One in Ten
Engaging the brightest minds working to solve one of the world's toughest challenges—child abuse. Join us for conversations with leading experts on science, law, medicine, morality, and messaging. One in Ten is brought to you by National Children's Alliance, the largest network of care centers in the U.S. serving child victims of abuse. Our host is Teresa Huizar, NCA's CEO and a national expert on child abuse intervention and trauma treatment. Visit us online at nationalchildrensalliance.org.
One in Ten
Image-Based Sexual Abuse: The Pain That Never Goes Away
Show Notes
In this episode of 'One in Ten,' host Teresa Huizar interviews Dr. Kimberly Mitchell from the University of New Hampshire's Crimes Against Children Research Center. The discussion centers on image-based sexual abuse (IBSA) and its unique, amplifying effects on victims. They delve into the disturbing prevalence of various forms of IBSA, including coercion and threatening behavior among youth. The conversation also explores the severe psychological impacts such as increased risk of suicide and non-suicidal self-injury among victims.
Additionally, Dr. Mitchell discusses the challenges and complexities of researching this rapidly evolving field amidst advances in digital and AI technology. Potential future research directions, including the role of social support and community engagement, are also highlighted.
Time Topic
00:00 Introduction to Image-Based Sexual Abuse
01:15 Defining Image-Based Sexual Abuse
02:53 Research Background and Technological Impact
05:07 Unique Harms of Image-Based Sexual Abuse
08:47 Study Design and Participant Demographics
11:05 Key Findings and Hypotheses
14:35 Diverse Experiences and Future Research
17:57 Prevalence and Prevention Challenges
23:35 Navigating Healthy Spaces and Influencer Strategies
24:37 Creative Approaches in Child Abuse Prevention
25:58 Global Perspectives on Youth Involvement
28:44 Vulnerabilities of Sexual Minority Youth Online
30:09 Social Support and Online Vulnerabilities
33:18 Non-Suicidal Self-Injury and Image-Based Sexual Abuse
38:24 Future Research Directions and Resiliency
39:52 Bystander Intervention and Positive Variance
41:00 Conclusion and Final Thoughts
Resources
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Teresa Huizar: Hi, I am Teresa Huizar, your host of One in Ten. In today's episode, Image-Based Sexual Abuse: The Pain That Never Goes Away. I speak with Dr. Kimberly Mitchell, research professor at the University of New Hampshire's Crimes Against Children Research Center. Now, we all know from the literature and our own experience, the long-term impacts of child sexual abuse, but what the research here wanted to explore were the unique impacts or amplifying effects of image-based sexual abuse.
This is a timely question, as so-called privacy advocates have repeatedly downplayed the harms of image-based abuse, whether they're AI generated material, deep fakes, or many others. But as you'll hear, image-based abuse is not a victimless crime. It's one with deep scars for the survivors. And I know that you'll find this conversation both as troubling and as important as I did.
Please take a listen.
Hi Kim. Welcome to One in Ten.
Kimberly Mitchell: Hey, thanks for having me.
TH: So you use a term in the paper we're gonna talk about today, and I just kind of wanna start with definitions before we dive right into the rest of it. But you talk about image-based sexual abuse and for our listeners who may not have heard that term before or know what it means, can you talk a little bit about it and how it may be different from other terms they may have heard, like abusive images? Or technology facilitated sexual abuse or other kinds of things?
KM: Yeah. It's a newer term, which is being used to recognize the evolving nature of child sexual abuse material or CSAM, which we've all heard, child sexual exploitation material or CSEM. So it extends beyond the dynamics of like hands-on childhood sexual abuse, where images are created by offenders.
So it can include creation, distribution, and misuse of sexual material involving children by other adults, but also other youth, including sometimes the minor that is being depicted in the material. So some examples are having someone take, make or share sexual material without their permission being threatened or strongly pressured to provide sexual images, having someone threatened to share a sexual image to make you do something like send other sexual images, sharing of sexual material even if they wanted to with someone significantly older. And even making, sending or posting of sexual material in exchange for money, drugs, and other valuables, which is a form of commercial sexual exploitation.
TH: Yeah. It's an umbrella term under which many of the things that we've talked about previously would fall under this and be a subcategory of this, if I'm understanding it. Right. Right. So just back up a little bit and say, how did you come to this work deciding to research image-based sexual abuse?
