Universal Digital Programs for Promoting Mental and Relational Health for Parents of Young Children: A Systematic Review and Meta-Analysis.

Digital parenting programs aim to increase program access, improve psychosocial outcomes for parents and children, and support triage to targeted interventions where required. This meta-analysis assessed the efficacy of online parenting programs in improving parenting skills and capabilities, and by consequence, the mental health and well-being of parents and children, and the quality of the parent-child relationship. Studies were included if they were: (1) online, (2) self-delivered, (3) designed for universal general population prevention, (4) evaluated experimental or quasi-experimental designs, and (5) assessed parent and child emotional and/or relational health, from pregnancy to 5 years of age. A systematic search of electronic databases and grey literature identified 22 studies that met inclusion criteria, including 24 independent samples, with 5671 unique parents. Meta-analyses were conducted using random effects models and Cohen's d effects. Small-to-moderate improvements in parent depression, anxiety, self-efficacy, and social support were observed. No effects on parent stress, satisfaction, or parent-child relationship quality were observed. Meta-regression and sub-group analysis were conducted to identify sensitivity or moderation effects. Collectively, findings suggest any benefits of online parenting programs mostly occur at the time of the intervention, for parent mental health and well-being outcomes, and that enduring effects are unlikely. However, given the cost effectiveness and accessibility of online programs, further research into ways of sustaining effects on parenting outcomes is warranted. Furthermore, given the centrality of the parent-child bond to child development across the lifecourse, additional investment in new digitally facilitated approaches focusing on this bond are likewise warranted.PROSPERO registration CRD42021275647.

Specialized late cingulo-opercular network activation elucidates the mechanisms underlying decisions about ambiguity.

Cortical task control networks, including the cingulo-opercular (CO) network play a key role in decision-making across a variety of functional domains. In particular, the CO network functions in a performance reporting capacity that supports successful task performance, especially in response to errors and ambiguity. In two studies testing the contribution of the CO network to ambiguity processing, we presented a valence bias task in which masked clearly and ambiguously valenced emotional expressions were slowly revealed over several seconds. This slow reveal task design provides a window into the decision-making mechanisms as they unfold over the course of a trial. In the main study, the slow reveal task was administered to 32 young adults in the fMRI environment and BOLD time courses were extracted from regions of interest in three control networks. In a follow-up study, the task was administered to a larger, online sample (n = 81) using a more extended slow reveal design with additional unmasking frames. Positive judgments of surprised faces were uniquely accompanied by slower response times and strong, late activation in the CO network. These results support the initial negativity hypothesis, which posits that the default response to ambiguity is negative and positive judgments are associated with a more effortful controlled process, and additionally suggest that this controlled process is mediated by the CO network. Moreover, ambiguous trials were characterized by a second CO response at the end of the trial, firmly placing CO function late in the decision-making process.

Sexting Among Australian Adolescents: Risk and Protective Factors.

Although consensual sending of sexts between adolescents is considered developmentally appropriate, it may also entail a range of negative consequences. Current sexting research lacks a comprehensive theoretical framework identifying a range of risk and protective factors underpinning adolescent consensual sending of sexts across individual, interpersonal, and distal levels. Further, there is a lack of systematic evaluation of how the importance of these factors may vary across adolescent age. This study investigated the utility of the Social Development Model to predict a range of risk and protective factors across individual, family, peer, school, and community-level factors. The sample included 1302 teenagers from Victoria, Australia (Mage = 14.54, SD = 1.14, 50.8% girls). Results indicated that 146 (11.7%) participants sent a sext (76 boys and 70 girls). Logistic regression analyses revealed that the Social Development Model accounted for 45.8% of variance in sexting, with greater likelihood of sending sexts being associated with older age, prior sexual activity, school sector, physical activity, lifetime substance use, greater depressive symptoms, sensation seeking, and perceived substance availability in the community. Multigroup analyses revealed that lifetime substance use was associated with a greater likelihood of sending sexts among younger teens. Among older adolescents, adaptive coping was associated with reduced engagement in sexting, while higher parental overcontrol and family conflict increased the odds of sending sexts. Overall, sexting is associated with a range of modifiable factors potentially amenable to intervention.

The Role of Consent and Motivations in Sext Dissemination.

