Words Can Hurt: A Taxonomy of Verbally Pressured Sexual Exploitation in the SES-V

ABSTRACT

This article describes the development of the Verbally Pressured Sexual Exploitation module of the Sexual Experiences Survey (SES)-Victimization (introduced by Koss et al., 2024). This module assesses the use of verbal or nonphysical, paraverbal pressure to obtain sexual acts without freely given permission. An interdisciplinary team of seven sexual exploitation researchers collaborated to create this module, with consultation from the full 15 member SES-V revision collaboration team. In this paper, we describe our process for developing this module. We briefly review empirical literature and theoretical frameworks (e.g., rape scripts, normative sexual scripts, intersectionality, and sex-positivity) that informed this work. Summary tables compare the SES-V items to verbal pressure items in prior versions of the SES and to other existing measures of violence. The comprehensive taxonomy developed herein includes six domains of Verbally Pressured sexual exploitation across 11 item stems. The components of the taxonomy include: positive verbal pressure, neutral verbal pressure, negative verbal pressure, substance-related pressure, postural violence, and threats to critical resources. The paper concludes with suggestions for future research, with priority on intersectional research that can illuminate the phenomenology and contexts of sexual exploitation against marginalized groups.

Books, movies, and song lyrics normalize using Verbally Pressured tactics to obtain sex, typically by depicting both the initiator and the recipient individual as being sexually satisfied and happy after exploitive sex (Hogan, 2021). Indeed, Verbally Pressured sexual exploitation is the plot driving many romantic comedies and popular teen films spanning decades, from Some Like it Hot, to Ghostbusters, and the teen phenomena Twilight (for further examples, see Beck, 2018). The fact that many readers will not recall the coercive nature of these romances demonstrates to some degree just how mainstreamed and normalized these behaviors are. These films and many others depict the now classic trope wherein a male character lies about something important to a female character but eventually wins her over. These popular cultural representations portray Verbally Pressured behavior as predictable, normative, and benign aspects of romance and seduction. In real life, individuals who experience sex following verbal pressure often report psychological distress and long-term negative emotional and physical health consequences (French et al., 2017; Jozkowski & Sanders, 2012; Rothman et al., 2021; Wadsworth et al., 2018).

The purpose of the current paper is to describe the premises and taxonomy that underlie the Verbally Pressured Sexual Exploitation module of the Sexual Experiences Survey (SES-V). We define Verbally Pressured sexual exploitation as any use of verbal or nonphysical pressure (i.e., nonverbal and paraverbal cues) to obtain sexual acts without freely given permission. This paper is connected to the other papers in this special issue, including papers that introduce the updated measure (Koss et al., 2024), present data from the SES-V in application (Anderson et al., 2024; Peterson et al., 2024), as well as the justification for other SES-V modules (Kowalski & Thompson, 2024; Peterson et al., 2024). We hope that this paper helps organize a somewhat disjointed literature on the construct of verbally coerced sexual exploitation by proposing a theorized taxonomy, introducing potentially helpful terminology, and highlighting key questions to spur future research on verbal pressure and related forms of sexual exploitation.

In describing the Verbally Pressured Sexual Exploitation module of the SES-V, we first provide an overview of the SES-V and articulate some basic conceptual premises. Then we discuss how verbal pressure is underrecognized as a form of sexual exploitation and how the construct has been assessed in prior versions of the SES. We then present our collaborative and interdisciplinary approach to item development for the SES-V, including our conceptualization of consent and decision-making processes. We then present our proposed taxonomy of Verbally Pressured sexual exploitation in the SES-V (see Table 1) and justify omitted constructs. We conclude by presenting recommendations for future research using the SES-V to ensure that it is a valid assessment for many different populations.

Table 1. Taxonomy of Verbally Pressured Sexual Exploitation.

Domain	#	Definition and Sub-constructs/Components	Item text	Correspondence to key papers or comparison measures
Positive Verbal Pressure	1	Giving compliments with the intention of coercing sexual activity.	Someone pressured me by saying positive things such as complimenting me, making promises about the future, saying “I love you” or “just do this for me” to: …	Eaton & Matamala, (2014); Livingston et al. (2004)
Neutral Verbal Pressure	2	Behavior is valence neutral in that it does not contain explicit criticism or compliments. May include paraverbal expressions.	Someone pressured me by trying to wear me down by doing things such as asking over and over, pleading, sighing, or rolling their eyes to: …	Black et al. (2011); Camilleri et al. (2009); Eaton & Matamala (2014); Livingston et al. (2004); Shackelford & Goetz, (2004); Straus et al. (1996); Struckman-Johnson et al. (2003); Waldner et al. (1999).
Substance Related Pressure	3, 4	Facilitation of sexual victimization through a deliberate and coercive administration of substances which results in engagement in sexual activity when an individual would not have otherwise. Alcohol (item 4) and drug use (item 5) are treated as separate components.	This question does NOT include situations when you were too intoxicated to give permission for sex. Someone pressured me to drink more alcohol than I wanted by doing things such as buying me drinks or making very strong drinks to engage in sex acts with me when I wouldn’t have otherwise to: … Substance item replaces “alcohol” with “drugs”	Rothman et al. (2021)
Negative Verbal Pressure	5	Subconstruct: Verbal criticism. Explicit expression of personal, critical comments. Could include abusive or mean comments.	Someone pressured me by criticizing, saying things such as, “don’t be so uptight,” “no one else would want you,” “you led me on,” or by questioning my sexuality to: …	Camilleri et al. (2009); Livingston et al. (2004); Shackelford & Goetz, (2004); Tyler et al. (1998); Waldner et al. (1999)
Negative Verbal Pressure	6	Subconstruct: Verbal threats to relationship. Specifically, threats to the relationship including ending the relationship or challenging the exclusivity of the relationship.	Someone pressured me by threatening the relationship in some way such as threatening to break up with me, to have sex with someone else, or questioning my commitment to the relationship to: …	Black et al. (2011); Camilleri et al. (2009); Eaton & Matamala, (2014); Krahé & Berger (2013); Shackelford & Goetz (2004); Struckman-Johnson et al. (2003); Tyler et al. (1998); Waldner et al. (1999)
Negative Verbal Pressure	7	Subconstruct: Verbal threats to social context, specifically to the targeted individual’s social reputation or exclusion.	Someone pressured me by threatening my social reputation, such as saying they would spread rumors about me, reveal private information, out me, or exclude me from social situations to: …	Black et al. (2011); Tyler et al. (1998); Waldner et al. (1999)
Negative Verbal Pressure	9	Subconstruct: Volatile behaviors. These expressions are meant to imply immediate, new episode of violence or abuse.	Someone pressured me by getting mad and by saying and doing things such as yelling, swearing, slamming things, or stomping around (but not using physical force) to: …	Black et al. (2011); Marshall (1992)
Postural Violence	8	Behavioral expressions of anger meant to invoke reminders of past experiences of violence that occurred outside the current sexual context for purposes of current intimidation.	Someone pressured me by saying or doing something that reminded me about how they had been angry, threatening, aggressive, or violent in the past to: …	Shackelford & Goetz, (2004)
Threats to Critical Resources	10	Threats to critical resources, specifically other people and critical life-sustaining resources.	Someone pressured me by threatening my access to something important like my children, money, housing, food, healthcare, medications, or legal documents to: …	Shackelford & Goetz (2004)
Negative Verbal Pressure	11	Subconstruct: Threats to harm self (i.e., suicide) expressed by an intimate partner perpetrator.	Someone pressured me by threatening to harm or kill themselves to: …	Baker, et al. (2014); Camilleri et al. (2009); Coker (2000); Fitzpatrick (2017); Struckman-Johnson et al. (2003)

