionnaires evaluating children's executive functioning., Results: In comparison to non-abused children, children with a history of CSA displayed greater executive functioning difficulties as assessed by both informant-reported questionnaires and self-completed tasks. Significant interaction effects were found, such as CSA predicting lower inhibition and executive functions at school in boys but not in girls., Conclusion: This study is a first step in understanding the association between CSA and executive functioning and offers a clearer picture of the differential impact of sexual trauma according to children's sex., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Despite acknowledging the detrimental impact of child sexual abuse material (CSAM) exposure on the mental and physical well-being of investigators and forensic examiners, there is a need for comprehensive exploration into the complex relationship between CSAM exposure, its various dimensions, mental health (i.e., anxiety, depression, and PTSD), and burnout, as well as the presence of positive attitudes towards the job., Objective: To understand how CSAM exposure, mental health and burnout interconnect and cluster within distinct networks of police investigators and forensic examiners., Participants and Setting: Police investigators and forensic examiners from across the United States who were exposed to CSAM as part of their professions (N = 470)., Methods: Participants, recruited through connections with the National Criminal Justice Training Center, completed an anonymous online survey., Results: The network analysis revealed differences in centrality between investigators and forensic examiners, particularly in their associations with exposure factors and mental health variables. Edges invariance tests showed differences in the strength of these associations, with some factors being more strongly linked to PTSD avoidance symptoms among investigators and others among forensic examiners. Stability analyses suggested potentially greater heterogeneity among investigators, while both groups displayed high stability in other centrality indices., Conclusions: This study contributes to our comprehension of the distinct experiences and challenges faced by CSAM investigators and forensic examiners, and specifically the nuanced disparities between CSAM investigators and forensic examiners in terms of their exposure to CSAM content and the associated mental health factors. These insights highlight the imperative need for tailored support mechanisms and interventions that can effectively address the unique challenges encountered by individuals working tirelessly in this critical field., Competing Interests: Declaration of competing interest The authors declare no conflict of interest with respect to the content of this manuscript., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Child sexual abuse (CSA) has been associated with mental health disorders throughout life during childhood, adolescence and adulthood; one of the most prevalent mental health conditions after CSA is post-traumatic stress disorder (PTSD). The present systematic review and meta-analysis aims to examine the association between CSA and PTSD in children and adolescents, evaluating also the role of potential effect modifiers, such as gender and geographic region. Participants were sexually abused (vs. CSA-free) children, adolescents and young adults, up to 21 years of age, with or without a PTSD diagnosis. Settings of eligible studies spanned school, college, university, community, hospital and non-hospital mental health facilities. Eligible studies were sought in PUBMED, ΕΜΒΑSE, PSYCINFO and GOOGLE SCHOLAR databases; end-of-search was set at August 31, 2020. Random-effects (DerSimonian-Laird) models were used for the pooling of studies. Results were reported as pooled odds ratios (OR) and 95% confidence intervals (95% CIs). Twenty-eight studies were identified, including a total cohort of 28,693 subjects. CSA was strongly associated with PTSD, at a similar extent in boys (pooled OR = 2.86, 95% CI 2.09-3.91) and girls (pooled OR = 2.38, 95% CI 1.76-3.23); meta-regression with gender confirmed the non-significant effect of gender. The association was present in all examined geographic regions. CSA is strongly associated with PTSD in childhood, adolescence and young adulthood, irrespectively of gender. Future studies should opt for thorough assessment of confounders and examine regions with paucity of studies, such as East Asia and Latin America., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

This article addresses the differences between girls and boys in the disclosure of sexual violence. The dataset combines data from the Finnish Child Victim Survey (FCVS) of 2008 ( N  = 13,459) and 2013 ( N  = 11,364), focusing on victims of sexual violence, ages 11 to 17 years, from the perspectives of disclosure and gender. Frequency and percentage analysis, cross tabulation, and a Chi-square test were used in the analysis. In the FCVS for both years, around 85% of the victims were girls. In almost two-thirds of the cases, the offender was a relative, friend, or some other known person, while in more than one-third of the cases, the offender was unknown to the victim. The second most common case was that the victim knew the offender, who was not, however, a friend. Sexual violence was found to be, in many ways, gendered. Most of the victims were girls, and most of the offenders were men. There was also a gender difference in the disclosure of experiences. Twenty-one percent of the girls and 45% of the boys reported that they had not told anyone about their experiences. Irrespective of the type of offender, the victims most often (63%) told a peer about their experiences, while 23% told parents, and only 10% told authorities. Moreover, victims reported shame and fear, distrust toward adults, and disbelief that disclosure would be helpful as reasons for not disclosing their experiences. To address this problem, raising awareness of the phenomenon, promoting an atmosphere that supports disclosing experiences of sexual violence, and improving readiness to address them are required., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

