Persistence of childhood image-based sexual abuse into young adulthood: Risk factors and psychological distress.

Objective: This study examined the persistence of image-based sexual abuse (IBSA) from childhood into young adulthood and its association with psychological distress.We aimed to identify specific forms of IBSA most likely to persist and evaluate psychosocial correlates of repeated victimization.Method: A crosssectional online survey was completed by 3,527 young adults (M = 22.2, SD = 3.1; range: 18-28 years; 66% female) who had experienced IBSA in their lifetime.Results: Almost half, 41.2%, experienced IBSA both in childhood and again in young adulthood.Coercive or threatening forms of IBSA demonstrated the highest persistence, with adjusted odds ratios exceeding 10.Persistence was associated with greater psychological distress (Cohen's d = 0.42), even after adjusting for cumulative adversity.Peer norms condoning nonconsensual image sharing significantly increased the odds of persistent IBSA (OR = 1.95).In contrast, image taking, making, or sharing without permission showed lower persistence rates, suggesting distinct underlying mechanisms.Conclusions: IBSA can persist through developmental periods, especially when coercion or manipulation is involved.These findings highlight the importance of early intervention, particularly among youth exposed to coercive IBSA, and the need for prevention efforts addressing peer norms.Clinicians should assess prior digital victimization and incorporate trauma-informed care to reduce long-term harm. Clinical Impact StatementThis study found that young adults who experienced image-based sexual abuse during childhood were significantly more likely to be victimized again in young adulthood, especially in cases involving coercion or threats.The continuation of such abuse was associated with higher levels of psychological distress.These findings highlight the importance of addressing early digital victimization and its longterm effects in clinical settings.Interventions focusing on coercive behaviors and promoting peer norms around digital consent during adolescence may help reduce persistent harm and improve mental health outcomes for vulnerable youth.