Kimberly J. Mitchell

Childhood sexual abuse (CSA) can have enduring consequences for sexual well-being, yet research on adult sexual distress and functioning has focused predominantly on women. A specific focus on men is needed because masculine expectations of strength, control, and sexual competence may shape how male survivors interpret both victimization and subsequent sexual difficulties. This study examined whether CSA is associated with sexual distress and sexual functioning among men, and whether these associations are moderated by masculine discrepancy stress and intrusiveness during sex. A cross-sectional sample of 586 adult men with a history of CSA completed validated self-report measures assessing all constructs. Hierarchical ordinary least squares regressions were conducted while adjusting for demographic and abuse-related characteristics. CSA severity was initially associated with greater sexual distress and functioning problems, but these associations were no longer significant after accounting for masculine discrepancy stress and intrusiveness during sex. Intrusiveness during sex was consistently associated with both greater sexual distress and more functioning problems, whereas masculine discrepancy stress was independently associated only with sexual distress. Masculine discrepancy stress moderated the association between intrusiveness and functioning problems: contrary to expectations, this association weakened as discrepancy stress increased. No comparable interaction emerged for sexual distress. These findings suggest that men’s sexual difficulties following CSA cannot be understood solely as direct consequences of abuse severity. Gender-sensitive, trauma-informed interventions should address both trauma-related experiences during sexual activity and the masculine meanings through which survivors understand their sexual well-being.

Adolescents and young adults are facing a mental health crisis, with disproportionate burden among youth with diverse gender and sexual identities. Resilience science highlights the importance of modifiable strengths and protective factors as targets for prevention. The Resilience Portfolio Model (RPM) conceptualizes resilience as a multidimensional system of strengths across regulatory, interpersonal, meaning-making, and environmental domains that promote well-being following adversity. This secondary analysis study examined whether strengths across these domains were prospectively associated with mental health and whether these associations differed across social identity groups. Data were drawn from a subsample (N = 1584) from Project Lift Up, a national longitudinal study of 4981 adolescents and young adults (ages 13–22 years), including an oversample of sexual and gender minority youth. Participants completed a baseline survey and follow-ups at six-month intervals. Strengths across the four RPM domains were assessed at different waves (Waves 1–4), and mental health symptoms were assessed at Wave 1 and Wave 5 using the DSM-5-TR Cross-Cutting Symptom Measure. Multiple strengths were independently associated with subsequent global mental health symptoms after adjustment for baseline symptoms, adversity, demographic characteristics, and social determinants of health. Mentoring, hope, self-compassion, and recovering positive affect were associated with lower Wave 5 global symptoms, whereas self-care was associated with higher symptoms. Other interpersonal and environmental strengths were not independently associated with global symptoms. Evidence for moderation was limited to two exploratory interactions involving sexual minority identity, indicating that recovering positive affect and activism may operate differently for these youth. Findings highlight the value of examining multiple dimensions of resilience simultaneously and suggest that regulatory, meaning-making, and selected interpersonal strengths may be particularly relevant to subsequent mental health during adolescence and emerging adulthood.

Background: Self-harm, including suicidal thoughts, self-injurious behavior, and disordered eating, is a major public health concern among adolescents and young adults. Youth increasingly encounter self-harm–related content online, including websites that explicitly encourage harmful behaviors. Although exposure to such content has been linked to poorer mental health, most research is cross-sectional and has not examined longitudinal exposure trajectories. Whether persistent exposure represents a distinct digital risk pattern remains unclear. Objective: This study examined longitudinal trajectories and correlates of exposure to self-harm–encouraging websites over 1 year and tested whether persistent exposure was associated with subsequent suicidal ideation, self-injury, and disordered eating. Methods: We analyzed data from 2197 US youth aged 13 to 22 years who completed waves 2 and 4 of Project Lift Up, a national longitudinal cohort study. Website exposure was categorized into 4 trajectories: none, desist (wave 2 only), new (wave 4 only), and persistent (both waves). Categories reflected reported exposure at the 2 assessment waves rather than the frequency or continuity of website use between assessments. Logistic regression models estimated associations between exposure trajectory and wave 4 suicidal ideation, self-injury, and disordered eating, restricting analyses to participants without the respective outcome at wave 2. Models were adjusted for demographics and wave 2 depression or anxiety symptoms and other mental health indicators. Results: Overall, 26.5% (583/2197) reported exposure to self-harm–encouraging websites at wave 2, and 18.5% (407/2197) reported persistent exposure. Privacy concerns, embarrassment, curiosity, and lack of offline support were associated with greater odds of persistence (adjusted odds ratios [aORs] 1.84‐3.23), whereas accidental exposure was associated with lower odds of persistence (aOR 0.28, 95% CI 0.19‐0.41). Compared with no exposure, persistent exposure was associated with higher odds of suicidal ideation (aOR 1.88, 95% CI 1.24‐2.86; P =.003), self-injury (aOR 3.14, 95% CI 2.05‐4.80; P <.001), and disordered eating (aOR 2.46, 95% CI 1.54‐3.93; P <.001). Adjusted predicted probabilities showed a graded pattern, with persistent exposure associated with the highest predicted probabilities (suicidal ideation: 33.4% vs 21.3%; self-injury: 25.7% vs 10.2%; disordered eating: 11.7% vs 5.3%). New exposure was associated with increased odds of self-injury (aOR 2.32, 95% CI 1.30‐4.15; P =.004) but was not significantly associated with suicidal ideation or disordered eating. The desist trajectory was not significantly associated with outcomes. Conclusions: Persistent exposure to self-harm–encouraging websites may represent a distinct digital risk pattern associated with higher subsequent odds of suicidal ideation, self-injury, and disordered eating. Assessing patterns of repeated website exposure and youths’ motivations for seeking this content—not merely whether exposure occurred—may improve the identification of youth at heightened risk and inform digital prevention and clinical intervention strategies.

