Help-Seeking Among Children Impacted by Commercial Sexual Exploitation: A Scoping Review.

This scoping review aims to summarize current research on help-seeking behaviors and patterns among children who have experienced commercial sexual exploitation of children (CSEC) victimization and/or are at high risk of exploitation. Because the literature on help-seeking specific to CSEC victimization is limited, the current review was expanded to summarize findings from help-seeking research for children who have experienced harms that often co-occur with CSEC, such as maltreatment and homelessness. The authors searched three large article databases (PsycInfo, Ovid MEDLINE, and Web of Science) for articles that were (a) empirical; (b) measured or used the term "help-seeking" in their framing and/or results; (c) included children between the ages of 12 and 18; (d) primarily focused on children from the United States; (e) published in English. Ultimately, 22 articles met all inclusion criteria and were included in the final review. Results suggest that cisgender white females are the most likely to seek help, followed by sexual and gender minority children. Cisgender male children were the least likely to engage in help-seeking behaviors. Universally, children were more likely to engage in informal help-seeking rather than formal help-seeking, with younger children being more likely to reach out to parents and older children more likely to reach out to friends. Importantly, ethnically diverse children were under-represented, leading to limited information about how and why these children seek help. Implications for help-seeking by children impacted by commercial sexual exploitation are discussed, providing guidance for programming and research related to CSEC prevention.

Trauma behind the keyboard: Exploring disparities in child sexual abuse materials exposure and mental health factors among investigators and forensic examiners - A network analysis.

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.

The mental health of officials who regularly examine child sexual abuse material: strategies for harm mitigation.

BACKGROUND: The current study aims to better understand the mental health and subjective well-being of investigators and forensic examiners exposed to child sexual abuse material (CSAM) by examining which components of this work are associated with elevated mental health conditions and decreased well-being, as well as the intra-personal and organizational variables that may mitigate harm and improve well-being. METHODS: Police investigators, forensic examiners, and others connected with the criminal justice system from across the United States who were exposed to CSAM as part of their professions (N = 500) completed an anonymous online survey. Participants were recruited through connections with the National Criminal Justice Training Center. RESULTS: Duration, frequency, amount, and content of CSAM exposure was not related to poorer mental health with the exception of exposure to violent CSAM which was related to elevated post-traumatic stress symptoms. Several agency-level practices and policies, such as the availability of an Officer Wellness Program and more frequently knowing the final case resolution, were related to better mental health and well-being. Harm mitigation strategies, such as talking to other officers investigating the case and taking breaks from the material being viewed, were also related to better mental health. CONCLUSIONS: Findings indicate that police agencies have options for implementing agency-level procedures and practices that have the potential to reduce the negative impact of CSAM investigations. Additionally, many investigators use strategies that are correlated with greater well-being, suggesting opportunities for improving training programs.

Pivots and Partnerships: Successes, Challenges, and Lessons Learned From Conducting Research During a Global Pandemic.

While the importance of including vulnerable populations in research is widely acknowledged, the differential effects of COVID-19 on vulnerable populations necessitated thoughtful participant recruitment. This research note describes one team's attempt at conducting a longitudinal, mixed-methods study during the COVID-19 pandemic with women in the perinatal period who had experienced intimate partner violence. Initial recruitment strategies are provided, as well as the ways in which those initial efforts necessitated revision and redesign. Lessons learned are offered, including ways these strategies may be adapted for other similarly vulnerable populations in the context of a community-level trauma.

Correlates of intimate relationship satisfaction among investigators of child sexual abuse material.