Sext dissemination (i.e., the online sharing of sexually explicit images) has the potential to result in legal, social, and psychological harms. Recent research has shown that this behavior can be consensual or non-consensual in nature; yet little is known about how motivations or attitudes may differ between these forms, or with gender. This study is based on a cross-sectional online survey investigating consensual and non-consensual sext dissemination and associated demographic, behavioral, attitudinal, and psychological factors. Participants were 2,126 cisgendered adults aged 18 to 30 years (M = 22.97, SD = 3.21, 55% women, 45% men), resident in Western, English-speaking nations, particularly Australia. Around 10% of respondents reported disseminating texts, and of these, only 19.8% indicated they had permission for this, with no differences across gender. When sexts were disseminated "to gossip," this was significantly more likely to be non-consensual. There were no significant differences between consensual and non-consensual dissemination in subjective attitudes or norms toward dissemination, nor levels of psychological distress. Women were more likely to non-consensually disseminate sexts that had been received as unwanted or unwelcome. Consensual dissemination was weakly associated with being sexually active and having given consent to having one's own images disseminated. We discuss implications for future research regarding consent, and relationship and sexuality education.

School Influences on Adolescent Depression: A 6-Year Longitudinal Study Amongst Catholic, Government and Independent Schools, in Victoria, Australia.

This study examined associations between school sector (Government, Catholic or Independent) and depressive symptomology over the secondary school years. Six waves of data collected annually from a representative Australian sample were examined. Multilevel piecewise linear and logistic regression controlling for a variety of demographic variables and protective factors was undertaken. In all sectors, depressive symptomology decreased between 10 and 13 years of age, but significantly increased for girls at age 13. Adolescents in Catholic schools reported significantly fewer symptoms of depression compared to those in Government and Independent schools. Adolescents in Catholic schools were less likely to report clinical levels of depressed mood compared to adolescents in Government schools.

Task-irrelevant emotional faces impact BOLD responses more for prosaccades than antisaccades in a mixed saccade fMRI task.

Cognitive control allows individuals to flexibly and efficiently perform tasks by attending to relevant stimuli while inhibiting distraction from irrelevant stimuli. The antisaccade task assesses cognitive control by requiring participants to inhibit a prepotent glance towards a peripheral stimulus and generate an eye movement to the mirror image location. This task can be administered with various contextual manipulations to investigate how factors such as trial timing or emotional content interact with cognitive control. In the current study, 26 healthy adults completed a mixed antisaccade and prosaccade fMRI task that included task irrelevant emotional faces and gap/overlap timing. The results showed typical antisaccade and gap behavioral effects with greater BOLD activation in frontal and parietal brain regions for antisaccade and overlap trials. Conversely, there were no differences in behavior based on the emotion of the task irrelevant face, but trials with neutral faces had greater activation in widespread visual regions than trials with angry faces, particularly for prosaccade and overlap trials. Together, these effects suggest that a high level of cognitive control and inhibition was required throughout the task, minimizing the impact of the face presentation on saccade behavior, but leading to increased attention to the neutral faces on overlap prosaccade trials when both the task cue (look towards) and emotion stimulus (neutral, non-threatening) facilitated disinhibition of visual processing.

Sexting with benefits? Exploration of sexting behaviours through the lens of protection motivation theory.

Sexting is a common form of sexual communication that is often considered normative and beneficial despite some research highlighting its negative social, psychological, and legal repercussions. Using protection motivation theory (PMT), this study examines how young adults weigh the pros and cons of sending consensual sexts, sexting under pressure, and deciding against sending sexts, and whether body image dissatisfaction interacts with any of the decision-making processes. In total, 906 participants (554, 61.14% women), aged 18-25 years (M = 21.65, SD = 2.01), completed an online measure of sexting behaviours, body image, and protection motivation. Overall, 71.41% of respondents ever sent a sext. Of those, 45.07% and 36.32% felt pressure to sext or sent a sext because of pressure. Further, 63.90% participants ever considered and decided not to send a sext. All models predicting various sexting behaviours were significant and provided a partial support for the PMT. Body image was a unique predictor of 'pressured' sexting but its interactions with the PMT subscales for pressured sexting and decisions against sexting were non-significant. Our study illustrates the need for increasing young people's self-efficacy and body image to improve their sexting agency and experience.

Telehealth service delivery in an Australian regional mental health service during COVID-19: a mixed methods analysis.