KM: Well, my work actually stems way back.
I'm at the Crimes Against Children Research Center at the University of New Hampshire, and really broadly, it's focused on understanding, preventing and treating young victims of child abuse and neglect. And I was fortunate enough to really begin my research career at this pivotal time when technology and the internet is rapidly just becoming a part of everybody's daily lives, including those of youth and offenders.
And one of the biggest changes during this time is how technology has allowed for the creation and distribution of sexual images and videos. And really this is something that continues to evolve really rapidly. Advances in digital technology, including even most recently, advances in AI technology, which allow for the creation and manipulation of these images in ways we're still really trying to fully understand.
So I think this particular topic is part of a larger research portfolio of mine, but one that's kind of naturally developed with the times and the changes in technology.
TH: It's like it's developed a parallel with the development of the internet in many ways, and the creativity, sadly, of offenders and exploiting technology.
KM: Yeah. Right. Sadly, you know, usually it's the kids and the offenders that pick up on the technology quickest.
TH: It's true that the rest of us as adults and investigators and prosecutors and MDT professionals and researchers have to catch up often in this way. But one of the things that I appreciated about the paper, it really laid out a couple of things early in the paper.
One was the harms that generally we all know, accrues to children who've been sexually abused. And there's lots of in the literature about that and decades of documentation about those harms. But then there's the piece of it that's specific to image-based sexual abuse, which seem to act as an amplifier for some of those.
And can you talk a little bit about those harms that are really specific to image-based sexual abuse are maybe amplified by it, even if they're not exclusive to it?
KM: Right. So I mean, there's a number of ways we feel that this form of abuse can be particularly harmful. So if there's a lot of this amongst older youth, there's often can be feelings of guilt and shame, ongoing fear over the circulation or the resurfacing of images online, worrying about being recognized in public.
There is research from survivors that note that the existence of IBSA is one of the most difficult aspects of the crime to overcome, and it contributes to things like guilt, embarrassment, ongoing vulnerability, helplessness, powerlessness. So we think these added elements for some kids can really impact the IBSA.
You know, and we can talk about this later, but it's also important to note that IBSA is very diverse in nature, and there are particular forms that we think are more linked to longer term impact.
TH: It's interesting because, you know, we worked on a research project to around this interviewing adult survivors around their experience.
And it's very true that they sort of almost universally felt that the fact that these images could, well, they didn't know what their future would be. They simply knew they weren't gonna disappear from the internet. Right. They could continue to be circulating those things. And in an earlier interview that I had with someone from the FBI.
She was talking about the fact that when they talk to survivors now about them, they try not to emphasize the permanency of them because her point was, aside from the fact, that's not very helpful. It's also the case that, there are so many new images that come into circulation on the internet all of the time that in fact, old images also can wind up buried.
It's an interesting feature that the explosion of these images in some way is, means that any individual person's image from five years ago, or four years ago, or three years ago, or two years ago, is not gonna have the same resonance. That perhaps it would've in a time when there were fewer of these images online.
And so I'm wondering what you are seeing or experiencing in that way, because it's certainly an understandable fear that people have that for the rest of their natural life, someone's going to happen onto a photo or video or whatever of them. But to what extent do you find that that may soften over time or are we just not there in research yet to know whether in fact that fear diminishes over time.
KM: I don't think we know that yet. I think that's a great question. I think that would be great for the qualitative research study actually. We can really get into the nuances around that. You know, my sense, particularly around kids is a lot of the fear is people in their own social networks finding out and seeing.
So friends going around school, parents finding out. And you know, whether that starts going and diminishing over time. We don't know either, but in the context of this is happening, that's what we see a lot of the deal.
TH: Well, Kim, I could go down a full rabbit hole on that topic just because I think it's really very interesting, especially when you're talking about kids who are concerned that somebody in their social circle might see it and sadly, often do.
But I know that your paper covered the waterfront, so I'm going to turn now to something else, which I found that the study design itself was interesting, including the age range that you looked at. So can you talk a little bit about just how you set up this study? What ages did you cover, and kind of what do the demographics of the participation really look like overall?
KM: So this particular paper used actually a subsample of our larger study participants where we had particular data about child sexual abuse. So it involved over 2,600 young adults ages 18 to 28 from across the whole country, and they were recruited through social media. We like to do that for a number of reasons, but particularly it allows us to have just a more diverse sample.