Introduction: This study investigates correlates of intimate relationship satisfaction among investigators of child sexual abuse material (CSAM). Previous research has shown that exposure to CSAM content can negatively impact investigators' emotional wellbeing, but little is known about its association with their intimate relationships. Methods: The study included 500 participants who were police investigators, forensic examiners, and other professionals connected with the criminal justice system in the United States that are exposed to CSAM as part of their profession. The study collected data through an anonymous survey administered via the Qualtrics online survey system. Results: The findings reveal that higher levels of depressive symptoms and post-traumatic stress disorder are associated with lower relationship satisfaction among CSAM investigators. Additionally, group connectedness is positively related to relationship satisfaction for both men and women. Parent investigators also reported lower relationship satisfaction, suggesting unique challenges faced by this subgroup. Exposure to varying types of CSAM content was not significantly related to lower relationship satisfaction. This study highlights the association between depressive symptoms and PTSD with relationship satisfaction among CSAM investigators, emphasizing the role of group connectedness in promoting positive outcomes for both male and female investigators. Discussion: Recognizing the association between depressive symptoms and PTSD with relationship satisfaction can guide interventions and support services for investigators, promoting group connectedness and addressing mental health concerns to enhance resilience and effectiveness in combating child exploitation.

Commercial Sexual Exploitation Outcomes in a Community Sample of Youth.

PURPOSE: Researchers have suggested that victims of commercial sexual exploitation (CSE) have deleterious long-term outcomes; however, longitudinal trajectories of youth who experience CSE have not been explored. For the current study, the National Longitudinal Study of Adolescent to Adults Health (Add Health) survey was used to compare trajectories of youth who had experienced CSE with their nonexploited peers. METHODS: Propensity score matching was used to match youth at waves 1 and 2 who experienced CSE and who did not experience CSE but had similar risk profiles. Youth with low-risk profiles were also matched. Our sample included 430 youth who experienced CSE, a matched sample of 430 youth who did not experience CSE but had a similar risk profile, and a sample of youth who did not experience CSE and had low-risk profiles (n = 782). Outcomes of interest included psychological, behavioral, physical, and interpersonal well-being. RESULTS: Youth who had experienced CSE had higher levels of injection drug use, more police stops, more emergency room visits, and lower relationship satisfaction than their nonexploited peers. Well-being for individuals who experienced CSE as youth changed some over time, but those changes were comparable to the changes experienced by individuals of similar risk who did not experience CSE. Well-being measures for low-risk youth were universally higher compared to high-risk youth, regardless of CSE. DISCUSSION: Youth receiving drug treatment, experiencing delinquency, or being seen in emergency medical settings may benefit from CSE screening, so that victims can be identified and provided immediate and comprehensive services.

Rigor and Respect: Recruitment Strategies for Engaging Vulnerable Populations in Research.

Engaging vulnerable populations in research is a critical focus for researchers seeking to find ways to improve safety and well-being for broader populations. Vulnerabilities often co-occur, meaning that individuals may experience vulnerabilities in multiple facets of their life (e.g., victim of abuse and mental health diagnoses). Unfortunately, many vulnerable populations remain underinvestigated due to difficulty reaching, engaging, and safely including such populations in research. While most researchers assert the importance of including vulnerable populations in research, few actively and successfully recruit them. Many vulnerable populations are understandably weary of research participation. Victims and survivors of domestic minor sex trafficking (DMST) are one such vulnerable population, in that identification may incur substantial risk for DMST victim's physical safety and well-being. In addition, DMST victims and survivors often experience co-occurring vulnerabilities including substance use, histories of abuse, delinquency, and poor mental health. Accordingly, they are notoriously difficult to recruit for research participation. The current paper uses a detailed case example to describe the recruitment and retention strategies used by one researcher to promote DMST survivor research participation. A candid account of challenges, successes, and lessons learned is offered in service of building methodological techniques for recruitment that both honor participant experiences while championing methodological rigor. Findings detail the importance of trust and a trauma-informed approach to qualitative data collection and analysis. Authors include specific strategies to promote comfort and candor amid traumatic response in ways that may empower research participants. A detailed discussion of how such strategies may be adapted for vulnerable populations beyond DMST victims and survivors is provided.

Parent-Child Attachment Moderates the Associations Between Cyberbullying Victimization and Adolescents' Health/Mental Health Problems: An Exploration of Cyberbullying Victimization Among Chinese Adolescents.