BACKGROUND: COVID-19 required mental health services to quickly switch from face-to-face service delivery to telehealth (telephone and videoconferencing). This evaluation explored implementation of a telehealth mental health response in a regional public mental health provider. METHODS: A mixed methods approach, combining service use data, brief satisfaction surveys, and qualitative interviews/focus groups was undertaken. Number and types of contacts from de-identified mental health service data were compared between April-May 2020 and April-May 2019. Mental health consumers and providers completed brief online satisfaction surveys after videoconferencing sessions. Attitudes and perspectives on the implementation of telehealth were further explored by applying a descriptive qualitative framework to the analysis of interview and focus group data supplied by consumers and providers. Template thematic analysis was used to elucidate key themes relating to the barriers and enablers of telehealth uptake and future implementation recommendations. RESULTS: Total contacts decreased by 13% from 2019 to 2020. Face-to-face contacts decreased from 55% of total in 2019 to 24% in 2020. In 2019, 45% of contacts were by telephone, increasing to 70% in 2020. Only four videoconferencing contacts were made in 2019; increasing to 886 in 2020. Consumer surveys (n = 26) rated videoconferencing as good or excellent for technical quality (92%), overall experience (86%), and satisfaction with personal comfort (82%). Provider surveys (n = 88) rated technical quality as good or excellent (68%) and 86% could achieve assessment/treatment goals with videoconferencing. Provider focus groups/interviews (n = 32) identified that videoconferencing was well-suited to some clinical tasks. Consumers interviewed (n = 6) endorsed the ongoing availability of telehealth within a blended approach to service delivery. Both groups reflected on videoconferencing limitations due to infrastructure (laptops, phones, internet access), cumbersome platform and privacy concerns, with many reverting to telephone use. CONCLUSIONS: While videoconferencing increased, technical and other issues led to telephone being the preferred contact method. Satisfaction surveys indicated improvement opportunities in videoconferencing. Investment in user-friendly platforms, telehealth infrastructure and organisational guidelines are needed for successful integration of videoconferencing in public mental health systems.

A Phenomenological Investigation into Cyberbullying as Experienced by People Identifying as Transgender or Gender Diverse.

Cyberbullying can present a serious risk for adolescents and young adults, with severe effects on victims including adverse mental health outcomes and increased risk of suicide. Transgender and gender diverse (TGD) individuals are significantly more likely to experience cyberbullying. However, little is presently known about the lived cyberbullying experiences of TGD adults despite the prevalence of cyberbullying experienced by the TGD community. TGD participants (n = 66, M = 24 years) were recruited through snowball sampling and completed an online questionnaire as part of a larger study, which included qualitative questions regarding cyberbullying. Participants reported that cyberbullying was experienced predominantly on social media sites and was largely anonymous. The content was often physically and sexually threatening and heavily transphobic. Additionally, some cyberbullying experienced by TGD individuals was perpetrated by other TGD individuals and focused on the identity policing and gatekeeping of TGD spaces. Participants reported cyberbullying evoked negative emotions, and they often responded by either arguing with or blocking the perpetrators, thereby demonstrating resilience. Some participants sought social support in response to cyberbullying, which acted as a protective factor. Findings reveal specific harms associated with cyberbullying as experienced by TGD individuals and highlight the need for further research and targeted support.

"Did You Bring It Home with You?" A Qualitative Investigation of the Impacts of the COVID-19 Pandemic on Victorian Frontline Healthcare Workers and Their Families.

Concerns regarding the physical and mental health impacts of frontline healthcare roles during the COVID-19 pandemic have been well documented, but the impacts on family functioning remain unclear. This study provides a unique contribution to the literature by considering the impacts of the COVID-19 pandemic on frontline healthcare workers and their families. Thirty-nine frontline healthcare workers from Victoria, Australia, who were parents to at least one child under 18 were interviewed. Data were analysed using reflexive thematic analysis. Five superordinate and 14 subordinate themes were identified. Themes included more family time during lockdowns, but at a cost; changes in family responsibilities and routines; managing increased demands; healthcare workers hypervigilance and fear of bringing COVID-19 home to their family members; ways in which families worked to "get through it". While efforts have been made by many healthcare organisations to support their workers during this challenging time, the changes in family functioning observed by participants suggest that more could be done for this vulnerable cohort, particularly with respect to family support.