Note: Indicates where the sub-items describing sexual behaviors begin. Items are listed in hypothesized order of perceived severity. We also consulted measures outside the traditional field of sexual violence in an effort to ensure de-siloing including The Revised Conflict Tactics Scales (Straus et al., 1996), The Conflict in Adolescent Relationships Inventory (Wolfe et al., 2001), the Life Events Checklist (Weathers et al., 2013), the Partner Victimization Scale (Hamby, 2016), and the Measure of Adolescent Relationships Harassment and Abuse (Rothman et al., 2021). Thus, the measures listed here are meant to be illustrative but not exhaustive.

Overview of the SES-V

The SES-V is a new behaviorally specific questionnaire designed to measure exposure to sexual exploitation. The SES has existed in various iterations since 1982 (Koss & Oros, 1982) and because of the precision afforded by behavioral specificity, has become the most frequently utilized assessment of sexual exploitation in adulthood (Fedina et al., 2018). The measurement of sexual exploitation requires three elements in any given item or questionnaire: the sexual behavior, the tactic used to obtain that behavior, and an operationalization of non-consent (Cook et al., 2011). The original SES advanced the field of sexual exploitation research by being very behaviorally specific about sexual behaviors and to some degree, tactics (Koss & Oros, 1982). This allowed respondents to endorse items that corresponded to an experience they have had without having to evaluate the murky meaning and stigmatizing nature of the word, “rape.”

A major shift and innovation in the SES-V is a restructuring to use tactic-first items. In prior versions of the SES, each item began with a description of a sexual behavior, followed by the exploitative tactic used to obtain that sexual act. Prior research has demonstrated that swapping these clauses to put the tactic first increases reporting rates without compromising validity or reliability (Abbey et al., 2005, 2021; Anderson et al., 2021a). These findings suggest that these memories may be stored such that they are more easily retrieved when phrased this way; however, the exact mechanism behind this effect is unknown. Nevertheless, given this finding, the SES-V and the items described in this paper use a compound item structure that begins with a main item stem describing a tactic followed by sub-stem items describing sexual behaviors.

Another goal of the SES-V that is particularly pertinent to understanding Verbally Pressured sexual exploitation was the desire to more fully capture the entire construct of sexual exploitation that occurs in adulthood (Kelly, 1987) even if that required many items. The modularization of the SES-V was undertaken to permit investigators and users with interests in particular forms of sexual exploitation to easily administer only modules specific to their needs. Although we had the goal of structuring each module similarly, some inherent differences in the forms of exploitation required some phrasing and formatting differences. To see the full questionnaire, visit https://tinyurl.com/3z6rf2h5 or see Koss et al. (2024), (Table 1).

Conceptual Premises

The SES-V presents a three-dimensional model of sexual exploitation to contextualize the domains (and corresponding modules) presented in the SES-V (Koss et al., 2024). We used this model to assess items for their degree of bodily invasiveness, form of coercion or pressure used to obtain the sexual act, and social norm violation. Using this model, the Verbally Pressured Sexual Exploitation module (see Table 1) includes items that we conceptualize to be toward the higher end of the continuum of bodily invasiveness as they involve direct contact, including both nonpenetrative and penetrative forms of sexual activity. These items fall toward the middle of the continuum of tactics because this module does not include threats or acts of physical violence. The verbal pressure items are hypothesized to represent the low end of the norm violation dimension of sexual exploitation (Strang & Peterson, 2020), as the tactics included within this module are often regarded as acceptable aspects of sexual relationships (Abbey, 2017; DeGue & DiLillo, 2004).

Further, verbal pressure is highly heterogenous and contextual. What may be wanted in one context is coercive pressure in another. For example, stating positive things to your partner (e.g., “I love you”) can be a welcome statement that enhances the sexual experience and may elicit responsive desire. However, saying “But, I love you” after a partner has declined a request for sex is coercive; this response creates pressure to reverse their initial refusal. Thus, although items within the Verbally Pressured Sexual Exploitation module of the SES-V reflect tactics mostly involving verbal pressure, a minority of the items rely primarily on nonverbal or paraverbal cues (e.g., threatening posture). We recognize that it is somewhat contradictory to have a module titled “Verbally Pressured Sexual Exploitation” that includes some nonverbal behaviors. However, after considerable discussion and deliberation, we agreed that the label “Verbally Pressured Sexual Exploitation” best captured the scope of items included in the module, which centers on the continuum of non-physically forceful means of pressuring someone to engage in sexual activity, most of which have a verbal element. We opted against using “coercion” as the literature has varied in how this term is used, in spite of this being the equivalent label for these items in past versions of the SES. In criminology and related fields, coercion often includes physical force (Benbouriche & Parent, 2018; Bouffard et al., 2016). Similarly, federal law and some but not all state laws use language that contrasts “coercion” with crimes defined by force to imply that coercion does not include force (USC, Title 18, Part 1, Chapter 109A, 2022 see also Texas, North Dakota laws), thus necessitating the modifier verbal or alternate term to coercion. Existing research on related but distinct forms of violence has used the term coercion to include penetrative acts (Bagwell-Gray, 2019; McCauley et al., 2017). We considered whether to use an entirely different term. For example, we considered the term manipulation; however, dictionary definitions of manipulation emphasize these behaviors are “skillful” which captures some but not all the behaviors detailed here (Oxford English Dictionary, 2023). Verbal pressure as a category label seems to potentially minimize behaviors such as threats to critical resources; however, verbal pressure seemed the least problematic and most encompassing of the terms considered. As the literature evolves, new terminology may also evolve and future versions of this Module may have yet a different name.

Verbal Pressure is Underrecognized as Sexual Exploitation

As noted above, popular culture normalizes the use of Verbally Pressured strategies to obtain sex, blurring the line between acceptable flirtatious and seductive behaviors and unacceptable coercive behavior (Abbey, 2017; DeGue & DiLillo, 2004). These cultural norms are built on long-standing patriarchal, cisheteronormative, cultural, religious, and legal norms that view men as privileged (e.g., women owing men sex); that promote the idea of non-males as devious and untrustworthy (e.g., women saying no to sex when they really mean yes); and that allow men to control others’ bodies, particularly in intimate relationships and especially the bodies of minoritized individuals (e.g., rape culture, Brownmiller, 1975; Burt, 1980; Deer, 2015; Johnson et al., 2021; Smith, 1974; Wriggins, 1983). Notably, trans and nonbinary individuals are considered deviant and even lower than women in a gender binary system (Hansen & Żółtak, 2022; Taylor et al., 2018). One of the few empirically supported, effective models for reducing the risk of sexual exploitation devotes considerable time to dismantling these persistent, harmful norms and beliefs, and this dismantling likely contributes to its effectiveness (Senn et al., 2020, 2018). Much of the research that follows has been conducted within the dominant model of cismen as perpetrators and ciswomen as victims; thus, some gendered language is used to accurately reference this work; however, we do not wish to reify the exclusion of trans, gender expansive, and non-binary individuals from sexual exploitation research nor to suggest that only cismen can perpetrate exploitation.

