DOI: https://doi.org/10.26758/14.1.19
(1) Spiru Haret University, Faculty of Psychology and Educational Sciences, Romania. E-mail: gabrielacdumitriu@gmail.com (corresponding author)
(2) M.A., Clinical psychologist and psychotherapist, private practice, Romania. E-mail: alexandradudu8@gmail.com
(3) M.A. & M.S.C., Clinical psychologist and psychotherapist, private practice, Romania. E-mail: victoria.nanau20@gmail.com
Address correspondence to: Claudia Gabriela DUMITRIU, Spiru Haret University, Faculty of Psychology and Educational Sciences, Bucharest, 050711, Romania. Ph.: +40-726-231-833; E-mail: gabrielacdumitriu@yahoo.com
Abstract
Objective. The present theoretical review explored the dimensions, stages and factors involved in the grooming process from the perspective of the both victim and the aggressor. Understanding the dynamics of the grooming process is highly relevant for the investigative process and for the forensic psychological assessment of the victim. The analysis was conducted with the purpose of conceptual clarification of factors and processes, emphasizing their relevance for preventing victimization.
Materials and methods. The research method used was a literature review on the concept of grooming. APA PsycNet, ScienceDirect, PubMed and EBSCOhost databases were accessed. Studies investigating the definition and evolution of the concept of grooming, victim vulnerability factors, characteristics of the sexual offender, comparative analysis of the phenomenon in physical versus online environments, and methods of preventing the phenomenon were included, both qualitative and quantitative. The time interval used was 2003–2023.
Results. The analysis revealed a series of stages in the grooming process, depending on the characteristics of the situation and people involved, such as target selection, gaining access, building trust, fulfilling needs, isolating the target, and sexualizing the relationship. Moreover, a number of victim vulnerability factors covering three areas were identified in the literature. Regarding sex offenders, the motivational theories of sexual abuse revealed a number of characteristics of the abuser.
Conclusions. Information about the victim and offender characteristics and the dynamics of the grooming process are discussed in relation to the prevention of the phenomenon, which cannot be done without adequate education about its characteristics.
Keywords: sexual abuse, grooming, sexual offender, victimization, prevention.
Introduction
The importance of defining and understanding grooming behavior stems from the worrying increase in child sexual abuse cases in recent years, with the increasingly prevalent activity of children in the online environment. In this context, it is estimated that between 30-45% of these cases are based on grooming tactics used by sexual abusers (Winters et al., 2022). The need to define grooming behavior has emerged since the 1980s, when this specific behavior of sexual abusers was first described in the literature (Lanning, 2018). Thus, a non-violent behavioral pattern was observed that aimed to create an intimate relationship with the child, within which sexual abuse was possible without being noticed. Since the 2000s, studies on grooming have become more numerous (McAlinden, 2007), however, it is only in recent years that the conceptualization of the phenomenon has gained scientific consistency. At a general characteristic level, grooming is the process by which a sexual abuser emotionally manipulates a potential victim to commit sexual abuse while using a range of tactics to prevent disclosure (Winters et al., 2022; Orrill & Cohen, 2016). Plummer (2018) describes a number of essential features of the grooming strategy, namely gaining the victim’s cooperation, eliminating or minimizing the risk of the abuse being discovered, and increasing the likelihood for future sexual interactions.
Recently, several criteria for a more precise definition of grooming have been identified based on exhaustive literature reviews (Winters et al., 2022). This should take into account that grooming is a process within which a series of steps can be identified, based on manipulation, with the aim of facilitating the perpetration of present and future sexual abuse and preventing disclosure. It is unanimously accepted that an operational definition is needed to generate a measurable but, more importantly, predictable construct upon which research, prevention policies, and clinical interventions can be conducted (Orrill & Cohen, 2016; Bennett & O’Donohue, 2014).
One difficulty worth mentioning in attempting to operationally define grooming behavior arises from differentiating normal adult grooming behaviors from those that aim to create a relationship intimate enough to allow for the perpetration of sexual abuse. Indeed, there are a number of behaviors that may be characteristic of normal relationships but that may also characterize the interactions of sexually motivated adults with children. Adult-child play, buying gifts, sharing secrets, and creating alliances can be characteristic of both types of relationships. From another perspective, defining and conceptualizing may be all the more complicated as the literature identifies several types of grooming, from the individual to the social – grooming of the child, the family, and the self, but also the community or the institution (Craven et al., 2006; Katz & Field, 2020; Katz & Barnetz, 2016; Winters & Jeglic, 2017). Also, the characteristics of the behavior may vary depending on the environment, the gender of the abuser, and the initial relationship with the child. Thus, there are differences between the methods used in online and physical environments (Elliott, 2017), particularly with regard to victim identification and gaining access to the victim, which will be discussed in the section on the stages of grooming.
From the perspective of preventing the phenomenon, a difficulty that is highlighted in the literature is related to the fact that grooming is easier to identify after the abuse is committed than before (Winters & Jeglic, 2017). It is readily understood that this is due to the similarity highlighted above between normal, caring adult behavior and grooming. This difficulty entails the very need for rigorous conceptualization and operationalization so that prevention becomes effective.
Given the complexity of the phenomenon that stems from its relational nature and the fact that most studies identify a series of stages of grooming behavior, this review sought to identify a solid descriptive model based on existing research. Another aim was to identify the vulnerability factors and characteristics of sexual abuse victims in order to raise awareness of those personal and environmental factors that may be predictors of sexual victimization risk. Last but not least, creating a profile of the abuser, based on available data and literature research was necessary in order to identify motivational factors, etiology, personality factors, and other types of traits that may predispose a person to commit sexual abuse. The fundamental aim of the present study was to support prevention by aggregating existing data and matching them to facilitate effective strategies.
Material and methods
The purpose of this study was to explore existing literature on the subject of grooming in order to determine a comprehensive model of the concept, both conceptually and operationally.
Search strategy
The research method used was a literature review on the concept of grooming. The following databases were used: APA PsycNet, ScienceDirect, PubMed and EBSCOhost. Also, an important source has been identified, namely the European Online Grooming Project – Final Report, prepared for and co-funded by the European Commission Safer Internet Plus Programme, which indicated the urgent need for protective measures to support child victims of sexual abuse.
The search covered the period of the last 23 years, from 2000 to 2023, and included studies and literature reviews that resulted from searches using the key terms: grooming, stages of grooming, sexual abuser profile, sexual abuse victim profile, online grooming, physical grooming, prevention of grooming, and child protection against sexual abuse.