Role of club doctors in the mental health management of Australian rules football players: a Delphi study.

Professional team athletes experience a range of mental health problems, both sports and non-sports related. However, there is limited information available for those charged with responsibility for managing these mental health conditions, particularly within the context of professional sporting clubs. This paper reports on consensus findings from a study of club doctors, who are primary care providers for professional team athletes within a specific code, the Australian Football League (AFL). Drawing on findings from a systematic literature search, a two-round Delphi procedure was used to develop a consensus on best practice for managing mental health conditions for club doctors as primary care providers for professional team athletes. Participants in this study were current and former club doctors employed in professional AFL clubs across Australia, with 28 doctors participating across two survey rounds. Overall, 77 statements were presented, with 50 endorsed as essential or important by ≥ 80% of the participants across the two rounds. Primary themes across nine domains include: (1) Prevention and Mental Health Promotion Activities; (2) Screening; (3) Engaging External Specialists; (4) Duty of Care; (5) Treatment: Assessment, Treatment and Case Coordination; (6) Communication; (7) Confidentiality; (8) Sleep Management and (9) Substance Use Management. This study is the first to offer club doctors working in professional team settings consensus guidelines for the management of mental health conditions, and the opportunity for greater clarification and consistency in role delivery.

The Role of Individual Differences in Cyber Dating Abuse Perpetration.

There is a growing research interest in cyber dating abuse (CDA). CDA includes abusive online behavior toward a current or former intimate partner, such as aggression, control, harassment, and humiliation. Despite the potential overlap and reciprocal relationship of CDA and intimate partner violence, there remains considerable paucity in research exploring predictors of this abusive online behavior. In the current study, we adopt the General Aggression Model framework and explore the role of gender, hegemonic masculinity, vulnerable narcissism, and sexual aggression myths to predict perpetration of CDA. Participants (N = 415, 51 percent women; Mage = 32.68 years) were recruited via social media advertisements and completed an anonymous, confidential online questionnaire. The questionnaire comprised the Conformity to Masculine Roles Norms Inventory, the Hypersensitive Narcissism Scale, the Acceptance of Modern Myths About Sexual Aggression Scale, and a modified Cyber Aggression in Relationships Scale. A hierarchical regression analysis indicated that hegemonic masculinity, vulnerable narcissism, and sexual aggression myths were all significant positive predictors of perpetrating CDA. As gender was a significant predictor until the inclusion of these variables, a multiple mediation analysis was performed, indicating that both hegemonic masculinity and sexual aggression myths fully mediated the relationship between gender and perpetrating CDA. These results add to the growing body of research exploring how CDA emerges as a behavior and highlight possible implications for management and intervention.

Just Checking It Out? Motivations for and Behavioral Associations With Visiting "Slutpages" in the United States and Australia.

"Slutpages" are a pernicious form of online image-based evaluative voyeurism (OIBEV), whereby (sexualized) images of women are posted on webpages for (predominantly) male groups to rate and comment. Despite media and public concern, OIBEV sites have garnered limited empirical study. This paper presents the first analysis of OIBEV site visitation motivations across United States and Australian samples. Participants comprised a convenience sample of 1148 young adults aged 18 to 29 years (M = 22.54, SD = 2.50); 53.0% women, 47.0% men; 54% residing in the U.S. and 46% in Australia. Respondents completed an online questionnaire. Overall, 23% of United States and 16% of Australian respondents had visited OIBEV sites. OIBEV site visitation was uniquely associated with gender and country (with men and United States being more likely to visit OIBEV sites), requesting and disseminating sexts and having one's own image shared. Cyberbullying perpetration was associated with reduced odds of OIBEV site visitation. Motivations differed by gender, with men (80%) being most likely to visit sites to "check them out" while women were equally likely to check it out (41%) or to see if they were depicted (36%). For men, unique predictors of OIBEV site visitation were having requested, disseminated and received disseminated sexts, lower levels of anxiety and reduced likelihood of cyberbullying perpetration. For women, OIBEV site visitation was uniquely associated with being a United States resident, sext dissemination victimization, receipt of disseminated sexts, higher levels of anxiety but reduced stress. Our findings confirm that OIBEV sites represent a highly gendered form of online image-based sexual abuse, and may have important mental health implications, given the associations with increased anxiety. Our results support the need for "slutpage" education for adolescents and young adults to address social and peer norms that encourage and support non-consensual use of intimate images.