Kanin’s (1967) early work on date rape and hundreds of studies since then have demonstrated that most sexual exploitation occurs between people who know each other and are in a current or past dating, sexual, or other close relationship (Black et al., 2011; Jeffrey et al., 2022). Yet, the normative rape script remains focused on stranger assailants and physically violent tactics, obscuring the more common and less easily recognizable forms of sexual exploitation. Endorsement of rape scripts that promote the idea that rape is typically physically violent (e.g., hitting, pinning the victim down, using a weapon) and that the victims’ actions contributed to what happened remain persistent, including across many cultural groups in the U.S. (Littleton et al., 2007; Littleton & Dodd, 2016; Du Mont et al., 2003; Prina & Schatz-Stevens, 2020; Tummala-Narra et al., 2015; Zidenberg et al., 2022). Not only are rape scripts harmful, normative consensual sexual scripts (sometimes termed the traditional sexual script) also contribute to the high levels of societal tolerance of verbal pressure strategies to obtain sex (Gavey, 2005; Muehlenhard & Peterson, 2004). Specifically, this script situates men as the sexual initiators and women as the sexual gatekeepers, responsible for deciding how far a sexual encounter will go. Further, whereas men are socially rewarded for engaging in casual sex and sex with multiple partners, women are often punished for engaging in the same behavior (e.g., slut-shaming; Endendijk et al., 2020). This promotes the belief that women may feel pressure to first say “no” to sex – even though they intend to say “yes” after repeated inquires – in order to maintain their sexual reputation (Norris et al., 1996). This rape myth encourages persistence after someone clearly states their nonconsent. Women who say no almost ubiquitously mean no (Muehlenhard & Rodgers, 1998) and men are actually quite sensitive to the subtle ways no might be communicated (Gavey, 2005; O’Byrne et al., 2006). Sometimes individuals might feel genuinely ambivalent about sex – that is, they might have reasons for both wanting and not wanting sex – yet still might ultimately say no; such a situation might be misinterpreted as token resistance even though the refusal was genuine (Peterson and Muehlenhard, 2004). Men believe token resistance to be more common than women do (Canan et al., 2018). Many college men still endorse token resistance, reducing their ability to accurately interpret whether consent was provided during various sexual scenarios (Shafer et al., 2018). Thus, cultural scripts and beliefs regarding both normative sexual behaviors (e.g., token resistance) and sexual exploitation (e.g., rape scripts) contribute to high levels of societal tolerance for verbal pressure and societal minimization of the potential negative impact of experiencing verbal pressure. Notably, these sexual scripts center cisgender heterosexual relationships; yet, sexual and gender minority individuals are also exposed to and influenced by these cultural scripts that permeate society (Canan et al., 2020; Ford, 2021; Hackman et al., 2022). Further, misogynist social norms may also paradoxically put men at risk for verbally coerced sexual exploitation because traditional scripts suggest that men are always ready and eager for sex and thus may suggest that men’s sexual consent is irrelevant (Fornicola & Peterson, 2022).

Considering those who instigate exploitation, Strang and Peterson (2020) demonstrated that men who use Verbally Pressured tactics do not try to hide it. They found that men were more likely to report using physical force to obtain sex when they believed their honesty was being monitored by a lie detector, however, presence of the lie detector had no impact on their reports of using Verbally Pressured strategies to obtain sex. These findings suggest that participants did not feel the need to conceal this behavior, consistent with societal acceptance of verbal pressure. These scripts are also promoted by traditional hegemonic masculinity, which blurs the line between seduction and coercive pressure by prioritizing men’s sexual needs and reinforcing rape myths that devalue women’s bodily autonomy (Connell, 1987; Messerschmidt, 2019). The consequence of this societal conceptualization of sexual exploitation as only including incidents involving severe forms of violence is that use of other forms of pressure to obtain sex is normalized and viewed as not harmful. Also, the use of pressure to obtain sex is largely legal (see Peterson et al., 2024 for in-depth discussion of legal statutes including affirmative consent standards).

Verbal Pressure Varies on Extant Sexual Victimization Questionnaires

The SES has always included verbal pressure as a form of sexual exploitation; however, compared to the SES-V, there have been fewer items. Table 2 compares the items used to assess verbal pressure in previous versions of the SES to the current Verbally Pressured Sexual Exploitation module. In this revision, we dropped some content (e.g., telling lies) and expanded both the types of Verbally Pressured tactics and the number of items used to operationalize these tactics. These changes were guided by emerging research described in a later section. Other questionnaires that measure Verbally Pressured sexual exploitation vary in coverage of the construct, ranging from one item to more than 20 items.

Table 2. Verbal coercion or pressure items in SES over the years and correspondence to current taxonomy and phrasing.

Year	Verbal coercion item text	Correspondence to current taxonomy	SES-V related item content
SES 1982	“ … because he threatened to end your relationship otherwise” “ … because you felt pressured by his continual arguments” “ … by saying things he didn’t really mean”	Negative verbal pressure Neutral verbal pressure No direct comparison	“pressured me by threatening the relationship … ” “pressured me by trying to wear me down … ” Not included in current taxonomy
SES 1987	“ … because you were overwhelmed by a man’s continual arguments and pressure”	Neutral verbal pressure	“pressured me by trying to wear me down … ”
SES 2007	“ … Telling lies, threatening to end the relationship, threatening to spread rumors about me, making promises I knew were untrue, or continually verbally pressuring me after I said I didn’t want to.” “ … Showing displeasure, criticizing my sexuality or attractiveness, getting angry but not using physical force, after I said I didn’t want to.”	Negative and neutral verbal pressure Negative verbal pressure; possibly postural violence	“pressured me by threatening the relationship … ” “pressured me by threatening my social reputation … ” “pressured me by trying to wear me down … ” Note: “telling lies” and “making promises I knew were untrue” were not included in current taxonomy. “pressured me by criticizing … ” “pressured me by getting mad and by saying and doing things.” “pressured me by saying or doing something that reminded me about how they had been angry.”

