Links between image-based sexual abuse and mental health in childhood among young adult social media users

Background: Image-based sexual abuse (IBSA) involves harm inflicted upon children through the creation, distribution, and misuse of explicit images. IBSA includes scenarios where explicit images are produced, shared, and misused by both adults and other youth. Objective: To examine the impact of IBSA, independent of child sexual abuse and adversity, on drug overdoses, suicide attempts and self-injuries before the age of 18 with a focus on sexual and gender minority youth. Participants and setting: Young adult social media users, aged 18 to 28 (n = 2630) from across the United States. Methods: Participants were recruited through social media and completed an online survey. Data is cross-sectional - asking young adults to reflect back on experiences prior to age 18. Data was collected between February 27, 2024 and April 1, 2024. Results: IBSA was associated with elevated odds of mental health impact, independent of in-person sexual abuse and adversity. Gender minority participants were more likely than cisgender participants to report IBSA; sexual minority youth more likely than those identifying exclusively as heterosexual to report IBSA. Gender minority youth with IBSA had increased odds of drug overdoses (aOR 3.0, p = .053) and suicide attempts (aOR 3.1, p < .001), controlling for other factors. Among sexual minority youth, IBSA was associated with increased odds of drug overdoses (aOR 3.9, p = .002), suicide attempts (aOR 2.4, p < .001) and non-suicidal self-injury (aOR 2.9, p = .001). Conclusions: Youth serving professionals should be aware that IBSA is associated with increased public health problems. Vulnerability to IBSA should be included among the concerns that clinicians and educators screen for, particularly among vulnerable populations.