This study aimed at assessing the extent to which factors associated with male child sexual offending may also be applicable to women with a self-identified sexual interest in children. Participants ( n = 42) took part in an anonymous online survey covering questions about general characteristics, general sexuality, sexual interest in children, and previously-perpetrated contact child sexual abuse. Group comparisons between women who reported committing contact child sexual abuse compared to those who had not were conducted in terms of sample characteristics. Furthermore, the two groups were compared regarding the factors of high sexual activity, use of child abuse material, indication of ICD-11 pedophilic disorder diagnosis, exclusivity of sexual interest in children, emotional congruence with children, and childhood maltreatment. Our results revealed that high sexual activity, indication of ICD-11 pedophilic disorder diagnosis, exclusivity of sexual interest in children, and emotional congruence with children were associated with previous contact child sexual abuse perpetration. We recommend further research on potential risk factors relating to child sexual abuse on the part of women., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Sexually exploited young men are prevalent, yet underrepresented in clinical practice, policy and research. There are multiple barriers that often prevent young men to disclose and to seek or receive support, such as gender norms, limited awareness of victimization and feelings of guilt and shame., Objective: By gaining more insight into the background characteristics of young men who experienced sexual exploitation and their needs, this study aims to raise awareness and to better inform policymakers, care- and educational professionals on adequate prevention and intervention efforts., Methods: Twenty-six young men (age 14-32) who experienced sexual exploitation or other forms of sexual violence in their youth or were at high-risk, participated in this qualitative study that was conducted in The Netherlands. By means of semi-structured interviews and case-file analyses, data was collected to identify risk and protective factors in their life-course and support needs., Results: Several vulnerabilities (e.g. previous experiences of abuse and neglect, household dysfunction, social rejection, running away, substance use) and a lack of positive and supportive relationships led young men into high-risk situations. Among these were involvement in pay dates, criminality and having to survive from day to day, which contributed to victimization. Prevailing gender norms and experiences of stigmatization were often a barrier to express vulnerabilities and to disclose victimization. There was a wide variety in support needs, including peer-to-peer support, therapy, support with day-to-day practices and anonymous support., Conclusions: These results will contribute to adequate prevention and trauma-informed intervention strategies that meet the unique needs of young men at risk for, or victim of sexual exploitation., Competing Interests: Declaration of competing interest All authors declare that they have no conflicts of interest to disclose., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The fact of having suffered Childhood Sexual Abuse (ASI) is considered a risk factor for the subsequent development of sexual dysfunctions, these being more frequent among women than among men. The objective of this work is to analyze the different sexual dysfunctions in people who have suffered ASI, with addiction problems and in the general population. The sample is made up of 426 participants (241 men and 185 women). A retrospective ex post facto study has been carried out using a sociodemographic data questionnaire ( ad hoc ) and the Golombok Rust Inventory of Sexual Satisfaction (GRISS). For data analysis, the Kolomogorov-Smirnov and Mann Whitney U tests were performed. The Mann-Whitney U test has been carried out to verify if there are significant differences between the people who present sexual dysfunction, between the groups that have suffered sexual abuse and have addiction problems, and the group that has not suffered sexual abuse and have addiction problems. The results indicate that the variables in which significant differences are found are the following: Dissatisfaction ( p = 0.013), Avoidance ( p < 0.001), No sensuality ( p = 0.008), Vaginismus ( p < 0.001), Anorgasmia ( p < 0.001), erectile dysfunction ( p = 0.045), and premature ejaculation ( p = 0.007). The average scores that have been obtained among people who have addiction problems, without having suffered ASI in comparison with those who have suffered it, are the following: Dissatisfaction (5.09 vs. 6.41), Avoidance (2.03 vs. 2.22), No Sensuality (2.96 vs. 4.50), Vaginismus (0.88 vs. 2.94), Anorgasmia (0.97 vs. 3.78), Erectile Dysfunction (2.41 vs. 1.69), Premature Ejaculation (3.60 vs. 2.22). People who have suffered ASI present, with a greater probability, sexual dysfunctions than those who have not suffered it., Competing Interests: Los autores no declaran conflicto de intereses., (©2024 The Author(s). Published by MRE Press.)