Note: SES = Sexual Experiences Survey

Our Collaborative and Interdisciplinary Approach

The Verbally Pressured Sexual Exploitation module team included seven researchers (the first seven authors of this paper) who volunteered from our larger team of 15 (see Koss et al., 2024). Our team includes both early-career scholars and others who are well established experts. To operationalize the widest range possible of verbal pressure tactics, we instituted two main strategies: brainstorming and consulting prior literature, including literature outside our primary areas to de-silo our thinking (Hamby & Grych, 2013). At the first team meetings, each member brought a previously brainstormed list of ideas and visions for the module. These priorities and behaviors were drawn from team members’ experiences in research, but the literature was not specifically consulted at this time. Then, in turning to the literature, we consulted both specific questionnaires, including the past versions of the SES (see Table 2), articles which offered theoretical perspectives (e.g., Livingston et al., 2004), systematic reviews (R. A. E. Anderson et al., 2021c; Fedina et al., 2018), and measures from related but unique forms of trauma and violence (Straus et al., 1996; Weathers et al., 2013) to ensure there were no gaps in content coverage. We also repeatedly consulted the larger SES-V revision team, including soliciting input on the operationalization of the concept of lack of permission in the context of Verbally Pressured sexual exploitation, selection of tactics to be included, and the wording of items. Two members of the larger team were added as authors to this paper (last two authors) because of their in-depth contributions in providing this periodic feedback.

As a team, our goal was to ensure the SES-V could be used beyond college campus samples that are unrepresentative of the population, consistent with a growing body of evidence indicating that racial, ethnic, sexual, and gender minority groups experience disproportionately high rates of sexual exploitation as compared to White, heterosexual, and cisgender populations, and that many of these groups are less likely to enroll in college and as such are underrepresented in much research on college samples (Abbey et al., 2010; Black et al., 2011; Fedina et al., 2018; National Center for Education Statistics, 2023; Rosay, 2016; Staples & Fuller, 2021; Stotzer, 2009). We adopted an intersectional feminist framework in constructing the Verbally Pressured Sexual Exploitation module to capture as comprehensively as possible the experiences of those who have been relegated to the margins in sexual exploitation research (McCauley et al., 2019). Rooted in Black feminist perspectives (Bilge & Collins, 2016; Collins, 2000; Crenshaw, 1993), intersectionality analyzes how socially constructed power dynamics underlie individuals’ experiences as they relate to intersections of identities, including but not limited to, race/ethnicity, gender, sexual, and economic identities.

As described above, we were heavily influenced by feminist works on gendered sexual power differences and traditionally gendered sexual scripts in thinking about the range of ways that individuals can verbally coerce sexual acts. Further drawing from an intersectional framework, we considered the wording of each item for relevancy and inclusiveness in relation to marginalized identities beyond gender. For example, the new item phrased, “Someone pressured me by threatening my access to something important like my children, money, housing, food, healthcare, medications, or legal documents to … ” was intended to include tactics often used against those living in poverty, immigrants, and people of color (Fedina et al., 2020). Another example is the item, “Someone pressured me by threatening my social reputation, such as saying they would spread rumors about me, reveal private information, out me, or exclude me from social situations to … ” This item uses the phrase “out me” to acknowledge how this often private, confidential information may be used against LGBTQ people by sexual partners. These types of threats may be especially harmful in contexts in which victims hold multiple marginalized identities, for example, being outed can increase risk of homelessness for queer youth, a risk that further varies by race and ethnicity (Morton et al., 2018; Robinson, 2018). The language regarding how someone was “outed” or what aspect of their sexuality was “outed” is intentionally nonspecific to be inclusive of people who engage in consensual non-monogamy, BDSM, and other forms of sexual expression to prioritize sex-positivity and “freedom to” engage in sex in a variety of ways.

We also attempted to develop a work process for writing and revising items that reflected intersectional feminism. Items were drafted by individuals or in group meetings. In editing items, we purposefully varied the order of which authors revised items and provided feedback so that no one team member’s input was given priority over other members either by explicit or implicit power dynamics. Varying the order to give different team members “first bite of the apple” also meant that the identities of different team members took precedence in editing at different times of the process. When we first began the item editing process, junior scholars were assigned as first editors to: a) balance input of junior vs. senior scholars and b) ensure intersectional perspectives were centered from junior team members who represented marginalized identities. We also treated feedback that came about during group meetings as equally important as feedback that was provided via e-mail outside of meetings to be inclusive of team members with family obligations who could not always attend meetings or who may have experienced difficulty providing feedback in a group with senior scholars. We sometimes broke into smaller teams when the larger group got stuck, but always came back to the full team for feedback and review. All items of the module were developed in this way and no items were added without a quorum of group members agreeing the item was necessary.

Consistent with other modules of the SES-V, we also adopted a sex-positive lens that is reflected in how we defined terms, including the conceptualization of consent. Prior versions of the SES were based on the legal code; thus, they prioritized the operationalization of illegal behavior. This version of the SES moves the conceptualization of sexual exploitation beyond narrow legal confines that focus on rape and other related forms of illegal sexual exploitation to a more comprehensive understanding of sexual exploitation. We attempted to center the sexual agency of women and other marginalized individuals who should have freedom to express their sexuality as they desire. As articulated by Fahs (2014), sex-positivity should include freedom to behave as we desire and freedom from oppression. Thus, one goal of the Verbally Pressured Sexual Exploitation module is to elaborate the variety of ways individuals should have freedom from coercion and pressure to have sex while also aiming not to problematize or pathologize instances of unwanted consensual sex (see next section for elaboration), consensual commercial sex, BDSM, or other acts that occur with freely-given permission. Thus, we used theories regarding sexual scripts, intersectionality, and sex-positivity to think through the ways individuals’ sexual agency is stunted by commonly-held social norms (e.g., rape culture). In other words, what are the ways that joyful, enthusiastic, consensual sex of a wide variety of forms is discouraged and hidden? We worked to word items in ways that would not pathologize enthusiastic, consensual sex of any type. By using the term “pressure” in each item we hope to convey non-consent without judging an individual’s sexuality. For example, consensual, planned drinking, role-playing, and paying compliments are all behaviors that could have been unintentionally captured without the clear demarcation of “pressure.”

Complexities in Ascertaining Consent within Verbal Pressure

As described in Peterson et al. (2024), the team put substantial thought into the language used to assess consent and nonconsent in the SES-V. This was especially relevant for the Verbally Pressured Sexual Exploitation module. Verbal pressure may involve eventual capitulation after being worn down in the face of pressure, manipulation, or threats that stop short of bodily harm. In this case, there is a reluctant agreement, not consent that is freely given. It was important that the language we used encourages respondents who experience sexual exploitation to recognize their experience in the text even if they do not perceive (e.g., label) their experiences as exploitive.

Strang and Peterson’s (Strang & Peterson, 2017) interviews with men who completed the SES 2007 perpetration measure identified problems with the language around non-consent in relation to verbal pressure on the prior version of the SES and provided insight into why some men would fail to endorse a verbal pressure item even when they had in fact used verbal pressure to obtain sex. Participants explained that the SES questions used the phrase “without her consent”; however, they had eventually extracted the woman’s consent through the use of pressure or manipulation. One man, said, “I’ve never actually done anything without her consent … I’ve tried to manipulate to getting her consent … I have lied and definitely tried to make crap up to get in her pants, for sure” (p. 980). Given that perpetrators in this study struggled to distinguish between freely given consent and capitulation in the face of verbal pressure, it is likely that those who are exploited might have the same struggle. Thus, we defined “freely given consent” briefly at the start of the Verbally Pressured sexual exploitation module but did not use the terms “consent or “nonconsent” within the body of the questions.