We're able to reach youth and young adults in ways that we may not otherwise be able to reach them, right? Either through schools or phones and that sort of thing. So I like social media recruitment for that reason. And of course we have a number of protections in place for fraud and all of those things that do come alongside social media recruitment.
It's not a national representative sample, that's important to note. For the purposes of the larger grant, we really were trying to over sample and find people that may have had this experience. So our finding that it's, I think it was about 46% reported any IBSA is not at all meant to say that in the US among that age group that that many people experience, IBSA, we had screener items that helped us let people into the survey.
So that's important to note. Let's see, what else? I mean, the goal of this particular paper was to examine the impact of IBSA, independent of child sexual abuse and adversity on different health outcomes. So we were particularly interested in drug overdose, suicide attempts and non-suicidal self-injury before the age of 18.
TH: One of the things that I'm wondering is when you went into the study, looking at those areas that you just described, what were you thinking you would find? What were you hypothesizing you would find? And then what did you actually find?
KM: So I was hypothesizing that we would find out for sure that 'cause of all the past research, childhood sexual abuse, non-victimization adversities, were all gonna be related to these health indicators. I was also expecting, based on the literature that's building out there, that IBSA itself would also be related to these outcomes. I was not a hundred percent sure if IBSA would independently contribute to mental health once we took into account the contributions of adversity and childhood sexual abuse, but it did actually, and particularly the suicide attempts and non-suicidal self-injury had made independent contributions to those health indicators, even in the context of sexual abuse and adversity. And those two experiences also were significantly related to suicide attempts and NSSI.
TH: I was gonna say, you know, the listeners to this podcast are all childhood abuse professionals. So sadly I don't think it's surprises us that childhood sexual abuses is tied to suicide attempts and self-injury. I think that it is an interesting question that you were trying to answer, which is even if there wasn't hands-on abuse, which is often how we think about it. Would it independently also contribute to suicidal thoughts or actions or self-injury if it was image-based sexual abuse in which there was no hands-on abuse? Talk a little bit about how common it was or what did you find related to that? I mean, you've clearly found there was some relationship to it, but was it a strong relationship to it, or how significant is it, is what I'm asking?
KM: So the overall odds was like an almost twofold, increased odds of suicide attempt in if they experienced IBSA, even when taking into account sexual abuse, which actually had a similar odd of suicide attempts also.
TH: So. What do you make of that in terms of, because when you think about childhood sexual abuse and hands-on abuse often what is making someone feel suicidal about it? I mean, there are many things, obviously. It's a tremendous betrayal, great feelings of shame. The fact that the offender may well have said many things that make the child erroneously feel responsible for their own abuse, they may be bullied or unsupported by caregivers or their peer network or other kinds of things.
But it's a little bit different when you're talking about something in which there isn't hands-on abuse in the same way where this may be something where it's an intimate photo that was further shared. It may be a picture that someone took of themselves or a video they took of themselves that then gets shared.
So. What's the driver for the suicidality, I guess is what I am asking you or what do you speculate it is that was not asking the question of why it wasn't necessarily in the study, but I'm curious about what you make of it when you reflect on your own findings,
KM: That circumstance where research just leads to more research questions.
You know, I think my answer would be it's really gonna vary depending on the scenario, and we can talk a little bit about just the diversity of who the kids are, that experience IBSA and the diversity within the actual IBSA. And both of those I think, contribute to thoughts of suicide, self-harm, depression over time.
I think for some, it's what we've been talking about, right? Just this idea that people are gonna find out these images are out there. I know that just anecdotally from some of the other research we do, it's really this, it's almost this more immediate social network. Some of these kids are in small towns and you know, parents finding out.
I think that can be very, very traumatic for kids. I should note too that the measure of suicide attempts and NSSI was essentially concurrent, right? It was, everything was before the age of 18, we asked them to reflect on, so a lot of this stuff could be going on at the same time. This particular paper didn't look at long-term mental health as a result of those experiences.
I do think it varies a lot on these kids, some of these kids, the IBSA was just a one-time thing that they essentially ignored. For other ones, there's significant intent to harm, manipulation, coercion, ongoing for long periods of time. And for some of these kids, the IBSA is linked with the CSA. It could be part of the same episode.
