Psychological and Emotional Harms of Online Child Sexual Exploitation and Abuse in Children Under the Age of 18: A Systematic Review of the Evidence

Online child sexual exploitation and abuse (OCSEA) is a growing public health concern, with significant psychological and emotional impacts on victims. As digital communication evolves, the complexity and prevalence of OCSEA increase, highlighting the need for a comprehensive understanding of its effects on children. This systematic review examines the psychological and emotional harms experienced by victims under 18, with the goal of improving prevention and intervention strategies. This review also explores the relationship between specific forms of OCSEA and their psychological outcomes, informing future policies and practices. Following Cochrane guidelines and PRISMA standards, this review covers studies from 1989 onwards, including primary, secondary and mixed-methods research, as well as grey literature. Studies reporting psychological or emotional harm due to OCSEA victimisation are included. Data extraction and quality assessment were performed using standardised tools, and a narrative synthesis was employed to summarise the findings. This review enhances understanding of the psychological and emotional impacts of OCSEA, supporting the development of effective strategies for prevention and intervention.