Another potential challenge in assessing experiences of verbal pressure is to avoid inadvertently capturing situations where a person consents to sex when they do not want to, which is sometimes called sexual compliance. This behavior is common in long-term relationships, including marriage (Farvid & Saing, 2022; Hawkey et al., 2019; Impett & Peplau, 2003; O’Sullivan & Allgeier, 1998). In a seminal study, O’Sullivan and Allgeier (1998) found that over a third of college students in committed dating relationships reported consenting to unwanted sex during a two-week period. Commonly identified reasons for engaging in sexual compliance included to satisfy a partner’s sexual need, to promote intimacy, and to avoid relationship tension. Since that original study, a number of other studies have demonstrated that individuals commonly consent to engage in sex that they do not fully want (Darden et al., 2019; Farvid & Saing, 2022; Hawkey et al., 2019; Impett & Peplau, 2003; Peterson & Muehlenhard, 2007; Vannier & O’Sullivan, 2010). Distinguishing between sexual compliance and Verbally Pressured sexual exploitation in survey items can be difficult. For example, if one’s partner showers them with compliments, that person may feel motivated to consent to sex that they do not fully want, not because they feel pressured or obligated, but because they want to show affection for their partner in return; such a situation probably would not qualify as Verbally Pressured sexual exploitation. In contrast, if one’s partner repeatedly showers them with compliments specifically to convince them to have sex and the recipient reluctantly goes along with sex due to feelings of obligation or pressure; such a situation probably would qualify as Verbally Pressured sexual exploitation. As discussed further below, we made careful language choices to try to avoid inadvertently capturing instances of sexual compliance in the absence of verbal pressure, for example, by specifying in the items that the other person (e.g., exploiter or perpetrator) must have engaged in behaviors that pressured the respondent. We encourage researchers to include follow-up questions that help understand the broader context in which the behavior occurred to rule out a variety of possible false-positive endorsements including sexual compliance (for more on false-positive endorsements, see Littleton et al., 2019).

As an alternative to the terms “consent” or “nonconsent,” some sexual exploitation measures refer to tactics used “after you have indicated ‘no’ to their sexual advance” (Struckman-Johnson et al., 2003) or “after they initially said ‘no’” (Strang et al., 2013) as a way to capture the fact that verbal pressure follows an initial refusal but leads to capitulation. These so-called behavioral operationalizations of nonconsent are also potentially problematic because someone’s lack of consent can be conveyed nonverbally (see Muehlenhard et al., 2016, for a review) or through indirect communication (e.g., offering reasons or excuses; Kitzinger & Frith, 1999) rather than through an explicit “no.” In the case of verbal pressure, the person may not necessarily even refuse sex, but may simply be hesitant, reluctant, or ambivalent and thus subjected to pressure. In a qualitative study, Hamby and Koss (2003) found that consent eroded by verbal pressure is not well represented by terms like “forced” or “nonvoluntary.” The word “force” was sometimes perceived as being limited to physical force and the term “nonvoluntary” was perceived as all-or-none and thus excluding more ambiguous forms of verbal pressure.

To address the issues described above, the instructions used in this module specify that “freely-given permission is absent when you were pressured to comply.” This language clarifies the distinction between freely given permission and feeling worn down, overwhelmed, or capitulating in the face of pressure. Additionally, to ensure that items in this module truly measure Verbally Pressured sexual exploitation rather than unwanted but consensual sex, in each item, we clarified that the tactics involved “pressure” to have sex. Although including the term “pressure” in every item may be repetitive, given attentional issues in survey taking (Huang et al., 2015) and the contextual nuance often present in potentially coercive situations, we felt this was necessary. Whether this is effective is a research question to be tested. This wording choice was informed in part by a study where adolescents were asked to indicate whether pressure was being exerted in different hypothetical sexual situations (Rosenthal, 1997). Over 80% of respondents identified instances in which one person indicated they did not want sex and the other person responded with physical or psychological threats as pressure; thereby demonstrating that the term “pressure” is understandable, even to relatively young participants and when items are measuring verbal tactics. Further, that the Sexual Aggression and Victimization-Scale (SAVS) was developed and tested across several European countries and also uses the word pressure to illustrate verbal pressure (Krahé et al., 2016). Qualitative testing suggested that participants understood the phrase “verbal pressure” to mean a variety of behaviors equivalent to lack of freely given permission (Krahé et al., 2016).

Additional Considerations for Word Choice in Item and Module Development

Overall, key research on Verbally Pressured sexual exploitation suggests less is more in developing items (Abbey et al., 2021; Strang & Peterson, 2017; Testa et al., 2015; Yule & Grych, 2022). Specifically, several methodological studies from both victimization and perpetration focused research have highlighted some areas of concern with the 2007 SES verbal pressure items (Abbey et al., 2021; Anderson & Delahanty, 2020; Anderson et al., 2019, 2021a, 2021b; Canan, 2020; Depraetere et al., 2020; Strang & Peterson, 2017), including the length of items (and need for reducing the number of words: Testa et al., 2015) as well as redundancy within item examples (i.e., “making promises I knew were untrue” is the same as “telling lies”). Strang and Peterson (2017) asked men to complete a perpetration version of the 2007 SES and another measure of sexual perpetration. They then interviewed them about their responses to the measures, with particular attention to discrepant reporting across the two perpetration measures. One common reason men gave for endorsing verbal pressure on the other measure but not on the SES is that each item on the SES listed multiple coercive tactics, and the men said that they had engaged in one of the tactics but not all of them. For example, one man, who had lied to a woman to get her to have sex but did not endorse the 2007 SES verbal pressure item said, “[The SES item] says more than just telling lies – ‘telling lies, [threatening] to end the relationship, spread rumors’ – I didn’t do any of that. I just told lies … I’ve done one, but I haven’t done the rest of that” (p. 980). Although that study focused on the measurement of sexual perpetration, it seems plausible that those who have been exploited might also have a difficult time recognizing their experiences fit with an item if what they experienced is a single tactic embedded within a longer list of irrelevant tactics.

Consistent with Strang and Peterson (2017), Anderson and Delahanty (2020) compared rates of verbal pressure victimization on the 2007 SES (Koss et al., 2007) and the Post-Refusal Sexual Persistence Scale (PRSPS; Struckman-Johnson et al., 2003) and found that, for both cisgender men and women, rates of Verbally Pressured sexual exploitation were substantially higher on the other measure as compared to the 2007 SES. The authors suggested that the more complex 2007 SES verbal pressure items as compared to the simpler PRSPS items might have contributed to the lower endorsements on the SES-SFV, consistent with Tummala-Narra et al.’s (2015) findings that the grammatical construction of the 2007 SES is at least twice as complex as the PRSPS. This finding has been replicated since (Anderson et al., 2021a, 2021b) for both victimization and perpetration and in comparison to the Sexual Coercion Inventory for verbal pressure victimization (Marcantonio et al., 2022). Similarly, using a strong experimental design and replicating prior work (Abbey et al., 2005), Abbey et al. (2021) found that the traditional long listing of items in the standard 2007 SES produced lower self-reports of verbal pressure perpetration as compared to tactic-first versions wherein the same tactic content was represented across several items. In sum, a larger number of simpler items as compared to a few more complicated items seems to improve comprehension, result in equivalent validity, and produce higher endorsement rates.