We weren't able to disentangle that in this study, but that's a very different picture than sometimes the main people involved were other kids. Sometimes they started as romantic relationships that kind of went bad. Sometimes they were adults, sometimes they were family members. So I think the next step is to really start digging into the diversity and the context under which these experiences are happening.
We also saw a big range of variability in the other things that are going on in these kids' lives. At the same time, some of these kids were essentially poly victims. IBSA was just one of a larger constellation of, you know, a whole kind of life of victimization and adversity. So some are engaging in a lot of kind of risky behaviors that all, and we know how they're just all interconnected in many ways.
TH: One of the, I think, challenges of something like looking at an umbrella term in this way is, as you say, the activities that you're examining are very diverse. In terms of what's actually occurring under that umbrella. And so it sounds like some of the work ahead is disentangling, perhaps in a unique contribution made to suicidality based on the type of exploitation or abuse it is.
Of course, there's always this contribution that's made by other forms of adversity, other forms of maltreatment, all of those things. I mean, I do wanna talk for a minute about among the various types that fall under the umbrella in the sample, seem to be more prevalent than others.
So even taking into consideration that you oversampled to get more image-based sexual abuse overall. Some people had much more likelihood within that age range to experience one form or another. Can you talk a little bit about that? Because I honestly, like, we know this happens out there, but I did find some of it just shockingly common.
KM: Right. So the most prevalent form of IBSA that we found in amongst our participants was having someone threaten, try to force or strongly pressure you to provide sexual material through technology. And in those instances, not all of the kids did. And in fact, Lisa's actually working on a paper now so we can better understand what is it about those kids that did that, actually followed through and sent the material versus those that didn’t. So more to come soon on that. So even in this sample of participants who reported IBSA, not all of them resulted in an actual sexual image. I wanna say it's about maybe about half and half.
TH: Interesting. Interesting.
KM: Yeah, so that's something to think about. It brings me back, I was very involved with the youth internet safety survey way back and we had a big group of youth who reported unwanted sexual solicitation.
So it's the, this idea that they're online and people are asking for things, which is a very different scenario, and sometimes they comply and sometimes they don't, than a kind of more traditional sexual abuse where there's digital pictures being taken and captured.
TH: There's so much child sexual abuse prevention education that goes on with parents. And we certainly talk about online harms and those kinds of things. But I'm not sure that until this paper we really had quite as clear a view of just how frequently kids, it's not just a case of, someone happening onto things or something like that, that kids are being routinely pressured.
A significant proportion of teens are being routinely pressured to provide these kinds of images of themselves. And that I think is something that parents need to be talking to kids about because this is not some unusual occurrence that might not ever happen to you. It's like, really?
You have about a third of, you know, about a third of teens based on this sample would expect that to be the case. And that's just a lot.
KM: Right. Right. And I think this is where it starts getting complex too, right? Because there is, the majority of teens have good relationships with their parents, right?
The parents are a good way to reach them from a prevention perspective. Those parents are very receptive. To, you know, ways they can help kids and those are the kids that are easiest to help. But I always go back to these David Finkelhor poly victims, a group of kids, no matter where they turn, bad things are happening, right?
Whether it's at school, it's at home, it's in their neighborhood, it's online. These are also the kids that are really, really hard to reach because these kids tend to have poor or no relationships with parents. Their school attendance is not consistent. And I think that is the group that we're, you know, they struggle, a lot of those kids struggle with their own substance use, they're running away, engaging in a lot of risky behavior. And I would love, just as a field of professionals, really wanna help these kids to find a way to reach those kids
TH: And who reaches those kids? Influencers. 'cause that's where they spend their time online. To your point, it's like, parents are wonderful frontline resource for prevention. If they have a good relationship with their kids, they love their kids, these kinds of things. But if they don't, and there is some proportion of kids who have parents who have abandoned them or neglect them, or frankly, I mean, we sort of don't wanna think that there is some small proportion of parents who don't really care about their kids, but that proportion does exist.
Who has the most influence on those kids? I would say that for a lot of kids, there comes a point in which their parents don't have the most influence anyway, even if they have the most loving parents in the world. Right? But you're pointing out a really key point that we need to spend some time thinking on, which is there's this sliver of kids for whom most of their day and their night is spent in environment that is not helping them be healthier, stronger, where they have some obvious helper they can turn to. And so for those kids, how do we get messages right to them by credible messengers? Right. And I think that's, as you say, something for us to be thinking about.