Selection of studies
All three authors independently selected quantitative and qualitative studies in English that were potentially relevant to this paper. The initial selection criteria were based on the title, abstract, relevance of the journal, papers, and articles available in full text. All studies selected were later revised by all authors based on the results and the topics included in the paper. The initial number of studies identified individually was 134. The studies were added to the free program Mendeley Reference Manager (Elsevier, n.d.), which helped organize the works alphabetically and identify duplicates. As a result, 15 of them were identified as duplicate studies, leading to their exclusion. A total of 110 abstracts (articles, meta-analyses, and literature reviews) and 9 book chapters were analyzed. In the Mendeley Reference Manager program, four categories were created: stages of the process, profile of the sexual offender, victim profile, and prevention, with each article being included in one of these categories. Subsequently, each author analyzed and evaluated them to reduce the risk of bias.
Among the exclusion criteria were: not aligning with the main objective of this systematic review; the type of subjects included in the study (victims over 18 years old); studies referring to brain areas; social aspects of pedophiles; and recidivism.
Upon review, 50 articles were selected to be the subject of this review. In these 50 articles, 2 meta-analyses, 7 reviews, and 10 book chapters were included.
Figure 1
The selection process (to see Figure 1, please click here).
Results
The results of the literature review on the structure and characteristics of sexual grooming behavior indicated several models agreed upon by the international scientific community. The detailed analysis of these models allowed us to identify some common stages of the model. Thus, the model widely agreed upon in the literature is composed of five stages: victim selection, gaining access to and isolating the victim, developing trust, desensitization to sexual touch and content, and post-abuse maintenance. These stages are, in turn, detailed into specific behaviors or characteristic sub-stages. A distinction was made between online and physical grooming.
The profile of an individual who engages in grooming and sexual offenses is complex, encompassing a multitude of factors. The main deduction to be made from the following paper refers to the versatility of the abusers’ profile. Abusers come from all walks of life, irrespective of a variety of demographic factors. They will often put up a social facade in the community as a way to ease access to the child and carefully cover up their intentions and tracks. According to theories like Ward and Siegert’s Pathways Model, predisposing factors can be of emotional, cognitive, or environmental nature. More precisely, emotional dysregulation, particularly for negative emotions, appears to be one of the strongest predictors of offense among sexual offenders. Personality traits, such as psychopathy, neuroticism, and narcissism, and their specific manifestations alongside cognitive distortions add additional layers of complexity to the ‘groomers’ profile.
Studies have highlighted various factors that shape the profile of grooming victims: personal, familial, and social factors. It is important to take these factors into account when considering the implementation of a prevention program, as simple information may not be sufficient when multiple risk factors are involved.
Psychoeducation in schools regarding what sexual abuse entails, its recognition, and reporting is the most common prevention method aimed at young individuals.
Discussions
Stages of grooming
Various studies on grooming have delineated a series of more discrete or overt stages, starting from identifying a potential victim, gaining their trust, establishing an intimate relationship, sexualizing them, and ending with committing sexual abuse accompanied by secrecy (Winters & Jeglic, 2017; O’Connell, 2003). The architecture of grooming behavior can range from positive to negative. Thus, we may encounter the offering of attention, gifts, and types of care that facilitate access to the child’s privacy, such as bathing or dressing the child, but also types of negative attention (Wolf & Pruitt, 2019), such as criticism or name-calling. All of these are directed at increasing the possibility of sexual abuse.
In one of the most extensive works on the subject of seduction and child sexual abuse, Christiane Sanderson has identified a number of stages of grooming: Victim selection; victim recruitment; befriending and gaining trust; building the relationship; introducing secrets; testing the victim’s ability to keep secrets; isolating the child; creating the illusion of being loved; introducing non-sexual touching; removing barriers and inhibitions (e.g., through exposure to pornography); manipulating to participate in sexual activities; emotional blackmail; repeating the abuse; recommitting to secrecy; ending the relationship (Sanderson, 2004). Other models vary in complexity, but the stages outlined above comprehensively illustrate the structure of a grooming process as described in the literature.
One aspect that needs to be considered in the present analysis is the difference that can occur between the online and physical environments.
Stages of online grooming
Nowadays, the online space offers an operating environment for sexual abusers that was not possible 20 years ago. Accessibility is an essential dimension that makes up the stage prior to sexual abuse. According to O’Connell’s (2003), accessibility is a key criterion in the typology of online grooming, along with opportunity and vulnerability. According to the author, in the online environment, the abuser goes through the following phases: making friends/contact followed by creating the relationship, assessing risks, obtaining relationship exclusivity, and putting it into action (O’Connell, 2003). As we can see, the architecture of the process is relatively similar, but because of the environment, it can be faster and more risk-free. In contrast to this linear process described by O’Connell, other authors have identified a less organized, circular dynamic of grooming, marked by re-framing, maintenance, and reconstruction phases throughout the process.
Thus, Williams, Elliott, and Beech (2013) conducted transcript analysis of chat room conversations and identified three characteristic themes: the relationship-building phase, the introduction of sexual content, and risk assessment. One strategy used to create rapport is to synchronize the abuser’s behavior and communication style with that of the victim in order to create emotional comfort and gain the victim’s trust.
Reciprocity within the relationship also involves showing interest in and understanding acceptance of the victim’s preferences and life circumstances (Williams et al., 2013). In this context, the abuser often assumes the role of mentor to the victim, on the one hand to stabilize the victim’s trust and on the other to negate potential guilt (Online Grooming Project, Webster et al., 2012). Other authors have also identified this tendency of sexual abusers to operate by virtue of the cognitive distortion that they are, in fact, the children’s rescuers (Ospina et al., 2010; Williams et al., 2013). The illusion of exclusivity is a component of establishing the relationship, which makes the child feel special and isolates them from significant others. Creating the sexual context involves sexualizing online communication with children and is a stage that, chronologically, is introduced subsequent to relationship creation. However, there is a category of abusers, identified as hyper-sexualized groomers, who are more likely to introduce sexual themes shortly after contact (Webster et al., 2012). Sexualization of the relationship can take various forms, including flirting, pornographic material, sexual photographs, and dirty talk (Ospina et al., 2010; O’Connell, 2003). The transmission of such content creates the ground for subsequent blackmail. Olson et al. (2007) identify two functions of relationship sexualization: desensitization and reframing. The first is to facilitate sexual interaction, and the second is to signify this interaction in a positive way.