Longitudinal Consequences of Adolescent Alcohol Use Under Different Policy Contexts in Australia and the United States.

OBJECTIVE: To test the premise that youth alcohol harm minimization policies (compared with abstinence policies) reduce later drinking and harmful consequences of alcohol use in young adulthood, we compared associations among adolescent alcohol use, young adult alcohol consumption, and alcohol-related harms in Victoria, Australia and Washington State, United States. METHOD: Data came from the International Youth Development Study, a longitudinal, cross-national study of the development of substance use. State-representative samples of seventh-grade (age 13) students in Victoria (n = 984, 53% female, 90% White) and Washington (n = 961, 54% female, 73% White) were surveyed in 2002, 2003, 2004, and 2014 (age 25). Participants self-reported alcohol initiation by age 15 and age 25 alcohol consumption (per the Alcohol Use Disorders Identification Test). Path modeling tested associations among age 15 alcohol use, age 25 consumption, and alcohol-related harms at age 25; multiple group modeling tested the equivalence of parameter estimates across states. RESULTS: Age 25 alcohol consumption was lower in Washington versus Victoria and was associated with poor physical and mental health, partner conflict, substance use, criminal behavior, and violence exposure in both states equally. Living in Washington predicted lower levels of multiple alcohol-related harms at age 25 indirectly via lower age 25 alcohol consumption. CONCLUSIONS: Young adults growing up in Victoria reported greater alcohol consumption in young adulthood, which was associated to the same degree with the harms measured regardless of alcohol policy context. Findings support state-level policies that promote alcohol abstinence in adolescence and reduced consumption in young adulthood.

Strategies to Increase Uptake of Parent Education Programs in Preschool and School Settings to Improve Child Outcomes: A Delphi Study.

Parent education programs, offered via family-school partnerships, offer an effective means for promoting the mental health and educational functioning of children and adolescents at a whole-school level. However, these programs often have a low uptake. This study aimed to identify strategies for increasing the uptake of parent education programs within preschool and school settings. A three-round Delphi procedure was employed to obtain expert consensus on strategies that are important and feasible in educational settings. First, thirty experts rated statements identified from the literature and a stakeholder forum. Next, experts re-appraised statements, including new statements generated from the first round. Ninety statements were endorsed by ≥80% of the experts. Primary themes include strategies for program selection; strategies for increasing the accessibility of programs and the understanding of educational staff on parent engagement and child mental health; strategies for program development, promotion and delivery; as well as strategies for increasing parent and community engagement. This study offers a set of consensus strategies for improving the uptake of parent education programs within family-school partnership.

Sext Dissemination: Differences across Nations in Motivations and Associations.

Sext dissemination presents policy and legislative challenges given its potential psychological, social, and legal harms. We report on a cross-national comparison of sext-image dissemination in a large sample of 1148 young adults aged 18-29 years (M = 22.54, SD = 2.50, 53.0% women, 47.0% men), either U.S. (53.8%) or Australian (46.2%) residents. The results indicate that 14% of young adults disseminated sexts, with no difference by gender or country. Over 50% of respondents indicated that the last time they received a disseminated sext, it was unexpected or unwelcome, with women twice as likely as men to receive unwelcome sexts. The most frequent motivations for sext dissemination were similar cross-nationally, relating to the attractiveness of the person depicted, as a joke, to gossip, because it was not a big deal, bragging, roasting or teasing, and to increase social status. Motivations of attractiveness, bragging, or social status were more commonly endorsed by men, while women endorsed reasons around gossip or roasting/teasing. Unique predictors of sext dissemination included U.S. residence, requesting sexts, receiving disseminated sexts, having one's own images disseminated, and more positive subjective norms to dissemination, and there was a country-gender interaction, where Australian women and U.S. men were more likely to disseminate sexts than then U.S. women or Australian men. The findings have implications for prevention programs seeking to address harmful online sexual interactions, including addressing respect, consent, and subjective norms supporting non-consensual dissemination.

Motor-response execution versus inhibition alters social-emotional evaluations of specific individuals.

