Mental health and psychological vulnerabilities in the context of technology-facilitated child sexual exploitation and abuse: A systematic evidence review

BACKGROUND: Technology-facilitated child sexual exploitation and abuse (TF-CSEA) represents a growing global threat, with over 300 million children affected worldwide. While research has documented severe psychological consequences of victimisation, specific mental health vulnerabilities that can be associated with increased likelihood of TF-CSEA remain poorly understood, limiting prevention efforts. OBJECTIVE: This systematic review examined the association between mental health and TF-CSEA victimisation, including psychological disorders, emotional vulnerabilities, and adverse childhood experiences (ACEs). METHODS: Following PRISMA guidelines, we conducted comprehensive searches across multiple databases, including PubMed, PsycINFO, EMBASE, and grey literature. Studies were included if they examined TF-CSEA victims with documented mental health conditions, emotional sequelae, or ACEs occurring prior to victimisation. Cross-sectional and longitudinal designs were included. Two reviewers independently screened studies using Covidence software, achieving substantial inter-rater reliability (Cohen's κ = 0.61). RESULTS: Ten studies met the inclusion criteria, encompassing 25,749 participants across seven countries. Depression and anxiety emerged as the most consistent associated factors, showing positive associations with all TF-CSEA forms across cultural contexts. Low self-esteem, prior trauma history, and family dysfunction were additional strong correlates. One longitudinal study revealed bidirectional relationships between mental health symptoms and victimisation, suggesting vulnerability cycles. Protective factors included family support and emotional security, whereas traditional parental monitoring was only moderately effective. CONCLUSIONS: Mental health vulnerabilities represent significant modifiable correlates for TF-CSEA victimisation. Prevention strategies should address psychological vulnerabilities through universal mental health programming while providing targeted interventions for high-risk youth. The bidirectional nature emphasises the need for trauma-informed approaches addressing both pre-existing vulnerabilities and post-victimisation consequences.