The Role of Sexual Images in Online and Offline Sexual Behavior with Minors.

Sexual images have long been associated with sexual interest and behaviour with minors. The Internet has impacted access to existing content and the ability to create content which can be uploaded and distributed. These images can be used forensically to determine the legality of the behaviour but importantly for psychiatry they offer insight into motivation, sexual interest and deviance, the relationship between image content and offline sexual behaviour, and how they might be used in online solicitation and grooming with children and adolescents. Practitioners will need to consider the function that these images may serve, the motivation for their use and the challenges of assessment. This article provides an overview of the literature on the use of illegal images and the parallels with existing paraphilias, such as exhibitionism and voyeurism. The focus is on recent research on the Internet and sexual images of children, including the role that self-taken images by youth may play in the offending process.