Social-emotional evaluations of unfamiliar people are negatively impacted by ignoring or withholding motor-responses from images that depict them; an effect attributed to the propensity of inhibition to affectively devalue associated stimuli. Prior findings suggest that the social-emotional consequences of inhibition may operate on category-level representations that impact all members of a corresponding group. Here we assess whether such social-emotional consequences of motor-response action versus inaction also operate on item-level representations of specific individuals. Participants memorized individual identities of a group of fellow students before completing a Go/No-go response-inhibition task designed to associate item-level representations of each previously-memorized person with action (Go trials) or inaction (No-go trials). Social identities associated with action were consistently rated as more trustworthy in subsequent evaluations than those associated with inaction. This suggests that the social-emotional consequences of motor-response execution versus inhibition can operate on item-level stimulus representations in memory.

Slutpage Use Among U.S. College Students: The Secret and Social Platforms of Image-Based Sexual Abuse.

The phenomenon of "slutpages," tied to high schools, fraternities, and the military, used to post, share, and comment on nude and semi-nude images of women, has emerged in mass media. To our knowledge, this is the first study to empirically investigate slutpage use behaviors including: visiting slutpages, posting nude images/videos online without consent, and using a vault app to store/share nude images. We conducted a survey of undergraduate college students attending a large Midwestern university in the U.S., with 1867 respondents (36.4% cis/transgender men, 63.6% cisgender women; 18-24 years old M = 20.39) to determine who is engaging in slutpage use behaviors. Our results showed that younger participants and men were more likely to engage in slutpage use behaviors than older participants and women, especially if they participated in Greek Life or played a team sport for their university. Men in a fraternity or on a team sport visited slutpages and posted nude images/video online without consent more frequently than men outside these groups, or women in general. Drinking alcohol and using pornography more frequently were also associated with slutpage use behaviors. This study provides a new understanding of slutpages as a social form of image-based sexual abuse and informs researchers, educators, and policy makers to expand their inquiry into online sexual experiences and exploitation to include this phenomenon.

Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis.

Importance: Although research has examined factors associated with child sexual exploitation (CSE), consensus is lacking in regard to which factors should be prioritized, thereby hindering policy reform, prevention efforts, and development of early detection and intervention. Objective: To provide a meta-analytic synthesis of studies examining factors associated with CSE and to quantify their relative importance. Data Sources: Electronic databases searched to June 2019 included Medline, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Informit, yielding 396 nonduplicative records. Literature search was performed in July 2019. Study Selection: Inclusion criteria were quantitative investigations of sexual exploitation and mean sample age of 18 years or younger. Data Extraction and Synthesis: Literature review and data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Thirty-seven studies met final inclusion criteria. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive odds ratios (ORs) for each factor. Data were analyzed from September 1 to October 28, 2019, and prediction intervals calculated in June 2020. Main Outcomes and Measures: Child sexual exploitation, defined as coerced sexual acts between a child or a young person (aged ≤18 years) and an individual or a group in exchange for money, gifts, substances, or other commodities and associated factors. Results: Thirty-seven unique studies were included with a total of 67 453 unique participants (mean [SD] age of 16.2 [2.5] years; 49.9% female). Fifty-two factors associated with CSE were included in the meta-analysis. The strongest factors significantly associated with exposure to sexual exploitation were engagement in sexual risk behaviors (OR, 6.31 [95% CI, 3.12-12.76]; P < .001), having more than 5 sexual partners (OR, 5.96 [95% CI, 1.63-21.87]; P = .007), a diagnosis of posttraumatic stress disorder (OR, 5.29 [95% CI, 3.40-8.22]; P < .001), historical exposure to child pornography (OR, 5.50 [95% CI, 0.99-30.53]; P = .049), and a history of childhood sexual abuse (OR, 3.80 [95% CI, 3.19-4.52]; P < .001). A number of other potentially modifiable factors had moderate to strong associations. Conclusions and Relevance: In this systematic review and meta-analysis, children and adolescents affected by sexual exploitation showed high levels of sexual risk taking, multiple sexual partners, posttraumatic stress disorder, exposure to child pornography, and childhood trauma. Accurate detection of CSE may prevent this type of sexual violence occurring to adolescents and/or provide opportunities for intervention and recovery. Therefore, prevention and intervention efforts will likely benefit from integrating these factors into screening, assessment, and treatment.