Risk assessment is a sub-step within the assessment of the child’s environment. Its purpose is to assess levels of trust and vulnerability and to prevent the discovery of the interaction (Williams et al., 2013). Risk management includes measures regarding the technology used. Thus, some sexual abusers use untraceable technological means, such as dedicated email addresses or phones, and avoid meeting their victims near their homes (Webster et al., 2012).
Victim deception in online environments has been shown to be easier than in physical environments (Palmer & Stacey, 2004; Jewkes, 2010). Indeed, concealing identity, real age, or modeling behavior in ways that do not create suspicion is easier to achieve online.
However, Wolak et al. (2008) point out that in most cases of sexual abuse, victims are aware that they are talking to an adult. Moreover, as a result of the grooming process, victims engage in sexual interactions with abusers in an apparently deliberate way. According to Ybarra et al. (2007), many victims who accept physical encounters expect to be involved in sexual interactions and often harbor feelings of love towards the abuser (Wolak et al., 2008).
Stages of physical grooming
Unlike online grooming, physical grooming involves several specific characteristics, some of which are facilitated by direct access to the victim.
The first stage is that of victim selection, which may be based on the vulnerability of the victim, the access the abuser has, or the extent to which the abuser feels attracted to the victim (Lanning, 2010). The child’s family background seems to play an important role, so there is a preference of abusers for children from single-parent families or with limited adult supervision. This explains the incidence of sexual abuse in blended families, where the abuser is a stepparent. Williams et al. (2013) highlight the risk that isolated or unsupported children may be selected as victims.
The second stage is gaining access to the victim with the aim of isolating them from significant others to make abuse easier (Lanning, 2010). The emancipation strategy in these cases depends on the status of the potential abuser—family member or outsider. Thus, in the case of family members, a number of specific behaviors may occur: creating alliances with the child, going to the child’s bedroom at night, and providing support in the bathroom. In the case of potential external abusers, they often either access environments where they can care for the children or gain the trust of the family (Lanning, 2010). Emotional recruitment of the victim is based on the process of gaining their trust, conceptualized as the ability to cultivate a relationship with the victim and their family to the point where sexual abuse is possible (Olson et al., 2007). According to McAlinden (2006), the process of befriending the child includes showing interest in their concerns, showering them with gifts, and sharing secrets to the point where the relationship becomes “special”.
In the later stage of building trust, physical desensitizing behaviors emerge (Winters & Jeglic, 2017; Leclerc et al., 2009). Accidental or innocent touching, activities involving physical contact with the child, and seemingly justified progressive nudity may occur, with the aim of trivializing this type of adult-child interaction. Progressively, they become more intimate and involve invasive touches such as tickling, hand-to-hand fighting, fondling, games with sexual connotations, and massage.
Post-abuse maintenance is the stage that occurs after the abuse, and its role is to prevent disclosure and encourage the child to maintain secrecy and continue to participate in the sexual relationship, sometimes taking responsibility for it (Jackson et al., 2015). In a study that aimed to explore the pattern of sexual grooming, Winters et al. (2020) investigated the views of 18 forensic psychology experts with scientific or practical experience on the topic of grooming. The objective of the study was to validate the five-stage model of grooming, along with subsidiary behaviors: victim selection, gaining access to and isolating the victim, developing trust, desensitization to sexual touch and content, and post-abuse maintenance. The completion of the questionnaire by the experts indicated that all five stages are relevant to the grooming process, resulting in a validated model (Winters et al., 2020), which can help parents or caregivers recognize the risk situations they are exposed to. The model includes, for each identified stage, characteristic behaviors. These cover a wide range of dimensions, from concrete actions involving emotional and physical contact with the child to extensive ones involving strategies for grooming the child’s environment.
General profile of the sexual offender
It is crucial to clearly define and portray the aggressor in cases of “grooming” behavior towards children for a variety of reasons, such as raising awareness, improving the judicial system, and increasing prevention. However, before discussing some of the characteristics, some clarifying aspects should be mentioned (Lim, Wahab, Kumar, Ibrahim, & Kamaluddin, 2021). Individuals who engage in grooming behavior constitute a heterogeneous population, meaning that they can occur irrespective of gender, sexual orientation, marital status, race, or economic and educational levels (Robertiello & Terry, 2007). In this sense, attention must be diverted from the potential stereotypes of the “pedophile” towards researching other characteristics to be able to spot the groomers. Another important aspect to mention is that not all grooming behaviors end up in sexual abuse, but most sexual offenders will utilize grooming to target children sexually (Craven, Brown, & Ghilcrist, 2007).
Individuals who engage in grooming behavior come from all walks of life. In fact, such offenders will often be an integral part of the community and hold stable jobs. Offenders will find means to make themselves useful and not shy away from “courting”, sketching a “too good to be true” portrait of themselves. These behaviors form an extremely useful facade for the offender in their desire to cover up their sexual fantasies (Winters & Jeglic, 2017). According to research such as the one conducted by Craven, Brown, and Gilchrist in 2006, sexual offenders are frequently charming individuals who skillfully employ seemingly innocent behaviors that act as manipulative strategies for the purpose of gaining the trust of the individuals around them. Raising awareness about the versatility of the offender can help break the stereotype and increase the possibility of recognizing them (Craven, Brown, & Ghilcrist, 2007).
With regards to demographics, research suggests that the majority of offenders are male, with female offenders representing only 2.2% of all sex crimes around the globe (Cortoni et al., 2017). In addition, for internet sex offenders, the typology seems similar, with men falling between the ages of 30 and 40, having higher levels of education and employment than offenders who act offline (Merdian, Wilson, & Boer, 2009). These statistics only paint half of the picture. As Cortoni and colleagues (2017) postulate, in one meta-analysis, if self-reportings of sexual crimes are taken into account, the existence of female offenders seems to be much higher than initially believed, approximating at 12%. It is widely accepted that sexual crimes are highly unreported in general. This discrepancy might be even larger for crimes committed by female offenders. One potential explanation for the discrepancy could be that cultural and societal norms shape our perception of gender roles (Mignogna, 2022).