Despite agreement on the importance of simplicity in writing question stems, our team nonetheless struggled when we initially attempted to list only one behavioral example in each item (for item text, see Table 1). There are many important ways that Verbally Pressured sexual exploitation can occur that may not be recalled unless specifically described in the item (Groves et al., 2009). As a result, our team felt it was important to provide multiple examples of each form of coercion or pressure to facilitate memory recall. Finally, we opted to keep the module’s instructions short, given evidence from dating violence research suggesting that additions to the instruction set do not necessarily affect participants’ responses as intended (Hamby, 2016; Sargent et al., 2020; Yule & Grych, 2022). For example, participants instructed to exclude violent acts that occurred while joking around often included them simply because they had occurred – despite the instructions they received (Yule & Grych, 2022). This decision is also consistent with the general survey research literature that simple instructions are preferable to longer or more complex instructions (Tourangeau & Yan, 2007; Ward & Pond, 2015; Yu et al., 2015). The SES-V and this verbal pressure module in particular were designed assuming participants would pay minimal attention to the instructions and be most influenced by the text of the items (i.e., descriptions of behaviors).

Outlining a Comprehensive Taxonomy of Verbally Pressured Sexual Exploitation

Our taxonomy of Verbally Pressured sexual exploitation was informed by prior research showing how various forms of positive, neutral, and negative pressure may be utilized by a partner to obtain sex (Eaton & Matamala, 2014; French et al., 2017; Livingston et al., 2004; Tyler et al., 1998; Waldner et al., 1999). Six domains of Verbally Pressured sexual exploitation are reflected in the taxonomy (see Table 1). The domains are positive verbal pressure, neutral verbal pressure, negative verbal pressure, substance-related pressure, postural violence, and threats to critical resources with some domains containing sub-domains. Items are listed in the module in perceived order of severity¹ to be consistent with how prior versions of the SES were ordered. Further, this order mostly, but not exactly, corresponds to the order in which domains are listed in the taxonomy in Table 1. As described earlier, we included only one type of tactic for each item in the SES-V, which resulted in some domains having more than one item to adequately cover subdomains. Each domain of Verbally Pressured sexual exploitation included in the taxonomy is described in more detail below.

Positive Verbal Pressure

Positive verbal pressure includes situations in which the verbal pressure tactic involves positively-valanced forms of behavior, such as an individual making compliments, making promises for the future, or saying “I love you” or “just do this for me” in the context of trying to pressure someone to have sex (i.e., the tone is positive but the function of the behavior is not). We chose not to include content about lying or false promises, which have been included in past versions of the SES and other sexual violence measures (Black et al., 2011; Struckman-Johnson et al., 2003; Tyler et al., 1998; Waldner et al., 1999) because in the moment, the recipient may not know that it is a lie. Further, regardless of whether the statement is a lie or not, when it is used as a form of pressure to overcome reluctance or refusal, it represents verbal pressure. Livingston et al. (2004) found evidence for positive, neutral, and negative forms of verbal pressure in qualitative interviews with survivors. Positive verbal pressure was most likely to be used in new relationships with the suggestion that sex would lead to more commitment (Livingston et al., 2004).

Neutral Verbal Pressure

Neutral forms of verbal pressure are present in situations in which someone pressures an individual by trying to wear them down by doing things such as asking them over and over, pleading, sighing, or rolling their eyes. Livingston et al. (2004) labeled this as neutral because the persistence was not emotionally charged (p. 291). This form of verbal pressure is a common form of exploitation within established relationships, including friendships as well as romantic partnerships (Crick et al., 2002), and has been included in past versions of the SES and other sexual exploitation measures (Black et al., 2011; Camilleri et al., 2009; Eaton & Matamala, 2014; Shackelford & Goetz, 2004; Straus et al., 1996; Struckman-Johnson et al., 2003; Waldner et al., 1999). The language in the SES-V was carefully chosen based on lessons learned in past research that emphasizes the importance of providing concrete examples of perpetrators’ behavior (e.g., Rueff & Gross, 2017). Thus, the new items eliminate the word continually as used in the 2007 SES and specify behavior instead, including asking them over and over, pleading, sighing, or rolling their eyes.

Pressure to Use Substances

The 2007 SES (Koss et al., 2007) only included sexual exploitation through use of substances in situations in which someone was too impaired to give consent. For example, the 2007 SES included items asking about sexual acts occurring because someone was “taking advantage of me when I was too drunk or out of it to stop what was happening.” Pressure to use substances is assessed with two parallel items – one evaluating alcohol and one evaluating other drugs. For researchers interested in examining the effects of a specific drug, we encourage them to use a follow-up item gathering more information about the substance in question. Drug-facilitated verbally pressured sexual exploitation is rarely assessed (an exception: Rothman et al., 2021).

The current substance-based verbal pressure items aim to capture cases in which someone pushes substance use for the purposes of lowering their inhibitions or increasing their interest in sex, but not completely incapacitating them. Therefore, in this revision of the survey, we have split the substance facilitated exploitation tactics across two modules based on level of intoxication – intoxication without incapacitation is included in the Verbally Pressured Sexual Exploitation module and intoxication with incapacitation is included in the Illegal Sexual Exploitation module. The moderate correlation between the Illegal and Verbally Pressured substance items suggests these experiences may co-occur but also that many participants did differentiate between these items (φ = .44 in Peterson et al., 2024).

Negative Verbal Pressure

Verbal pressure may also be negative or critical in nature (Rapaport & Burkhart, 1984). We recognize that negative verbal pressure could occur in several ways, including: 1) criticism; 2) threats to the relationship; 3) social threats; 4) by showing anger such that an individual thinks they cannot refuse engaging in sexual activity without experiencing harm; or 5) threats of suicide. Thus, we conceptualized negative verbal pressure as a taxonomic component with five sub-constructs (see Table 1). Notably, this component is the most complex of the seven proposed based on the complexity of negative verbal pressure behaviors, prior research available, our conceptualizing of this component, and how we chose to implement findings from prior literature. Thus, particularly for negative verbal pressure content, we carefully evaluated the content of proposed items to ensure that each item was referring to a single form of behavior.

The item assessing negative verbal pressure via criticism includes saying things such as “don’t be so uptight,” “no one else would want you,” “you led me on,” or questioning someone’s sexuality. This form of Verbally Pressured sexual exploitation is reflected in past versions of the SES. This subconstruct was also very common in other sexual violence measures (Camilleri et al., 2009; Shackelford & Goetz, 2004; Tyler et al., 1998; Waldner et al., 1999).

