Project VERANDA: Requirement Analysis Survey

Overview

Between 0.6% and 22.2% of the global adult male population has a sexual interest in children (SIIC), depending on evaluation methods \[1\]. SIIC constitutes a major risk factor for child sexual abuse (CSA) and viewing of child sexual abuse material (CSAM). The true rates of CSA offences cannot be estimated, but self-report studies find 30 times higher rates of child-reported CSA compared to reports from child protection services or police. Engagement in therapy is a protective factor against the risk of child sexual abuse and can lead to reductions in CSAM consumption and severity. Anticipated negative therapist behaviour is associated with less willingness to seek treatment. The fear of being reported by the therapist discourages participation in therapy, a concern complicated by mandatory reporting laws in some countries. Negative attitudes towards ISIC are high, and SIIC may be the most stigmatised trait globally. Identifying barriers to treatment for ISIC, and of measures to overcome them, is important to increase therapy engagement, with the goal to improve wellbeing, reduce CSAM consumption, and reduce the risk of CSA offences. Patient anonymity during therapy may play an important role in increasing disclosure of stigmatised traits. It remains unclear whether anonymous therapy addresses patient treatment anxieties and therefore increases the comfort or willingness to engage in therapy. To address this research gap, we conduct an anonymous online survey with ISIC to answer the following questions: RQ1. Can online therapy preferences be identified for minor-attacted individuals and for their therapists? RQ2. Are there individual factors that predict stigmatized individuals' online therapy preferences? (E.g. Trust, Self-Stigma) RQ3. Are there differences between the different stigmatized groups', therapists, and general populations' online therapy preferences?

Detailed description

Participants will receive a study information that describes the aim of the project and a brief overview of data anonymization procedures. This study information is in simple English for comprehesability. Participants will have the option to access more detailed study information, explaining that privacy protections are implemented; tracking technologies are disabled; data will be encrypted and stored on Charité - Universitätsmedizin Berlin servers in compliance with the EU General Data Protection Regulation; and that anonymized data might be shared with academic research institutes within the project consortium. It is also stated that data could be stored for up to three years and that access will be restricted to project members only. To ensure accessibility and comprehensibility for diverse populations, the study information was additionally provided in an easy-to-understand language version. Participants are required to provide informed consent (collected via checkbox without personally-linkable ID) before participation. The questionnaire is available in both German and English.

Pilot testing was conducted prior to the main data collection, involving researchers and general members of the public who are not experts in the topic of the study. The pilot study evaluated the comprehensibility, sensitivity, clarity, and overall acceptability of the questionnaire items. In addition, technical functionality and user experience were informally tested across different individuals and devices.

This study was approved by the Institutional Ethics Committee of Charité - Universitätsmedizin Berlin (ID EA4\_187\_24).

The Charité data protection officewas consulted prior to the start of this study to ensure compliance with applicable data protection regulations, and their advise was implemented.

An instance of the survey tool SoSci Survey was hosted on Charité servers. Server-side IP logging disabled are disabled. Within SoSci Survey, cookies and IP-tracking are disabled, and a "Leave and delete my data" button is available for participants prior to final submission of their data. Participants are instructed not to provide any identifiable information either within the Survey or by email to the study team.

For preservation of anonymity, consent will be collected only via checkbox, and no records of individual identity were stored. To limit the identifiability of the data through data linkage, demographic information is limited to high-level information rather than specific information, such as country of residence rather than nationality, and age range rather than precise age. We also provide guidelines to participants about how to increase their privacy on the project website (https://project-veranda.github.io/VERANDA/news/How\_to\_protect\_your\_identity/) online. To the best of our efforts, this survey will be conducted anonymously.

Primary outcome measures

• Preferences of design features [Time frame: May 2025 - May 2026]

Secondary outcome measures (1)

• Preferred choice of consultation method [Time frame: May 2025 - May 2026]

Eligibility criteria

Inclusion criteria

• Belonging to one of the target groups.
• Otherwise, for general members of the public, none.

Exclusion criteria

• Younger than 18

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Observational model

Cohort

Study locations

Germany · 1 center

• Charité - Universitätsmedizin Berlin — Berlin

Publications

• Fear NT, Seddon R, Jones N, Greenberg N, Wessely S. Does anonymity increase the reporting of mental health symptoms? BMC Public Health. 2012 Sep 17;12:797. doi: 10.1186/1471-2458-12-797. PMID 22985427
• Jahnke S, Imhoff R, Hoyer J. Stigmatization of people with pedophilia: two comparative surveys. Arch Sex Behav. 2015 Jan;44(1):21-34. doi: 10.1007/s10508-014-0312-4. Epub 2014 Jun 20. PMID 24948422
• Edwards W, Hensley C. Contextualizing Sex Offender Management Legislation and Policy: Evaluating the Problem of Latent Consequences in Community Notification Laws. Int J Offender Ther Comp Criminol. 2001 Feb 1;45(1):83-101.
• Grady MD, Levenson JS, Mesias G, Kavanagh S, Charles J. "I can't talk about that": Stigma and fear as barriers to preventive services for minor-attracted persons. Stigma and Health. 2019;4(4):400-10.
• Jahnke S, McPhail IV, Antfolk J. Stigma processes, psychological distress, and attitudes toward seeking treatment among pedohebephilic people. PLoS One. 2024 Oct 24;19(10):e0312382. doi: 10.1371/journal.pone.0312382. eCollection 2024. PMID 39446727
• Schuler M, Gieseler H, Schweder KW, von Heyden M, Beier KM. Characteristics of the Users of Troubled Desire, a Web-Based Self-management App for Individuals With Sexual Interest in Children: Descriptive Analysis of Self-assessment Data. JMIR Ment Health. 2021 Feb 19;8(2):e22277. doi: 10.2196/22277. PMID 33605895
• Van Deinse TB, Cuddeback GS, Wilson AB, Edwards D Jr, Lambert M. Variation in Criminogenic Risks by Mental Health Symptom Severity: Implications for Mental Health Services and Research. Psychiatr Q. 2021 Mar;92(1):73-84. doi: 10.1007/s11126-020-09782-x. PMID 32458340
• Beier KM, Grundmann D, Kuhle LF, Scherner G, Konrad A, Amelung T. The German Dunkelfeld project: a pilot study to prevent child sexual abuse and the use of child abusive images. J Sex Med. 2015 Feb;12(2):529-42. doi: 10.1111/jsm.12785. Epub 2014 Dec 4. PMID 25471337

Identifiers

NCT: NCT07424872 · VERANDA: Requirement Analysis

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