In a study analyzing the portrayal of female sexual offenders as presented in newspaper articles, Christensen (2018) postulates that societal biases may play a role in how women are perceived in society. Precisely, women seem to be believed to be caregivers and nurturers and thus cannot be imagined as perpetrators. This biased misconception can lead to the misidentification of perpetrators. Further supporting this, research suggests that females’ perpetrators are more likely to have committed prior offenses, such as drug or property offenses (Mignogna, 2022). In addition to this, female offenders, as opposed to men, are less likely to act alone in crime or to use physical force (Robertiello & Terry, 2007). Furthermore, literature investigating female drug-related offenses portrays females as “specialist criminals”. This categorization speculates that females become experts in their ways of committing crimes, covering up their traces and evading detection from the judicial system (James, Gosho, & Wohl, 1979, as cited in Dina et al., 2021). As mentioned, their proficiency in all stages of committing offenses could influence the number of underreported female-conducted crimes.
It is in this sense that we can expect a sexual perpetrator to hide behind any gender, race, or other demographic or psychological variables and act on a variety of plans, be they online or offline, physically or only psychologically. The next part of this paper will aim to profile the sexual offender from an etiology of motivation for offenses perspective, personality traits, affect dysregulation, cognitive distortions, and finally the behaviors they exhibit.
Etiology – The Pathways Model
In order to accurately profile the person who engages in grooming, it is important to understand the motivations behind such actions that both initiate and also sustain the behavior. A multitude of theories have been proposed to investigate this, but three theories about the etiology of the motivation behind child abuse have been most prominent in the literature, namely Finkelhor’s Pre-condition Model (1984); Marshall and Barbaree’s Integrated Theory (1990) (Ward, 2002); and Hall and Hirschman’s Quadripartite Model (1992) (Ward, 2001). However, in 2002, a new theory that integrates aspects from the previous was proposed by Ward and Siegert. This theory is known as the Pathways Model. For this review, only The Pathways Model has been discussed, being the most influential and researched model to date. Ward’s and Siegert’s theory suggest that different dysfunctional psychological mechanisms are involved in the etiology of motivation for abuse (Ward & Siegert, 2002). According to this model, the deficits can be attributed to environmental, biological, and cultural factors. The model claims four core mechanisms that give rise to five different pathways that lead to a sexual offense. The authors suggest that while one mechanism may prevail as a core dysfunction in an individual, all mechanisms interact to varying degrees in each case. Emotional regulation, intimacy deficits, cognitive distortions, and distorted sexual scripts are core elements of the theory.
Intimacy and social skills deficits are considered by the theorists to be the core pathways of the explanatory model. Intimacy deficits are believed to stem from the development of an insecure attachment style (anxious or avoidant) developed by the offender during childhood. More precisely, the rise of an insecure attachment could be the result of unresponsive attachment figures during upbringing regarding the child’s emotional needs (Sigre-Leirós et al., 2015). As a result of insecure attachment, these individuals often struggle to cultivate close, meaningful relationships, as Ward and Siegert suggest. A difficulty in forming close relationships leads to feelings of rejection, which in turn promotes social isolation (Ward & Siegert, 2002).
Social isolation is a commonly linked risk factor for sexual offenses (Robertiello & Terry, 2007; Marshall, 2010). According to Ward and Siegert, this pathway in the model presents normal sexual scripts, with individuals having adult sexual preferences and even preferring adult relationships. Yet, these individuals can also engage in relationships with children when adult relationships are not an option (Ward & Siegert, 2002).
A second pathway within the Pathways Model known to be dysfunctional are the deviant sexual scripts. According to Ward and Seigert (2002), these scripts are the building blocks of the belief system that guides individuals’ sexual behavior, attitudes, and expectations about sex. Fundamentally, these scripts represent a set of instructions for action that, when malfunctioning, can result in abusive, inappropriate, and harmful behaviors. Ward (2002) suggests that abnormal scripts and, in turn, aberrant behaviors might arise from the premature exposure to sexual content or the early sexualization of the offender. Within this explicative pathway, the offender might have experienced sexual abuse during their early upbringing. As a result of such exposures, one’s perception of sexual acts can be modified. Consequently, sexual abuse as an early sexual experience may be one of the contributing factors to developing malfunctioning sexual belief systems (Ward & Siegert, 2002). This is in line with results from a meta-analysis demonstrating that a history of sexual abuse is more prevalent in sexual offenders as opposed to non-sexual offenders (Jespersen, Lalumière, & Seto, 2009).
Emotional dysregulation is another core deficit in the Pathways Model. The incapacity to regulate emotions, in particular negative emotions, develops as a result of an insecure attachment. In turn, the individual develops negative beliefs about others, the world, and the self. Individuals with emotional regulation problems present difficulty tolerating frustration or negative emotions, controlling aggression and impulsivity. Failure to self-regulate may lead to criminal behavior such as sex crimes (Martínez-Catena et al., 2016). Notably, these individuals do not have aberrant sexual scripts, but they still experience difficulties with adult relationships, generating frustration for the individual and pushing them to seek intimacy and comfort from children while fostering frustration. In this pathway, sex becomes a coping mechanism to self-regulate (Wart & Siegert, 2002).
Cognitive distortions represent the fourth key deficit in Ward and Siegert’s Pathways Model. These distortions refer to skewed thinking styles that influence one’s belief system and attitudes that build up the core of the offender’s moral system (Ward & Siegert, 2002). These distortions are created by mental schemes, beliefs, and personal theories that ultimately drive the individual to behave in accordance with dysfunctional belief systems. Individuals with this deficit have antisocial tendencies, including pro-crime attitudes and other illegal acts such as substance abuse and impulsivity. These individuals, according to the authors, do not have sexual script distortions but will have the tendency to act in accordance with their distorted belief system (Wart & Seigert, 2002).
The fifth pathway or multiple dysfunctional mechanisms is considered the pathway to “pure” pedophiles, having a particular interest in sexual relationships only with children.
According to Ward and Seigert (2002), these people are individuals who have a history of sexual abuse or early-life sexual exposure that has generated distorted sexual scripts. With time, these individuals may also develop cognitive distortions and other flawed psychological mechanisms as a method of rationalizing, to themselves and the world, their interest in children (Wart & Seigert, 2002). Within this group of individuals, the idealized relationship type is the relationship between a child and an older person. Ward and Siegert point out that these individuals usually present a range of deficits commonly found in child abusers. Specifically, they exhibit abnormal sexual arousal patterns, intimacy deficits, emotional regulation issues, and cognitive distortions. In this case, offenders suffering from all aforementioned deficits might exhibit early abnormal sexual behavior towards children and might engage in sexual abuse early in life (Wart & Seigert, 2002).
