Peer-reviewed article
Understanding Mental Health and Childhood Adversity in Technology-Facilitated Child Sexual Exploitation Perpetrators: A Systematic Review of the Evidence
Sabrina Page, Eva Notté, Isabelle Pearson, Iqra Ilyas, Norsayyidatina Che Rozubi et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review examined mental health conditions and childhood adversity among individuals who perpetrate technology-facilitated child sexual exploitation and abuse. The review of 22 studies found that perpetrators are heterogeneous, with common mental health issues including depression, anxiety, and personality disorders. The research identified two distinct perpetrator profiles based on how they were identified, with differences in their psychological characteristics and offending patterns.
Key points
- Depression (29%–60%) and anxiety (28%–52%) were prevalent among TF-CSEA perpetrators across different identification methods
- Emotional dysregulation was pervasive, with shame, guilt, chronic loneliness, and emotional detachment consistently reported as both antecedents and consequences of offending
- Childhood adverse experiences were widely documented, including childhood sexual abuse (17%–45%) and emotional abuse (27%–31%)
- Justice-identified individuals showed more antisocial traits, while self-referred individuals more commonly reported internalising symptoms and desire to desist
- Most evidence comes from cross-sectional designs and convenience samples without comparison groups, limiting causal inference
Limitations
The review is focused on perpetrators rather than child victims or protective interventions, and acknowledges that most included studies use cross-sectional designs with convenience samples and lack direct comparison groups, making causal associations only hypothesis-generating. The evidence base is predominantly from Western, high-income countries, limiting generalisability.
Abstract
This systematic review examined the mental health conditions, emotional characteristics, and adverse childhood experiences (ACEs) documented among individuals who perpetrate technology-facilitated child sexual exploitation and abuse (TF-CSEA). Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, 10 databases and grey literature sources were searched for studies published from 1989 to March 2024. A narrative synthesis of 22 studies, comprising justice-involved, self-referred, and anonymous online samples from predominantly Western, high-income countries ( n = 8 to 3,500), revealed that TF-CSEA perpetrators are heterogeneous. Depression (29%–60%), anxiety (28%–52%), antisocial personality disorder (~42%), and compulsive sexual behaviour (42%) were prevalent across identification methods. Emotional dysregulation was pervasive, with shame, guilt, chronic loneliness, social avoidance, and emotional detachment consistently reported as both antecedents to and consequences of offending. ACEs were widely documented, including childhood sexual abuse (17%–45%), emotional abuse (27%–31%), and physical neglect, with higher cumulative ACE burden associated with more compulsive offending patterns. Subgroup analyses identified two potentially distinct profiles: justice-identified individuals exhibited more entrenched antisocial and externalising traits, whilst self-referred or anonymously identified individuals more commonly reported internalising symptoms, emotional conflict, and desire to desist. These findings are contextualised within established multi-factor models of sexual offending, acknowledging that ACEs and mental health represent only a subset of relevant factors alongside sexual deviance, antisocial cognition, and opportunity structures. Given the predominance of cross-sectional designs, convenience samples, and the absence of direct comparison with contact-only offenders, these associations are hypothesis-generating. Future research priorities include prospective longitudinal designs, standardised measurement, comparison groups, and greater demographic diversity.