KM: Yeah. And I think those kids are online, you know?
They're turning to social media to make connections, to make friends to look for help. And I think that's where we need to be. But I think it's still challenging 'cause there's a lot of great stuff out there for them. A lot of supportive people. Professionals, but there's also a lot of, not so much so helping them navigate to the healthy places and people, I think is something that is always good for us to strive towards.
TH: You know, I just recently had this interesting conversation with two different organizations who, and we're looking at this, who had decided, yeah, trying to get someone to Google National Children's Alliance to come to us, is gonna be hard.
So in their respective organizations, same thing. Hard to get people to go there. They had hired a firm who works with influencers, who actually hired influencers, and they trained the influencers to disseminate their message. To the population that they wanted to reach. And I'm not gonna go into who and why 'cause I don't have their permission to do that.
But the bottom line is I thought it was brilliant because these were influencers that already had millions of followers in the age and population they were exactly looking for. So I think the other thing for us, as child abuse professionals is to get a little more creative. I'm not sure we're ever gonna talk a teen into coming to NCA's website.
No matter what we do, like we can go see that up all we want. We can launch our own TikTok channel, which we are, still teens are not gonna be who's looking at it, right? It's gonna be other people, but teens are watching somebody's TikTok. They're on all of those things. So how do we get appropriate messages into the hands of those people?
Yeah. And engage them. And I think that's like to my mind, the work of the future.
KM: Yeah, that's a fabulous idea. Having two teens, myself, I--
TH: Well it wasn't mine. I've gotta credit these others that you know who you are if you're listening. Yeah. I thought what you did was fabulous and really novel.
KM: I've heard of some groups that do that.
And in other fields around behavior change and stuff. And I think kids have certain types of people that they're much more willing to listen to. I mean, even in other violence prevention fields, we're learning more and more that like peer led and peer involved messaging and prevention goes a long way.
They'd much rather hear it from someone that's likely been there or can understand where they're at than a much older adult. That's the wave of the future.
TH: I do think it's the wave of the future. And interestingly enough, this fall, I was in a conference in another country and all the other attendees pretty much just about except us were signatories on the UN Convention for the Rights of the Child.
And one of the very interesting implications of that is that in those countries that have signed on, there's a much stronger, I would say, not just belief. But in practice, including youth in the design of studies and the implementation of studies and the dissemination of results of studies, like this whole universe of things that are taken very seriously because of their obligation to the convention.
And I think that some of it even, to the degree that I was like, what IRB board in the US is gonna prove that. But nonetheless, it was like really interesting, the degree to which they were not only informing those things, but often leading focus groups to do, very young kids, even leading focus groups to discuss topics that would be found to be pretty sensitive here.
TH: I just, I was fascinated by that because I thought, you know, for the most part. I don't know. I mean, we've seen this greater movement toward peer led, but I have not made the connection for why in some countries that work is so much further advanced than our own. And I really do think that is an interesting connection point, that there's no commitment except goodwill on our part to do it in large part because there's nothing that obligates our government or anyone funded by our government for that matter to do it.
So it's just one of those things where I was like, a light bulb went on. I was like, oh wow. This is fascinating.
KM: Yeah. I mean, it makes so much sense too, right? We've done that in the past in survey development, right? We're creating new instruments. We actually do focus groups with kids, and then a lot of interviewing with young children to make sure they're understanding it in the same way we are understanding it.
There's a big movement, it feels like, to me, for community participatory research, which again, it's kind of a similar idea where the people that you're doing the research for and about, have a role and a stake in how you're doing it, and then it comes full circle. Right. They may have a very different way and more applicable way of interpreting the findings.
TH: That's what I thought was so interesting. 'cause I read a report that had been developed by youth for youth explaining the findings of a study. And I was like, oh, this is just fascinating. But to come back to your own for a moment, because we've opened up lots of interesting areas of inquiry in this conversation, Kim, I really appreciate it.
But the other thing that you looked at is whether there were some specific vulnerabilities that certain children have, or certain youth have by virtue of the fact that there's sexual minority youth. And I do wanna talk for that a minute because I think that there are some specific added vulnerabilities online.