Affect dysregulation
Affect, broadly defined to include emotions, moods, and stress responses (Gross, 2015, as cited in Gunst et al., 2017), serves as a crucial driving force behind human behavior. However, emotions can be problematic when they are not well understood or when they are ignored or repressed. Behaviors that stem from this deficit include difficulty managing and responding appropriately to emotional experiences, in particular negative emotions. Multiple studies have linked difficulties with affect regulation to a variety of psychopathologies, such as bipolar disorder (Mancke, Herpertz, & Bertsch, 2015), aggressive behavior, and sexual violence (Gunst, Watson, Desmet, & Willemsen, 2017).
Early literature has not focused on the role played by emotional states regarding sexual offenses, but demonstrates that the inability to manage emotional states plays a role in sexual offenses. Emotional regulation issues seem to stem from early life experiences in which adversity has been present. The mechanism of action postulated for the development of this deficit is the interruption of the normal development of adaptive coping strategies. As a result, maladaptive stress coping mechanisms and difficulties with decision-making arise (Dvir, Ford, Hill, & Frazier, 2014; Gunst, Watson, Desmet, & Willemsen, 2017). New literature also links dysregulation in the form of anger-management issues to a high number of sexual offenders (Ward & Hudson, 2000).
To emphasize the above-mentioned, Smallbone and Dadds (2000) state that “men who have experienced insecure attachments and who later engage in rape or child molestation [….] may be responding inappropriately to internal (affective distress) and external (close physical proximity to a child) cues”. This suggests that sexual offenses may be a result of inappropriate responses to emotional suffering.
Lastly, a meta-analytic review also found that emotional dysregulation is a good predictor of reoffence among sexual perpetrators (Gillespie, Mitchell, Fisher, & Beech, 2012). In this sense, we can expect the “groomer” to have extreme difficulties in managing emotions, particularly negative emotions, finding it difficult to engage helpful coping mechanisms, often resorting to maladaptive coping behaviors.
Personality traits
One of the most important factors in the profiling of the sexual offender is the personality of the offender. Psychopathy is a personality trait that has been widely researched in the case of sexual offenders due to associated behaviors. Lack of remorse, acting irresponsible and impulsive, and exhibiting antisocial behaviors, all stemming from psychopathy (Merdian, Wilson, & Boer, 2009). However, research linking psychopathy to grooming behaviors is scarce, with most of the literature focusing on sexual offenders.
Literature employing the Five-Factor Model (FFM) of personality has consistently indicated higher scores in neuroticism among sexual offenders. According to Hans Jürgen Eysenck, neuroticism is a construct of low self-esteem, high emotional instability, anxiety, nervousness, and restlessness (Dennison, Stough, & Birgden, 2001; Boillat et al., 2017). While studies on the personalities of sexual offenders generate varied results, neuroticism stands out as the most consistently linked trait to both psychopathy and sexual criminality (Merdian, Wilson, & Boer, 2009).
Additionally, narcissism has also been identified as a prevalent trait among offenders (Baumeister, Catanese, & Wallace, 2002). As a personality trait, narcissism manifests in the form of a sense of entitlement, utilizing the exploitation of others for personal gain. Moreover, narcissism might be behind certain sexually aggressive behaviors as well as manipulative tactics – such as the ones commonly seen in grooming (Baumeister, Catanese, & Wallace, 2002). As such, narcissistic individuals might manipulate and deceive in order to gain access to the victim and engage in desired behaviors, showing no remorse or a lack of remorse. Supplementary research also suggests that the individual who engages in grooming often will be a patient individual, as grooming is a multi-staged process. Its success depends on the skillful and slow gain of trust of the child and the individuals around them (McAlinden, 2006).
Cognitive distortions
Cognitive distortions are a term that encompasses problematic thinking styles, attitudes, and beliefs about others and the world, shaping one’s perception of reality and behavior. Cognitive distortions are known to be driving forces resulting in offenses. Maladaptive thinking styles such as excusing, blaming, and rationalizing are often found among sexually abusive individuals (Ward, 2000; Gannon et al., 2007). For example, one study investigating the most frequent distortions found among child offenders shows distortions such as “She enjoyed it.”, “This won’t hurt her or affect her in any way.” and “This is not so bad, it is not really wrong.” as commonly occurring between male offenders (Neidigh & Harry Krop, 1992).
The works of the aforementioned and the influential work of Abel and colleagues in 1984 led to the theorization of five broad areas of flawed cognitions. As such, sexual offenders suffer from the following: seeing children as sexual objects (blaming victims and falsely believing victims are enjoying themselves), entitlement (falsely believing that their actions are excusable due to them being superior, children not being actual victims), dangerous world (believing that the world is a dangerous place and believing that relationships with children are safer than with adults), uncontrollability (blaming external forces for their actions, such as being intoxicated or having experienced sexual abuse), and lastly, nature of harm (distortions of minimizing the impact their actions have on the victim) (Steel, Newman, O’Rourke, & Quayle, 2020).
Behaviors
Only 5% of child sex offenders are recognized, and this fact can be attributed to the result of successful grooming strategies (Salter, 2003). Groomers purposefully modulate the environment around them, positioning themselves strategically so their behaviors seem natural and go unnoticed. Moreover, these individuals usually act kind and charming, while slowly building entrance to the child. It is important to earn the trust of both the child and its caretakers to maintain cover while engaging in sexual grooming (van Dam, 2006).
One study conducted by Winters and Jeglic (2017) demonstrated that participants failed to identify grooming behaviors. Participants were given sexual grooming vignettes and non-sexual grooming vignettes. The vignettes described a sports professor and a young boy and different grooming behaviors across all stages of grooming, such as 1) victim selection; 2) gaining access; 3) trust development; 4) touch desensitization; as well as vignettes showcasing all stages. Overall, the results revealed that participants were unable to recognize sexual grooming behaviors, regardless of the grooming stage.
The insidious tactics employed by groomers often go undetected, even when their actions may seem explicit. Covert behaviors, like selecting a potential victim, are inherently discreet and challenging to notice for the individuals outside. However, even more overt actions, such as taking a child out for ice cream, hugging the child, or offering rides home, are often overlooked. These acts, while seemingly innocent, are skillfully thought out and played out with the scope of desensitizing the child to physical touch and cultivating trust, subtly paving the way for abuse.