Cyberbullying is a public health concern worldwide, including China. Cyberbullying victimization has negative effects on adolescents' health and mental health. This study examined the associations between cyberbullying victimization and several health and mental health problems among adolescents in China. A total of 3,232 adolescents aged 15 to 17 were recruited from 18 high schools in Xi'an, China, using a stratified random sampling method. Self-report data were collected via survey from adolescents in Xi'an, China. In total, 22.2% and 6.3% of the sample reported having experienced cyberbullying victimization in their lifetime and the past year, respectively. Ordinary least squares (OLS) regression revealed that lifetime and preceding-year cyberbullying victimization was, respectively, significantly associated with poorer health (ß = -1.58, p < .001; ß = -2.22, p < .001), more severe depressive symptoms (ß= 3.74, p < .001; ß = 4.48, p < .001), and posttraumatic stress disorder (PTSD) symptoms (ß = 7.16, p < .001; ß = 4.77, p < .001). Binary regression revealed that lifetime and preceding-year cyberbullying victimization was, respectively, significantly related to higher odds of problem drinking (odds ratio [OR] = 1.64, p < .001; OR = 1.84, p < .01), cigarette smoking (OR = 1.69, p < .001; OR = 2.21, p < .001), and gambling engagement (OR = 1.35, p < .05; OR = 1.97, p < .01). Furthermore, greater levels of parent-child attachment were a protective factor against the negative effects of cyberbullying victimization on adolescents' depressive symptoms (p < .001) and PTSD (p < .05). It is critical to develop and implement prevention and early intervention programs that are tailored to address the needs of adolescents in China. Parental involvement needs to be incorporated into interventions for cyberbullying victimization.

"It's All about Breaking down Those Barriers ": Exploring Survivors' Perspectives on Services and Treatment Needs following Commercial Sexual Exploitation during Childhood.

Purpose: In recent years, there has been an increase in funds and services available to address the needs of commercially sexually exploited children (CSEC). While previous studies have explored the mental, behavioral, and physical needs of CSEC victims and survivors, few studies have focused on the service needs CSEC victims and survivors themselves deem most important. The current study seeks to bridge this gap by garnering American CSEC victims' and survivors' perspectives regarding CSEC service strengths, weaknesses, and gaps.Method: Semi-structured, in-depth interviews were conducted with 13 adult survivors of CSEC to examine their perceptions of current CSEC services in the United States. All interviews were recorded, transcribed verbatim, and imported into a qualitative data analysis program. Using an inductive approach, two major themes emerged: short-term needs and long-term needs.Results: Short-term needs included victim identification, housing, and emergency medical care. Long-term needs included life-skills, community building, legal assistance, and medical care. The results point to the complex needs of CSEC victims/survivors.Discussion: While CSEC services continue to develop, there remain many gaps in care in the services available. Study findings provide valuable insight to practitioners and researchers alike and identify the most critical needs of CSEC victims and survivors. Implications for practice and research are discussed.

"Sometimes, Somebody Just Needs Somebody - Anybody - to Care:" The power of interpersonal relationships in the lives of domestic minor sex trafficking survivors.

Domestic minor sex trafficking (DMST) is the recruitment, harboring, transportation, provision, or obtaining of U.S. minors for the purposes of a commercial sex act. DMST victims and survivors often become involved with state-level systems including the child welfare and/or juvenile justice systems. This study presents exploratory qualitative findings regarding the role of interpersonal relationships in the lives of system-involved DMST survivors from the perspectives of DMST survivors. Results indicate survivors perceive interpersonal relationships as key to promoting risk, providing protection, and fostering resiliency over DMST. Findings from the current study not only provide a context for understanding the role of interpersonal relationships in the lives of DMST survivors but also point to directions for development of interventions targeted toward this population.

Measuring Substance Use Among System-Involved IPV Survivors: A Research Note.

This research note presents findings from a qualitative study exploring female, system-involved intimate partner violence (IPV) survivors' perspectives on substance use disclosure in the context of research studies. The study sample includes 22 women who completed a court- and/or child protective services (CPS)-mandated IPV parenting program. Analyses revealed three key areas of participants' perspectives on substance use assessment and disclosure: (a) administration setting/format and measurement clarity, (b) administrator characteristics, and (c) repercussions due to breach of confidentiality. Findings from the current study offer insights into barriers for survivors reporting their substance use and suggestions for researchers seeking to assess substance use among this population.