Verbal pressure may also include various forms of threats, excluding threats of physical harm that are covered in the Illegal Sexual Exploitation module of the SES-V (Peterson et al., 2024). Threats may be specific to the relationship, such as threatening to break up with a partner if they do not engage in sexual activity with them, threatening to have sex with someone else if a partner does not comply with sexual acts, or questioning a partner’s commitment to the relationship. Researchers frequently assess this domain (Black et al., 2011; Camilleri et al., 2009; Eaton & Matamala, 2014; Krahé & Berger, 2013; Shackelford & Goetz, 2004; Struckman-Johnson et al., 2003; Tyler et al., 1998; Waldner et al., 1999). We debated extensively as to whether we should include “guilting” someone as a part of this domain. Trying to make someone feel guilty is included in past versions of the SES and some other sexual exploitation measures (Camilleri et al., 2009; Shackelford & Goetz, 2004; Tyler et al., 1998; Waldner et al., 1999); however, item phrasing required participants to infer the perpetrators’ intent rather than describing an observable behavior. Taking this information into account, we omitted guilt as an example in any of the Verbally Pressured sexual exploitation items because of the imperative to focus on external behaviors, rather than internal emotional states. This content may be partially captured by some of the paraverbal behaviors described like sighing [See Table 1, item 2(27)].

Threats may also be social in nature; for example, someone may pressure another person to engage in sexual activity by threatening their social reputation; saying that they will spread rumors about them if they do not comply with sexual activity; threatening to share private information such as photographs, videos or other information intended to be kept secret; threatening to “out” them by revealing their sexual orientation or another hidden identity or behavior to others; or threatening to exclude them from social groups or situations. This form of exploitation is reflected in past versions of the SES and many other sexual exploitation measures (Black et al., 2011; Tyler et al., 1998; Waldner et al., 1999).

Negative verbal pressure may also be communicated through behavioral expressions of anger (e.g., slamming things, yelling, stomping) and other volatile behaviors. Again, we attempted to operationalize this form of pressure by focusing on the person’s behaviors rather than their emotional states because behavior, in contrast to emotion, is readily observable by others. This form of exploitation is reflected in past versions of the SES and at least one intimate partner violence measure (Black et al., 2011; Marshall, 1992). This is distinct from postural violence in which a specific prior instance of harm is invoked (discussed below). Still, there are instances in which these volatile behaviors may not be so distinct from postural violence. Although we generally tried to avoid overlap between items, classical conditioning suggests that even if a volatile behavior is not intended to evoke past violence, it may nonetheless. Thus, in certain situations such as chronic intimate partner violence, a respondent may not be able to distinguish this type of negative verbal pressure from postural violence. However, were we to exclude volatile behaviors altogether, we would likely fail to assess important and relatively common ways that individuals experience sexual exploitation. Preliminary data presented in Peterson et al. (2024) suggests that the postural violence item was not endorsed as frequently as this item, suggesting that participants do differentiate volatile behaviors from postural violence to some degree.

Lastly, threats of self-harm also may be used to coerce an individual to engage in sexual activity. For example, a partner may verbally pressure another person to engage in sexual activity by threatening to harm themselves (e.g., complete suicide). This type of coercion or extreme pressure is included in some sexual exploitation measures (Camilleri et al., 2009; Struckman-Johnson et al., 2003) and is well documented in intimate partner violence research (Baker et al., 2015; Coker, 2000).

Postural Violence

Sexual activity may be coerced because an individual feels that they cannot refuse without incurring harm to themselves or others. This form of pressure occurs because of prior, completed experiences of harm. For example, an individual may feel pressured to engage in sexual activity because a partner said or did something that reminded them of a situation in the past where the partner was abusive, angry, threatening, or violent. This may have included past threats or completed acts of harm to oneself or others such as children or pets – for example, if a partner previously held the respondent down to force sex after an argument and later verbally hints at that same conflict to verbally coerce sex without force. This could also include reminders of times when a person was harmed for refusing sex. Thus, this item reflects content potentially captured in the Illegal Sexual Exploitation module that at a different, later time is presented in a verbal form to instill fear and compliance without repeating the illegal behavior. This form of sexual exploitation is particularly important to include in assessments of verbal pressure given its occurrence as a form of intimate partner violence (Maldonado et al., 2020; Murphy & Hoover, 1999; Myers, 2020).

The postural violence domain was one of the most challenging to operationalize. We considered a range of phrasings and wording options. Our team chose not to use the wording “because you felt you could not refuse” in the item, even though this is likely reflective of individuals’ emotional experiences, because this language does not reflect the instigator(s)’ behavior. Further, this phrase “because you felt you could not refuse” is so broad it could potentially reflect too wide a range of pressures and therefore, not clearly capture the construct. For example, we did not want to capture internal emotional pressures that might reflect sexual compliance. We also wanted to maintain a focus on the specific behavioral tactic that was used to coerce sexual activity (Abbey et al., 2021). Thus, we wanted to specify that the exploiter directly pressured the respondent in some way to distinguish, for example, between instances in which there was direct verbal pressure and instances in which someone felt internal pressure because they did not want to hurt their partner’s feelings or disappoint their partner.

Threats to Critical Resources

Pressure may also relate to threats to material goods, such as keeping an individual from accessing things that are important to them, including their children, money, housing, food, healthcare, medication, or legal documents (e.g., driver’s license, passport, immigration papers). These behaviors are often not codified as illegal because the law often requires an exploiter or perpetrator’s demonstration of intent to cause “serious harm or physical restraint” (National Human Trafficking Hotline, n.d.). For example, hiding one day’s worth of diabetes medication to coerce sexual activity is certainly exploitation, but may not be legally defined as causing serious harm. The broad nature of possible threatened resources listed in this item could overlap with instances of commercial sexual exploitation or sex trafficking, although we purposefully did not include language referencing performance of these behaviors for money to distinguish from this form of illegal sexual exploitation. .

What was Not Included in the Verbally Pressured Sexual Exploitation Module

As our work was focused explicitly on revising and expanding Verbally Pressured sexual exploitation tactics in the SES-V, we did not include in our conceptualization tactics that are purely physical or involved incapacitation, as those are addressed in other modules in the SES-V. This is consistent with prior research suggesting that verbal tactics are often used in the absence of physical or incapacitation tactics (DeGue et al., 2010; Norton-Baker et al., 2018; Parkhill & Abbey, 2008). Similarly, we excluded any descriptions of commercial sexual exploitation though this may sometimes be accomplished through verbal tactics. We also differentiated verbal pressure from verbal sexual harassment in that we are focusing on experiences of contact sexual violence in this module. Indeed, some aspects of verbal sexual harassment are presented in the new Non-Contact module in the SES-V (see Koss et al., 2024).