Behaviors of individuals who groom, such as covert behaviors, can easily go unnoticed (e.g., selecting the victim). Yet, participants seem to not be able to recognize overt actions either, such as hugging the child, taking certain children out for ice cream, or driving the child home, which were meant to desensitize the child to physical touch from the abuser and gain trust. Offenders also tend to groom the adults around them, in particular the ones closest to their victim, to modulate the environment and gain access to the child more easily (Craven, Brown, & Ghilcrist, 2007). It is possible that one explanation for not being able to recognize an abuser’s actions is due to their innocence in nature (Winters & Jeglic, 2017). These findings are in line with past studies showing that sexual grooming is hard to recognize (Carter et al., 2006; Lanning, 2010). In this sense, it is crucial to increase the capacity to profile groomers to raise awareness and increase education about the actions of groomers across all stages of the grooming process.
Victim profile
According to the Sexual Grooming Model (Winters et al., 2022), perpetrators select victims with the following characteristics: they are respectful or trustful of adults; have low self-esteem; are lonely or isolated; face difficulties; are needy; feel unwanted or unloved; lack a close relationship with their parents; come from single-parent families, raised by single mothers, and require a father figure; and they are unsupervised.
Studies have indicated that most victims of online grooming are between 13 and 17 years old (Staksrud, 2013; Wolak, Finkelhor, Mitchell & Ybarra, 2008), are predominantly girls (Wolak et al., 2004), with boys accounting for a quarter of victims, and gay boys or boys who question their sexual orientation are a more vulnerable category, along with those who live in abusive home environments, have social problems, face depression, and show tendencies towards delinquency associated with the use of chat rooms and communication with strangers (Wolak et al., 2008). The authors of another study (Peter, Valkenburg, & Schouten, 2006) identified boredom, curiosity, and inhibition as factors that lead children aged 12 to 14 to communicate with strangers online.
Those who have lived in abusive environments are at greater risk of sexual abuse, as they do not perceive the risk of sexual advances or misjudge it, as childhood trauma, among other factors, is associated with risky sexual behavior (Wolfe et al., 2006, as cited in Wolak et al., 2008). Furthermore, young people who exhibit emotional, psychological, and family instability are more likely to be victims of grooming (Winters et al., 2022).
The study by Wolak et al. (2003) characterizes victims of online sex crimes as having poor relationships with their parents (conflictual relationships in the case of girls, lack of monitoring in the case of boys, and depression in both girls and boys) (Wolak et al., 2003, as cited in Wolak et al., 2004), being single and depressed, gay boys or questioning their sexual orientation, compliant, or statutory victims (persons who develop a strong attachment to the abuser and may collaborate with the abuser to the detriment of justice).
Qualitative research (Quayle, Jonsson, & Lööf, 2012) studied the experiences of minors aged 11 to 17 at the time they were victims of online grooming, resulting in six categories: I’m missing something, Being someone who’s connected, Caught in a Web (e.g. Seeming like a normal relationship, Being groomed, Losing control), Making choices, Others involvement, Closing the box and picking up the pieces.
Ciurbea et al. (2021) cited Papalia, Olds, & Feldman (1978/2010, p. 411), emphasizing the significance of group membership during adolescence. Group membership plays a crucial role in shaping identity and self-image for adolescents, as the group to which they belong often serves as their reference group (Duduciuc, Ivan, & Chelcea, 2013, as cited in Ciurbea et al., 2021). Healthy peer relationships are considered an important factor in online sexual victimization (Wolak et al., 2008), which is possible when the network of friends is non-existent, the victim isolates himself/herself and thus increases the risk of rapidly developing Internet relationships through self-disclosure (McKenna, Green, & Gleason, 2002, as cited in Wolak et al., 2008). Additionally, erotic conversations can lead to strong feelings that are difficult for young people to manage (Wolak et al., 2008).
The study by Winters, Kaylor, & Jeglic (2017) analyzed 100 transcripts of online conversations between abusers and fake victims (95 girls and 5 boys) aged between 13 and 15, and in terms of the profile of the alleged victims, found that over 80 of them lived in the same state as the abuser and 10 of them in the same city. Researchers concluded that abusers choose their potential victims based on proximity to facilitate face-to-face meetings, and the research also revealed that none of the victims had sexually suggestive usernames.
Chat rooms can be an attraction for online sexual abusers, with studies showing that teens who communicate through them often have family problems, feel lonely, sad, or may have a history of sexual abuse (Beebe, Asche, Harrison, & Quinlan, 2004; Sun et al., 2005, as cited in Wolak et al., 2008), and young people in their early teenage years may not yet have the ability to respond appropriately to sexual invitations (Greenfield, 2004, as cited in Wolak et al., 2008). The study conducted by Kloess et al. (2019) analyzed the grooming process of five abusers by examining 29 transcripts and 22 interactions, finding that one of them had initial contact with victims in private chat rooms, one on a site that allows video communication, two on social networks, and one on a dating site (although this information could not be confirmed). Later on, four of them exchanged email addresses to send instant private messages.
Two boys and six girls, aged between 12 and 14, victims of online grooming and subsequently experiencing a form of sexual abuse, were interviewed, and the girls included in the study reported considering their abuser as a “friend” at a certain point (Whittle et al., 2014). In five cases, the abuser was the one who initiated the conversation, initially engaging in discussions similar to those with friends, except for two out of the 6 cases where the initial conversation was sexual (Whittle et al., 2014). All respondents stated that they found emotional support discussing their problems, particularly family issues, thereby creating a sense of trust and perhaps dependency and attachment to the abuser through regular interaction, attention, and the abuser’s knowledge of their schedule (Whittle et al., 2014). More than three-quarters of the abusers included in the study by Wolak et al. (2004) used multiple communication methods to stay in contact with the victim, with Whittle et al. (2013) considering this a manipulative way in which the child becomes increasingly dependent on the offender.
The European online grooming project – Final report (Webster et al., 2012) classifies victims of online grooming into two categories: vulnerable victims and risk-taking victims. The first category includes people in need of attention and affection, people who have difficult family relationships, are looking for love online and believe they are in a relationship with the perpetrator, and those who do not disclose and wish to continue the relationship; and the second category includes those who seek adventure, feel in control, less known about family risks, and are open to blackmail from the perspective of apparent complicity (Webster et al., 2012).
Regarding the personality of vulnerable children, Sanderson (2004) argues that abusers prefer children who are naive and immature, malleable, shy, and not assertive. In addition, those who feel unloved, lonely, unwanted, or are victims of bullying are more prone to victimization and may often have family problems or be excluded from the peer group, all of which tend to lead to a desire for attention and affection (Sanderson, 2004). Furthermore, the unmet needs of children can pose a risk factor, as pedophiles are highly skilled at identifying and fulfilling them (Sanderson, 2004).
