Peer-reviewed article

The psychological impact on and mental health outcomes for victim-survivors of technology-assisted child sexual abuse: a systematic literature review.

Alice Forrester Fellowes, Juliane A Kloess, Sarah Gladden · 10 Apr 2026

Abstract

BACKGROUND: The increased use of online technologies has expanded the social landscape for individuals with ill-intent to sexually exploit and abuse children. To date, the specific psychological impact on and mental health outcomes for children who have experienced Technology-Assisted Child Sexual Abuse (TA-CSA) remain underexplored in comparison to those of CSA in the physical world. AIM: This mixed-methods systematic literature review synthesizes the findings from existing studies that have explored these phenomena. METHOD: A systematic search of three databases (EMBASE, MEDLINE, and PsycINFO) was conducted. Included articles (n = 18) were assessed for quality using the Mixed Methods Appraisal Tool. The findings were integrated using a narrative thematic approach. RESULTS: The synthesis yielded seven key themes: (i) An Onslaught of Painful Emotions, (ii) A Shattered Sense of Self: Self-Blame and Guilt, (iii) A Future Held Hostage: Image Permanence and Hypervigilance, (iv) Broken Bonds: Social Isolation and Relational Rupture, (v) Prevalence of Mental Health Difficulties, (vi) Behavioral and Interpersonal Sequelae, and (vii) Gender-Based Variations in Psychological Outcomes. CONCLUSIONS: The findings reveal that experiences of TA-CSA lead to a range of significant mental health outcomes, from profound emotional distress and a shattered sense of self to a high prevalence of psychological? Difficulties. The unique features of TA-CSA, such as digital permanence, are associated with persistent trauma responses. Implications for clinical practice, policy, and future research are discussed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42024548986.