The study matters for reasons that extend beyond the wellbeing of the participants themselves. Internalizing problems such as depression and anxiety are recognized in the clinical literature as dynamic risk factors for child sexual abuse, meaning they are modifiable states that can increase the likelihood of offending. If stigma drives distress, and distress elevates risk, then understanding the psychological chain connecting the two could inform prevention strategies that protect children by supporting people who have never harmed anyone. This prevention-oriented framing, sometimes called a public health approach to sexual abuse, has gained traction among researchers who argue that waiting for an offense to occur before intervening is both ethically and practically inadequate.

The research team recruited 90 individuals who reported sexual interests in minors, using a cross-sectional questionnaire design. Recruitment for studies of this population is notoriously difficult, and the authors relied on partnerships with organizations that provide support or outreach to people with pedophilic or related attractions, including Stop It Now! Flanders, a helpline-based prevention initiative. Participants completed validated measures of depression, anxiety, and stress using the Depression Anxiety Stress Scales, along with instruments assessing self-stigma, rumination, emotional attentional control, cognitive reappraisal, and self-esteem. The study received ethical approval from the Medical Ethics Committee of Ghent University Hospital, and all participants provided informed consent.

The first key finding confirmed what smaller studies and qualitative reports had suggested: people with sexual interests in minors experience significantly higher levels of anxiety, depression, and stress than members of the general population. This is a population living under what researchers describe as profound social stigma, a stigma that applies even to those who have committed no offense. Previous survey work by Sara Jahnke and colleagues has shown that public attitudes toward people with pedophilia are more punitive and rejecting than attitudes toward people with many other stigmatized conditions, and that merely applying the label pedophile intensifies negative judgments regardless of whether the person has offended.

The second strand of the study examined cognitive processes. The researchers drew on established models from cognitive psychology of depression and anxiety, particularly the impaired disengagement hypothesis of rumination developed by Ernst Koster and colleagues. According to this framework, people with reduced attentional control, especially the ability to disengage attention from emotionally charged material, are more likely to become trapped in repetitive negative thinking. Rumination, in turn, is one of the most robust cognitive predictors of depression. The team distinguished between brooding, a passive and maladaptive form of rumination characterized by moody self-questioning, and reflection, a more purposeful attempt to understand one’s problems.

The results showed that self-stigma, meaning the degree to which participants had internalized society’s negative views and applied them to themselves, was associated with poorer emotional attentional control, higher brooding, and greater internalizing psychopathology. Poor emotional attentional control was also linked to more brooding and more distress. Reappraisal, the ability to reframe emotional situations in less negative terms, showed the expected pattern of associations as well. In other words, the same cognitive machinery that predicts depression in mainstream clinical populations appears to operate in this stigmatized group, suggesting that general models of emotional dysfunction may extend to populations defined by their sexual interests rather than their mental health status.

The most technically interesting result came from mediation analysis. Using structural equation modeling in the R statistical environment, with bootstrap-based confidence intervals for the indirect effects, the researchers tested whether brooding statistically explained the association between self-stigma and internalizing symptoms. It did. The indirect pathway from self-stigma through brooding to anxiety, depression, and stress was significant, meaning that people who had absorbed society’s condemnation tended to chew over it repetitively in a brooding style, and that repetitive negative thinking was in turn associated with worse mental health. This mirrors findings from minority stress research in sexual and gender minority populations, where rumination has been shown to longitudinally mediate the link between stigma-related stress and depression, and it suggests a shared psychological architecture of stigmatization across very different groups.

The theoretical significance of this mediation finding is considerable. Minority stress theory holds that stigma operates as a chronic stressor that accumulates and erodes mental health, and the new study extends this framework to a population whose stigma is arguably more intense than that faced by almost any other group. Self-stigma is thought to damage self-esteem, and low self-esteem is a well-established predictor of depression, but the Ghent team’s data suggest that the cognitive route, in which stigma fuels brooding rumination, is a key conduit. If that is correct, then interventions targeting rumination, such as rumination-focused cognitive behavioral therapy or attentional control training, might reduce distress even when the external stigma itself cannot be quickly changed.

The authors are careful about the limits of their design. Because the data are cross-sectional, the direction of the pathways cannot be established with certainty; it is possible that distressed individuals perceive more stigma, or that rumination and distress reinforce each other in loops. The sample of 90 participants, while substantial for research with this hard-to-reach population, is modest, and self-selected volunteers recruited through support organizations may differ systematically from people with similar attractions who never seek contact with such services. The researchers themselves call for follow-up longitudinal studies to validate the findings and to test whether the observed associations hold over time. They also note that the dataset without demographic information and the analysis scripts are publicly available on the Open Science Framework, an unusual and welcome degree of transparency for research on this topic.

The practical implications, if the findings replicate, point toward targeted support and prevention services. Prior research has documented that fear of stigma and rejection deters minor-attracted individuals from seeking therapeutic help, and that many mental health professionals report limited training and low confidence in working with paraphilic concerns. The new study suggests that reducing self-stigma and breaking brooding cycles could lower the anxiety, depression, and stress that are themselves considered dynamic risk factors for offending. In this view, offering confidential, nonjudgmental support to people who are attracted to minors but determined not to act on it is not leniency; it is a rational component of child protection, aimed upstream of harm. As the authors conclude, the ultimate goal of this line of research is to inform interventions and support strategies for this population that could help prevent child sexual abuse before it happens, a goal that requires both scientific rigor and a willingness to study one of the most uncomfortable subjects in human sexuality.

Subject of Research: Self-stigma, rumination, and internalizing psychopathology in individuals with sexual interests in minors

Article Title: The Relationship Between Cognitive Processes, Self-Stigma, and Internalizing Psychopathology in Individuals with Sexual Interests in Minors

Article References: Demeester, D., Vander Zwalmen, Y., De Boeck, M., Hoorelbeke, K., & Koster, E. H. W. (2026). The Relationship Between Cognitive Processes, Self-Stigma, and Internalizing Psychopathology in Individuals with Sexual Interests in Minors. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-026-03537-8

Image Credits: AI Generated

DOI: 10.1007/s10508-026-03537-8

Keywords: self-stigma, rumination, brooding, internalizing psychopathology, minor-attracted persons, pedophilia, anxiety, depression, minority stress, emotion regulation, attentional control, child sexual abuse prevention