Directions for Future Research

We lay out aspirational goals for future research and also discuss specific research questions that came up in the process of designing this module. First, we encourage all researchers using the SES-V to adopt an intersectional framework because verbal pressure is such a heterogenous and contextual form of sexual exploitation. Intersectionality is essential for understanding the phenomenology of Verbally Pressured sexual exploitation and how the social, economic, and health consequences of sexual exploitation differentially affect people of color and others from historically marginalized and underserved groups (Basile et al., 2015, 2016; Fedina et al., 2022; Loya, 2014; McGilloway et al., 2020). We recommend that researchers using the SES-V consider including other measures in their study that may help explain and contextualize sexual exploitation experiences. For example, including measures of discrimination and resource access may help contextualize, and possibly serve as a mechanistic explanatory variable (i.e., moderator or mediator) explaining disparate rates of sexual exploitation among various subgroups. For example, research with bisexual women, including women of color, has demonstrated how sexual stigma is associated with heightened rates of sexual victimization (Flanders et al., 2019, 2021) and how perpetrators often mention negative stereotypes of bisexual women while assaulting them (Flanders et al., 2020). Yet intersectional research on sexual exploitation, much less specifically applied to psychometric evaluations, is rare. For example, even though we know that, as a racial group, Indigenous women experience perhaps the greatest vulnerability for sexual exploitation (Rosay, 2016), we are not aware of any studies that have interrogated sexual exploitation questionnaires from an Indigenous women’s perspective to ensure that these measures adequately capture their experiences. We consider inclusive, intersectional research to be a high priority for any future psychometric research on the SES-V, but especially research focusing on Verbally Pressured sexual exploitation. Qualitative and quantitative research with diverse samples of individuals who have often been omitted from sexual exploitation research may help identify types of verbal pressure that need to be included in future versions of this measure.

We encourage all investigators to conduct research that can help improve the measurement of sexual exploitation, including Verbally Pressured exploitation. Although many of us have ideas and projects in mind, the field and the SES itself is strengthened by the inclusion of new innovators and ideas. The SES-V should be rigorously and repeatedly evaluated just like any other new research tool. We encourage researchers to be transparent and carefully document how the SES-V items compare to modified SES-V items or other measures, rather than modifying without transparency or testing, to advance the science of measurement. The ideas we discuss here we hope are just the start and should not be interpreted as an inclusive list nor are these research questions presented in any particular order.

Whether the SES-V items correlate with other sexual exploitation items is merely one piece of evidence supporting the validity of the SES-V with a particular population (they do, in fact, in a college sample; see Anderson et al., 2024). Understanding the psychometric properties of the SES-V will come from a body of research which necessarily needs to be population-specific. We recommend interested readers examine the COSMIN website and criteria for ideas as to how to comprehensively evaluate outcome measures (https://www.cosmin.nl/; Mokkink et al., 2010). Some specific research questions arose during the process of developing this module. For example, writing items that clearly differentiated between verbally pressured substance use and illegal substance use was difficult and resulted in the substance-facilitated verbal pressure items being much longer than any others in the module. These items also include phrases like “when you were not too intoxicated” that are potentially ambiguous, and which cognitive interviewing studies could be helpful in ensuring are interpreted as intended. Another question raised in this article is whether the word “pressure” needs to occur in every item in this module or whether that inclusion impairs careful attention. We struggled mightily to write an item about guilting someone into sex and were not able to come up with a satisfactory solution – we hope others also attempt to develop this item as we expect to revisit and revise the SES-V as data accumulate. As noted, in describing negative verbal pressure we often opted for multiple, distinct items. However, we were less strict with this principle for other components given the paucity of research on other subconstructs. For example, future research may examine whether the threats, to critical resources item, which combines many types of threats is more effectively sub-divided into separate items for health-related, legal, or familial threats.

Next, we detail some questions that apply to the Verbal pressure module especially and to some degree the SES-V more generally. A major structural change between the 2007 SES and the SES-V is the instructions. In the 2007 SES, a paragraph of instructions is given, also including language on confidentiality. The SES-V provides nearly a page of educational information on consent, including many example behaviors. This combined instructional/educational text is lengthy and perhaps unique in its dual purposes. Whether participants read this information and how it influences their responding is an important question (Greenberg & Dillman, 2023), especially for the Verbally Pressured Module wherein respondents may not easily recognize the ways their consent was coerced. Another important project is the development of a short form of the module (and of the SES-V generally). Although researchers explicitly seeking to understand verbal pressure will likely want to administer the entire module, this is not always necessary nor practical. It is likely there is a shorter set of items that would have adequate sensitivity to identify most cases. Critical to this module is understanding order effects: are the substance use items in this module interpreted differently if they are administered alone or before Illegal Sexual Exploitation substance items. Finally, we encourage research on the acceptability and usability of the module. The Verbally Pressured Sexual Exploitation Module is the longest of all the SES-V components capturing a wide range of coercive behaviors with a battery style item layout. Do participants experience the Module as aversive because of the expanded content? Is it cognitively taxing to complete and understand, and if so, under what conditions? Research suggests that emotional distress decreases cognitive processing (Vytal et al., 2012) which means that for sensitive questionnaires like the SES, readability and cognitive load should be low as possible. Although assessing cognitive load is complex (Stenger et al., 2022), the 2007 version of the SES required a college reading level (Anderson et al., 2023; Testa et al., 2015) and it is likely the reading level of this Module is high as well. Survey research suggests that cognitively complex items tend to be skipped or responded to with an acquiescent style (Calderón et al., 2006; Swain et al., 2008). The issue of skipping or acquiescing complex items is magnified on long and complicated questionnaires (Dillman, 2022, and see selected chapters in Beatty et al., 2019 for greater detail on many and related survey design issues). While we feel the length and complexity of this Module is important for comprehensibility and comprehensiveness at this stage of development (Mokkink et al., 2010), it is also important to acknowledge these issues in making the Module accessible to many populations.

Conclusions

Verbal pressure is one of the most common forms of sexual exploitation, yet it is underrecognized in the literature and by those who experience it. Verbally Pressured behaviors impose an ongoing barrier to an individual’s freedom and sexual agency. To expand the SES-V’s assessment of Verbally Pressured sexual exploitation, we developed a six-domain taxonomy with 11 total items that was grounded in theory and empirical literature. Next steps for the field include data collection with diverse populations to elaborate the psychometric properties. We encourage other researchers to join us in generating data to learn how the SES-V functions. As this work continues, we hope that the more comprehensive SES-V leads to a new generation of sexual exploitation research that captures the range of sexually exploitative behaviors that individuals experience, informed by an intersectional perspective. As noted in Koss et al. (2022), over 40 years of research on sexual violence has not yet “moved the needle” in reducing the prevalence of sexual exploitation. We hope that better measurement will encourage more nuanced theoretical and prevention approaches, which in turn, will reduce all forms of sexual exploitation for future generations.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Dr. Anderson’s work is supported by Grant [#5K01AA026643-05]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Notes

¹ We use the language “perceived level of severity” here to indicate the subjectivity of severity ratings. Notably, even if this continuum is supported empirically as corresponding to many individuals’ impression of severity there will also be individual variation in exploitation experiences and how they are experienced that should be honored and respected and not labeled as “severe” or not following a hierarchy such as this.