Adolescents and young adults have high rates of exposure to the suicide thoughts and behaviors of people in their social networks and also report frequently trying to help. The current study aimed to describe the wide array of helping actions young people take and their perceptions of what was most helpful. Data came from the cross-sectional baseline data of Project Lift-Up, a national longitudinal online survey of adolescents and young adults (ages 13–22 at baseline). Participants who reported exposure to social network members’ suicide thoughts and behaviors were asked about up to 33 helping behaviors they may have tried to use. Participants’ own lived experiences of self-harm were related to greater types of helping for non-suicidal self injury and lower helping for suicide ideation. Lived experience was related to perceiving helping actions to reduce risk or to help the person regulate emotions as most helpful. While the study is limited by its focus on bystanders’ perceptions of helpfulness, the study helps paint a broader picture of the engaged helping young people are providing in their social networks and argues for more nuanced training of potential helpers for this population.

As the impact of commercial sexual exploitation (CSE) of children and youth became better recognized in the United States, policymakers and advocates urged the development of interventions and prog...

Professionals working with child sexual abuse, including child sexual abuse material (CSAM), are at risk for adverse mental health outcomes due to repeated exposure to distressing experiences. Previous research on trauma-exposed professionals working with CSAM has focused on forensic examiners and law enforcement personnel, overlooking other Children's Advocacy Center multidisciplinary team (MDT) members who engage in CSAM-related work. Guided by compassion fatigue and secondary traumatic stress frameworks, this study examined heterogeneity in occupational functioning among MDT professionals working with CSAM-related cases. This study applied latent profile analysis to examine mental health and support patterns in a sample of 357 MDT members affiliated with Children's Advocacy Centers in the United States. Profiles were based on symptoms (e.g., depression, burnout), work-related attitudes, support seeking, and agency support. Occupational and agency-level factors were compared across profiles. A four-profile solution emerged: (1) isolated burnout (9.2%), (2) unsupported burnout (21.9%), (3) ambivalent (51.0%), and (4) empowered and supported (17.9%). Profiles differed across levels of psychological distress, burnout, organizational support, autonomy, and work-related functioning. The isolated burnout profile demonstrated the highest levels of depression, anxiety, and burnout, whereas the empowered and supported profile demonstrated the lowest distress and greatest organizational support. Findings highlight heterogeneity in trauma-related occupational functioning among MDT members, with the majority reporting good mental health and feelings toward their work. The findings suggest that MDT professionals exposed to CSAM-related work do not experience uniform psychological outcomes and that organizational support, autonomy, and positive professional engagement may co-occur with more adaptive functioning. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Sexual and gender minority (SGM) youth face disproportionate hardships from systemic inequality and are overrepresented among youth at risk for commercial sexual exploitation (CSE), yet little is known about the help they desire as sexual risk escalates. Using data from a national online survey of 1272 SGM youth aged 13–22 in the United States, this study examined patterns and predictors of desired help across domains of need by level of CSE risk. Nearly all participants reported wanting help for at least one concern, with mental health needs most prevalent. Youth with confirmed CSE reported the highest rates of desired help across all domains, including mental health, sexual health, substance use, food, and housing. Socio-structural conditions, particularly unstable housing, food insecurity, and poor home conditions, strongly shaped help-seeking for basic needs and attenuated associations between CSE status and desired assistance. Findings indicate that SGM youth at risk for or experiencing CSE desire support.

Image-based sexual abuse (IBSA) during childhood and adolescence is linked to substantial mental health risk, yet harms are not experienced uniformly. This study tested moderators of the association between cumulative IBSA exposure (number of IBSA forms endorsed before age 18) and psychological distress, suicide attempts, and self-harm in a diverse U.S. convenience sample of 2,854 young adults who reported 4,205 incidents of IBSA during childhood or adolescence. In fully adjusted models, the main effects of cumulative IBSA exposure were not statistically significant; however, its associations with mental health outcomes varied across incident, developmental, and sociodemographic characteristics. Childhood adversity and sex assigned at birth moderated the association with psychological distress. Dating-partner involvement and repeated victimization moderated the association with suicide attempts, while adult-perpetrator involvement, explicit sexual content, racial or ethnic minority status, and educational attainment moderated the association with self-harm. Commercial involvement was associated with higher odds of suicide attempts but lower odds of self-harm. These findings underscore the importance of trauma-informed, context-sensitive responses that account for heterogeneity in survivors’ experiences and vulnerabilities.