Prevention
According to Uzieblo et al. (2022), special attention should be given to grooming behaviors to avoid confusion with appropriate behaviors. They suggest considering behaviors in conjunction rather than in isolation. O’Leary et al. (2017, as cited in Uzieblo et al., 2022) state that having guidelines regarding appropriate interactions between adults and minors would help in better understanding inappropriate behaviors within institutions. Additionally, there are many similarities between how a relationship is formed and developed online and the stages of online grooming; the differences may be less obvious to young individuals (Bryce, 2010, as cited in Whittle et al., 2013).
Sexual abuse prevention programs can be categorized into two groups: programs aimed at potential victims or victims and programs targeting potential abusers or abusers.
VicHealth (2007, cited in Quadara et al., 2015) emphasizes primary prevention in the context of sexual abuse, similar to violence prevention, where it refers to preventing violence before it occurs; this involves preventing victimization or ongoing victimization through strategies implemented before the abuse takes place, by focusing on addressing the factors that cause abuse (Caffo, Asta, & Scandroglio, 2021). Smallbone, Marshall, & Wortley (2008) argue that in these cases, primary prevention should target two directions: firstly, preventing child sexual abuse, and secondly, preventing potential abusers from committing sexual offenses. Secondary prevention can be applied to individuals who are at risk of victimization or those at risk of committing the offense, aiming either to halt the process before it occurs or to reduce or stop its progression; these interventions can be implemented at the family, school, and individual levels (Smallbone et al., 2008). Within tertiary prevention, according to the authors, we find individuals who have been victims of sexual abuse or who have committed offenses in this area, and the focus here is on reducing the risk of revictimization and recidivism (Smallbone et al., 2008).
According to Smallbone et al. (2008), interventions that take place only after sexual abuse has occurred are prevalent, with prevention campaigns focusing on encouraging people to report abuse rather than focusing on strategies to prevent it. They propose developmental prevention, which aims to “prevent the emergence, over the course of individual social cognitive development, of dispositions and vulnerabilities associated with the onset of child sexual abuse offending” (Smallbone et al., 2008). Through interventions at key life stages (early attachment relationships, transition to school, transition to high school, and transition to parenthood), the probability of committing sexual abuse can be reduced and prevented. According to the authors (Smallbone et al., 2008), early attachment relationships influence the development of behavioral self-control through the internal model of interpersonal relationships. According to Quadara et al. (2015), such a program has not yet been implemented and tested, so there is no analysis of how it might work.
Quadara et al. (2015) summarize the main existing preventive measures, including: psychoeducation for children, parents, and teachers regarding protective behaviors; preventing crime in high-risk environments such as schools or organizations with many children by implementing strategies to discourage sexual abuse (e.g., clear conduct rules, surveillance cameras, transparent doors); psychotherapy for children and youth exhibiting problematic/abusive sexual behaviors; preventing relapse through psychotherapy; identifying and monitoring individuals who commit sexual offenses; and involving children who have experienced sexual abuse in psychotherapeutic programs to prevent revictimization.
While most prevention programs are implemented at the school level and involve educating children on recognizing, resisting, and reporting abuse, their effectiveness remains a controversial subject (Caffo et al., 2021; Letourneau et al., 2017). On one hand, children are more knowledgeable about what constitutes sexual aggression; however, on the other hand, it is still unclear whether they will be able to apply this theoretical knowledge when they find themselves in a real-life situation (Topping & Barron, 2009).
The Dunkelfeld Prevention Project, launched in Germany since 2005, addresses pedophiles who have not yet committed sexual offenses but are aware of their preference and seek help; those who have committed abuses but have not been convicted and fear relapse; and those who have committed sexual aggressions and have been convicted but are no longer under judicial supervision and fear reoffending (Beier et al., 2009). The initiators thereby reduce the chances of applicants participating solely due to judicial pressure. This program combines cognitive-behavioral therapy techniques with medication and sexology. The results of this project are controversial; the study conducted by Beier and colleagues (2015) highlighted the program’s effectiveness, while the research by Mokros and Banse (2019, as cited in Caffo et al., 2021) challenges this finding, citing methodological issues.
Uzieblo, Smid, & McCartan (2022) state that the use of the Sexual Grooming Model (Winters et al., 2022) by clinicians can help to outline the factors that lead to relapse, thus being able to create a prevention plan. Although abusers may not follow the same pattern, it is necessary to know the elements that led to relapse in the past. The model can also be used to inform victims and can lead to reduced self-blame by knowing the manipulative mechanisms behind the abuse (Uzieblo et al., 2022).
Regarding online grooming, Winters and colleagues (2017) cite the study conducted by Black and colleagues (2015), indicating that online abusers may select their victims based on proximity criteria. The authors draw attention to the information children provide on the internet, emphasizing the importance of monitoring their activities and teaching safe internet usage (Winters et al., 2017). Additionally, online offenders attempt to make their victims feel safe and trusting, and providing personal information to strangers increases the risk of online sexual victimization and, subsequently, real-life meetings (Wolak et al., 2008). However, Wolak and colleagues (2008) emphasize that it’s not just the publication of personal information itself that represents a risk, but rather engaging in conversations with strangers. The study by Ybarra and colleagues in 2007 suggests that concurrent engagement in multiple risky behaviors online increases the risk of victimization (disclosure of personal information, aggressive behavior towards others, talking to known people online, sexual behavior, downloading images through file-sharing programs). Wolak and colleagues (2008) compile a list of nine risky online behaviors that, when combined, elevate the risk of online victimization: sharing personal information, having virtual unknown friends, communicating with unknown individuals, posting hurtful comments, sharing personal information, engaging in sexual conversations with strangers, downloading images through file-sharing programs, browsing pornographic websites, and posting humiliating comments about acquaintances. This list is not exhaustive, and the researchers acknowledge that there could be other risky behaviors not considered in their study (Wolak et al., 2008).
Wolak and colleagues (2008) argue that minors need honest discussions about sexuality, encompassing both its aspects and its implications; they advocate for comprehensive education regarding appropriate and inappropriate adult behavior; furthermore, they suggest that prevention efforts for young people should prioritize education on safe Internet usage, assertiveness skills, and resistance techniques; and starting from puberty onward, the focus should shift to healthy sexual development, along with providing information about the predatory nature of sexual requests from adults.