Sometimes, because I think often these kiddos may not feel accepted by their family or in their own local social circle. And so the internet becomes this online place where they're making friends talking more, all of these things. But this also, this added time online can also make them, I think, uniquely vulnerable.
And so can you talk a little bit about your findings there?
KM: Yeah, I do a lot of work with that population. They have so many health disparities, right? They have a higher likelihood of suicidal thoughts and behavior and depression and victimization and sexual abuse, right? So, we are starting to see they are more vulnerable to IBSA as well.
And they do go online. They don't necessarily have the supports in their own homes or communities. Some do and that's great. They do go online. A lot of my research suggests that is where they have really close friends online that understand them and support them, and in a lot of ways that's really good and beneficial for them, I think where we just have to be careful.
We found some, we've had some research, which there's a lot of research on social support, for example. And I've decided it's a very generic term, right? So it's good in so many ways. But we found in some of our research, particularly with some of these vulnerable populations, where we were looking at suicide, exposure to suicide and their own personal suicide.
And for some of these vulnerable groups, if they reported high social support, which was online, they increased their likelihood of their own thoughts of suicide. And there is a body of research that talks about kind of who their support network is, so kids can go online and doesn't even necessarily have to be online.
They can have this group of kids, they feel like they are very supported by, but if those kids are engaging in the same risky behaviors as they are, it's not necessarily gonna be protective.
TH: Oh, that's interesting.
KM: Yeah, I just found that fascinating. So it's really helped me kind of broaden my approach to measuring social support and just kind of how we think about social support, 'cause the support is still important for them.
TH: And it's also becoming a question of, it's what we're describing social support or social connection, you know? 'cause we think about support in the other meaning of the term, right? Which is why it gets a little confusing. We're like, wait a minute. Social support should be something that's contributed positively.
This also just takes me back to my own youth where there certainly were groups of kiddos in which basically the grouping of kiddos were all kids who were struggling. And you can see how that would be reinforcing behavior for whatever those struggles were about or if one person was suicidal, maybe that somehow and talked about a lot that might destigmatize that actually for the other kids. And so, I don't know. That's interesting. So I'm wondering as well, whether there were any sort of beyond this sort of general vulnerability and maybe more sort of additional vulnerability along the lines of self-harm or suicidality, was there anything that you found, and I just can't remember, I'm thinking back to your study, related to substance abuse?
'cause that was another area I think you looked at. Am I remembering that right?
KM: Yes. So yeah, one of the, it was a very kind of simple yes, no question about drug overdose. So kind the extreme end in this particular paper, and it wasn't super commonly endorsed. It was a small subgroup, and I think partly there was a power issue.
But you know, IBSA in the context of just demographic characteristics was related to drug overdose. But when you started taking into account CSA and adversity, those basically eliminated that significant relationship. But I think a lot more information is needed about that. Looking at substance use more broadly, not just overdose.
TH: Okay. Yeah, I hadn't remembered it was just focused on overdose. That's interesting. I wanna go back to non-suicidal injury or some form, I can't remember what term was being used, but basically it was cutting was more or less if I'm, yeah. You know what it was describing.
That I have to say I do, again, having worked in and around CACs my whole career, I'm not shocked by it. Like we saw that routinely, sadly, with so many kids who came through the center that I was the director of, but the sort of unique contribution and high levels of it with image-based sexual abuse.
I think if I had just pick out one finding that was surprising to me, it might be that one. And I'm just curious what you make of it.
KM: Yeah, and I'm seeing this in some of my other data also that have social media samples, very high rates of non-suicidal self-injury. And it is a broad definition, right?
So it's cutting, it's burning, it's hair pulling. I think it's an interesting concept. It's often grouped with suicidal thoughts and behavior. It's a form of self-harm. But it is unique in some ways. It's not my top area of expertise, but I'm rapidly starting to learn a little bit more about it because it is showing up a lot.
You know, I think my very, very kind of low-level kind of understanding, 'cause there's a big literature on it, a lot of it is coping as a form of kind of distracting from other pain, things like that. But yeah, I do think we need to dig into that. Quite a bit more because it doesn’t, you do see overlap.
There's plenty of kids that do both. Suicidal thoughts, behaviors. But you do have a group that is really NSSI and there are some experts in that field that feel like more attention needs to be made so we can better understand NSSI is a behavior.
