Online child sexual victimization and associated health risk behaviours and mental disorders: Findings from a national survey in Australia

Online child sexual victimization (OCSV) is increasingly prevalent, but little evidence exists about associated health outcomes. This study investigates whether two types of OCSV – nonconsensual sharing of sexual images, and sexual solicitation by an adult – are associated with health risk behaviours and mental disorders. This study analyzed data from the Australian Child Maltreatment Study (ACMS), a nationally representative cross-sectional survey. A sub-sample of 3,500 Australians aged 16-24 years provided information about OCSV. Items from the Australian National Survey of Mental Health and Wellbeing assessed non-suicidal self-injury, suicide attempt, and smoking. The MINI International Psychiatric Interview assessed generalized anxiety disorder (GAD); major depressive disorder (MDD), and alcohol use disorder (AUD). Logistic regression examined associations between online child sexual victimization and health risk behaviours and mental disorders. Experiencing nonconsensual sharing of sexual images was significantly associated with suicide attempt among all youth (OR=1.45), self-harm among women (OR=1.90) and all youth (OR=1.94), smoking among women (OR=1.86) and all youth (OR=1.86), and MDD among men (OR=1.92) and all youth (OR=1.43). Online sexual solicitation was not significantly associated with health risk behaviours or mental disorders except for self-harm among all youth (OR=1.45). Nonconsensual sharing of sexual images is strongly associated with multiple adverse outcomes, especially health risk behaviours, and particularly among women. Future research could consider other adverse outcomes of online sexual solicitation by adults, such as distress, and behavioural outcomes. Findings can inform educational, health and legal policies and programs promoting safe technology use and addressing related health issues. • Nonconsensual sharing of sexual images is strongly associated with suicide attempt, self-harm, smoking, and major depressive disorder. • Sexual solicitation by adults is associated with self-harm. • Technology, education, health and legal systems need to promote online safety, digital citizenship, and sexuality education. • Health and other supports are essential to mitigate effects.