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 cross-sectional 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.