TH: That's what I was thinking to myself in reading through this and reflecting on it was, you know, also when children come to a Children's Advocacy Center, it's kind of a crisis point, right? They're at a point where they're ready to make a disclosure most of the time. And if there is one to be made too, and in many cases they may have been actually quite, you know, suicidal up to that point, it's not at all uncommon that we see that on screeners.
But on the other hand, sometimes that's the peak of their distress. I should qualify this if they're caregivers are supportive if they're extended family support, if they've made the disclosure, if they get support, often that will drop. However, it doesn't always immediately tail off cutting behaviors, for example.
And so I think to your point about that being something slightly different, it does make me think about when I'm thinking about it here, where you're talking about. In many cases, non-contact abuse, right? It's the sharing of a photo or video or sextortion or whatever it is, and this sort of release of pain or whatever.
What I'm wondering, because we definitely talk to kids about, you know, suicidal ideation and self-harm for contact abuse, but I do wonder if we talk to kids enough about or even ask questions about, to the degree that you might have this other non-suicidal self-harm behavior when we're like, but there was a picture of them and their boyfriend that their boyfriend shared to a bunch of people.
I'm not sure we're clueing in on it to the same degree. And it makes me wonder if there's something that we should be asking more questions around or making sure that in therapy we're tapping on more around that or something else.
KM: You're so right and I would say yes. You know, I feel like because it's seems to be pretty common and I wish I knew the literature a little bit more and maybe there are some answers to this, but you know, I personally would be really interested in understanding differences in dynamics between kids who self-harm in ways that it's visible and noticeable to others versus hiding it.
TH: Yes. You know, is it serving a different purpose based on that? That's interesting. Right, right.
KM: It’s a cry for help for some kids and yeah. And I think I totally agree that's a huge important next step. And in some ways maybe that's easier to talk to kids about. If you're thinking about starting conversations with these kids, is that potentially an easier introduction than just asking if they've tried to?
TH: Interesting. So we've talked about all the things that I'd love you to research in the future. No, I'm teasing you, but where do your research interests take you next? I mean, we know researchers always have papers going all the time. But what's next for you research wise, either in terms of what's being published next or just where do your research interests take you next as well?
KM: Yeah, I've been really kind of shifting focus a little bit away from risks. We know the risks, we know which kids are at risk for all these experiences. There’s decades and decades of literature on that. What we know less about is why is it that there are some kids that go through all of this trauma but end up okay.
So, resiliency. And not just, resiliency is as the absence of risk, right? So is it, what is it within the individual, their community, or that is potentially modifiable that we can actually learn from and use it to help kids in need to help them manage these things. You know, I have some data on kids who grew up in households where there was significant substance use problems among caregivers.
And some of the things like self-mastery and being able to bounce back and recover are huge when it comes to, as an adult coming out okay. I think it's complex. I think resiliency is multifaceted. Maybe people use different strategies and different scenarios. So I think there's so much to learn from that.
So that's one big area that I think there's just so much room for research and understanding. And then I've also been doing a lot more work with the bystander perspective.
TH: Oh, I love it.
KM: So I work really close with Vicki Banyard, who's one of the gurus on Bystander for Interpersonal Violence. We have an NIH grant right now that is trying to see how that applies to self-directed violence, whether the same scenarios. 'cause we know kids are the first to tell other kids when they're struggling. So we have a very large longitudinal sample on that. And moving beyond all the prevention and intervention that's targeted directly at victims and offenders. And knowing that kids know what's happening with other kids, how can we find ways to harness that? 'cause we know kids try to help too. And then supporting those kids who are trying to help, I think is another really important.
TH: I just love that because, not only because it has such practical implications, but I think to your point, we don't look at positive variants enough, right? We're always digging around in the whys, of why something goes wrong, but not necessarily. The flip side of that. That's fascinating. When that work is done, come back on the show. Let's talk about it. Okay. I'm personally so fascinated by it.
Well, Kim, it's been a pleasure having you on and talking about all the things. My goodness. I could have talked to you for another hour, but I know that you have to get on with your day.
KM: Yeah, that's okay.
TH: But thank you so much.
KM: I’ll have to come on again.
TH: Yes, please do. Anytime.
KM: Great. Thank you.
TH: Thanks for listening to One in Ten. If you like this episode, please share it with a friend or colleague and for more information about this episode or any of our other ones, please visit our podcast website at oneintenpodcast.org.