Informing young people about the manipulative mechanisms behind online grooming, that offenders also communicate with other people, and that any information shared online can be evidence in the eyes of the law can help raise awareness that a relationship between a minor and an adult can constitute a crime (Wolak et al., 2004).
Wolak et al. (2008) cite Berliner (personal communication, July 17, 2007), who proposes a model of intervention based on Stages of Change (Prochaska & Prochaska apud Wolak et al., 2008), by identifying the stage of victimization, increasing motivation, and applying cognitive-behavioral techniques.
Whittle et al. (2014) state that blackmailing young people to send sexually explicit pictures is a clear sign of grooming, and they should be informed about ways to seek help in such situations. Furthermore, some of the participants in this study believed that they were in a romantic relationship with the abuser. The authors consider the need to educate young people regarding the distinction between age-appropriate and inappropriate relationships, as well as recognizing abusive elements, online grooming techniques, and associated consequences (Whittle et al., 2014). The openness and willingness of parents to talk to young individuals are important aspects of prevention. However, researchers also emphasize the importance of educating parents about grooming to prevent them from becoming victims themselves. They highlight the importance of parents and individuals working with children understanding the stages of the grooming process and the tactics used by abusers. Through this understanding, abuse can be stopped before it occurs (Winters et al., 2020).
Prevention should aim to encourage young individuals to disclose when a friend is in a close relationship with someone known online to protect them, especially concerning young people who have difficult relationships with their parents, as they are more prone to forming such relationships (Wolak et al., 2004).
The European Commission has launched the INSAFE project in 27 countries, as indicated in the European Online Grooming Project – Final Report (Webster et al., 2012). This initiative aims to organize Safer Internet Day, encouraging safe Internet use.
Simultaneously, Sanderson (2004) emphasizes the need to provide parents with comprehensive information about the grooming process and its characteristics; this is crucial since, in the absence of such knowledge and awareness, parents themselves can become targets of grooming. The author suggests that parents should be vigilant about the people they allow their child to spend time with and show openness on the part of the parent to discuss the activities the child engages in with that person (and others) and what they feel can help in the early detection of an inappropriate relationship. Additionally, open relationships with parents and teachers based on trust and warmth can reduce the risk of children falling victim to sexual abuse (Sanderson, 2004).
Research has shown that prevention programs should target young people, especially those with risk factors associated with the possibility of victimization, parents and caregivers, victims of abuse when it has occurred, in order to integrate the experience and prevent revictimization, and abusers to prevent re-offending or potential abusers to prevent abuse.
Conclusions
Regarding the stages of grooming, one conclusion that emerged was that, in general, there is a greater number of studies examining online grooming and a greater concern about prevention in the online environment due to the increasing exposure of children to the online environment over the last two decades. Although this public policy strategy is effective, there remains, however, a significant uncovered risk segment with regard to children who are sexually abused in the physical family environment. The latter are, by their very nature, more difficult to detect and would require attention from researchers and practitioners in order to develop early detection and prevention methods.
This research has implications across a variety of areas. First and foremost, there is a need to broaden the public’s knowledge and education level about the construct of grooming and the possible signs and behaviors that these individuals might showcase. The public, parents, professionals, and children could benefit from being informed on recognizing the subtleties of their tactics and schemes.
Furthermore, this paper adds to the existing literature by highlighting internal aspects of the psychological world of such individuals. From literature such as this, more rigorous psychological screening methods could be developed. Assessing individuals prematurely to identify those at risk of offending before they act could represent a great prevention mechanism against sexual offenses.
Informing the entire community about the strategies used by sexual offenders can reduce the risk of victimization. Additionally, young people need open discussions about sexuality and information about what is appropriate and what is not. Parents and teachers can provide the necessary framework, highlighting the need for proper education of individuals responsible for minors in their care. Research has found the short-term utility of these programs in educating children, but they have not examined the effectiveness of these prevention programs in the medium and long term, so it is not clear whether they can truly prevent sexual abuse. Therefore, it is important for future studies to investigate the long-term effects of such programs.
Regarding prevention in the case of abusers, there are two directions in the literature: interventions aimed at reducing recidivism when sexual abuse has occurred and interventions aimed at potential abusers. However, similar to programs for children, the results of studies are controversial, highlighting the need for careful research into the ways in which these programs can be implemented as well as the need for longitudinal studies to examine the long-term outcomes of such programs.
Study limitations
One limitation of this study is that, to our knowledge, there is a lack of studies investigating the profile of the individual who engages in grooming behavior. This paper has reviewed literature that investigates the profile of sexual offenders more broadly. There is a possibility that differences between children’s sexual molesters and groomers might exist. Additionally, there is a chance that “groomers” could also be further categorized into multiple subcategories. Further research should investigate the profile of groomers to better aid the judicial system in recognizing them and increasing awareness. Moreover, additional research could focus on deciphering differences between groomers who act online and those who act offline to deepen the existing knowledge and understanding of the phenomenon.
It is pivotal to address the limitations of this study based on methodological considerations that may have impacted the findings. Firstly, as this study is a systematic literature review, the inclusion and exclusion criteria utilized for the selection of studies may have introduced potential biases. While the authors aimed to provide as much of an extensive view as possible, it is not unlikely that some relevant research may have been inadvertently omitted. Furthermore, the timeframe for the literature search, while extensive, does not represent the totality of all related literature, and new research may have emerged since the cutoff date used for this systematic literature review.
From a PRISMA guideline perspective (Page et al., 2021), the title, abstract, and introduction are in line with the methodological regulations. However, in regards to the methods, more information could have been mentioned to allow for better replicability. Moreover, this paper could have specified the inclusion and exclusion criteria more thoroughly, and if the variables in the selected studies had any missing or unclear information.
Moreover, the current study could have better described the process used to decide the eligible studies for synthesis and the methods used to assess confidence in the body of evidence. Regarding the results section, this paper did not provide a thorough analysis and description of the studies of each individual study included in the review. Furthermore, from a discussion perspective, this paper has provided a general interpretation of the results in the context of other research as well as discussed, any limitations of the evidence and the review process. However, despite these limitations, our review closely followed the PRISMA guidelines (Page et al., 2021), ensuring a transparent and reproducible approach to literature synthesis and offering an unbiased summary of the existing literature within the constraints of our methodology.
A summary of this paper was presented at the online international conference: Individual, family, society: contemporary challenges, fifth edition, October 4–5, 2023, Bucharest, Romania, and published in the journal Studii şi Cercetări de Antropologie, No. 8/2023.
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