Domestic Minor Sex Trafficking Among Child Welfare-Involved Youth: An Exploratory Study of Correlates.

Our research team used the National Survey of Child and Adolescent Well-Being II to explore relationships between demographic factors, domestic minor sex trafficking (DMST) status, and several psychosocial dependent variables for children and youth in the child welfare system who affirm that they have been paid for sex within the past 6 months. The sample included a total of 814 children and youth, 38 of whom reported DMST victimization. Results revealed that youth with a history of DMST victimization were more likely than their nonexploited peers to report runaway behavior, demonstrate externalizing behaviors, and test in the clinical range for a substance abuse problem. Research and practice implications are discussed.

Mindfulness-oriented recovery enhancement for internet gaming disorder in U.S. adults: A stage I randomized controlled trial.

Empirical studies have identified increasing rates of Internet gaming disorder (IGD) and associated adverse consequences. However, very few evidence-based interventions have been evaluated for IGD or problematic video gaming behaviors. This study evaluated Mindfulness-Oriented Recovery Enhancement (MORE) as a treatment for IGD. Thirty adults (Mage = 25.0, SD = 5.4) with IGD or problematic video gaming behaviors were randomized to 8 weeks of group-based MORE or 8 weeks of a support group (SG) control condition. Outcome measures were administered at pre- and posttreatment and 3-months following treatment completion using self-report instruments. Linear mixed models were used for outcome analyses. MORE participants had significantly greater reductions in the number of Diagnostic and Statistical Manual of Mental Disorders-5 IGD criteria they met, craving for video gaming, and maladaptive cognitions associated with gaming than SG participants, and therapeutic benefits were maintained at 3-month follow-up. MORE is a promising treatment approach for IGD. (PsycINFO Database Record

Mental Health and Behavioral Outcomes of Sexual and Nonsexual Child Maltreatment Among Child Welfare-Involved Youth.

Our research team used the nationally representative National Survey of Child and Adolescent Well-Being II to explore the differences in mental health and behavioral outcomes between children who enter the child welfare system with substantiated sexual abuse and those who enter with exclusively nonsexual maltreatment. The sample included 380 children between the ages of 8 to 17.5 who were substantiated for maltreatment (sexual and nonsexual) and had the same caregivers at both wave 1 and 2 (n = 380). Results show that the average age of children in the sample was 11 years old, and the results corroborate literature that has indicated children and youth with histories of childhood sexual abuse experience significantly more post-traumatic stress disorder symptoms than children with histories of nonsexual maltreatment. This finding held after controlling for baseline trauma symptoms and all covariates, including race, age, placement type, and caregiver characteristics. Childhood sexual abuse was not significantly related to an increase in behavioral symptoms after controlling for covariates. Implications for research and practice are offered.

Problem Internet Overuse Behaviors in College Students: Readiness-to-Change and Receptivity to Treatment.

This mixed methods study explores college students' readiness-to-change and receptivity to treatment for problem Internet overuse behaviors. Focus groups were conducted with 27 college students who self-identified as Internet over-users, and had experienced biopsychosocial problems related to Internet overuse. Participants completed standardized questionnaires assessing their Internet use and sociodemographic forms. Focus groups explored readiness to change problem Internet overuse behaviors and receptivity to treatment. Similar to college students with other addictive behaviors, students with problem Internet overuse fall along a continuum vis-à-vis readiness-to-change their behaviors. Over half of the participants were receptive to treatment for their problem Internet overuse behaviors.

Diagnostic Criteria for Problematic Internet Use among U.S. University Students: A Mixed-Methods Evaluation.

Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteria for substance use disorder, gambling disorder, and Internet gaming disorder. A total of 27 university students, who self-identified as intensive Internet users and who reported Internet-use-associated health and/or psychosocial problems were recruited. Students completed two measures that assess problematic Internet use (Young's Diagnostic Questionnaire and the Compulsive Internet Use Scale) and participated in focus groups exploring their experiences with problematic Internet use. Results of standardized measures and focus group discussions indicated substantial overlap between students' experiences of problematic Internet use and the signs and symptoms reflected in the DSM-5 criteria for substance use disorder, gambling disorder, and Internet gaming disorder. These signs and symptoms included: a) use Internet longer than intended, b) preoccupation with the Internet, c) withdrawal symptoms when unable to access the Internet, d) unsuccessful attempts to stop or reduce Internet use, e) craving, f) loss of interest in hobbies or activities other than the Internet, g) excessive Internet use despite the knowledge of related problems, g) use of the Internet to escape or relieve a negative mood, and h) lying about Internet use. Tolerance, withdrawal symptoms, and recurrent Internet use in hazardous situations were uniquely manifested in the context of problematic Internet use. Implications for research and practice are discussed.

Eating Disordered Behaviors and Body Disapproval in Adolescent Males Adjudicated for Sexual and Nonsexual Crimes.

Using a large sample of adjudicated delinquent male youth (N = 696), we compared data from youth who had been adjudicated for sexually aggressive crimes and those who had been adjudicated for nonsexual offenses on eating dysfunction, body disapproval, history of sexual abuse, and pornography exposure. The sample included 526 (75.8%) youth adjudicated for sexual offenses and 170 (24.4%) youth adjudicated for nonsexual crimes. The average age of the sample was 16.8 years (SD = 1.6), and approximately half of the sample (47.7%, n = 310) self-identified as White. The results of hierarchical multiple regressions indicated that sexually aggressive youth scored significantly higher than nonsexually offending youth on both eating dysfunction and body disapproval measures. Pornography exposure and substance use predicted body disapproval and eating dysfunction in the entire sample of adjudicated youth. History of sexual abuse was a significant predictor of body disapproval in all adjudicated youth but was not a significant predictor of eating dysfunction. Implications for research and practice are offered.

The Effect of U.S. University Students' Problematic Internet Use on Family Relationships: A Mixed-Methods Investigation.

This is the first study to investigate how college students in the U.S. with problematic Internet use perceive the role the Internet plays within their families of origin. The sample included 27 U.S. university students who self-identified as excessive Internet users. Participants reported spending more than 25 hours a week on the Internet on non-school or non-work-related activities and reported Internet-associated health and/or psychosocial problems. This study provides descriptive statistics from participants' completion of two problematic Internet use measures (i.e., Young's Diagnostic Questionnaire and the Compulsive Internet Use Scale) and reports findings from four focus groups. Three themes emerged from the focus groups: (1) family connectedness, (2) family conflict/family disconnection, and (3) family Internet overuse. The findings of this study are a first step toward the design of effective interventions for problematic Internet use among U.S. college students and serve to inform clinical practice and health policy in this area.

Characteristics of internet addiction/pathological internet use in U.S. university students: a qualitative-method investigation.

Studies have identified high rates and severe consequences of Internet Addiction/Pathological Internet Use (IA/PIU) in university students. However, most research concerning IA/PIU in U.S. university students has been conducted within a quantitative research paradigm, and frequently fails to contextualize the problem of IA/PIU. To address this gap, we conducted an exploratory qualitative study using the focus group approach and examined 27 U.S. university students who self-identified as intensive Internet users, spent more than 25 hours/week on the Internet for non-school or non-work-related activities and who reported Internet-associated health and/or psychosocial problems. Students completed two IA/PIU measures (Young's Diagnostic Questionnaire and the Compulsive Internet Use Scale) and participated in focus groups exploring the natural history of their Internet use; preferred online activities; emotional, interpersonal, and situational triggers for intensive Internet use; and health and/or psychosocial consequences of their Internet overuse. Students' self-reports of Internet overuse problems were consistent with results of standardized measures. Students first accessed the Internet at an average age of 9 (SD = 2.7), and first had a problem with Internet overuse at an average age of 16 (SD = 4.3). Sadness and depression, boredom, and stress were common triggers of intensive Internet use. Social media use was nearly universal and pervasive in participants' lives. Sleep deprivation, academic under-achievement, failure to exercise and to engage in face-to-face social activities, negative affective states, and decreased ability to concentrate were frequently reported consequences of intensive Internet use/Internet overuse. IA/PIU may be an underappreciated problem among U.S. university students and warrants additional research.