Introduction
Sexual assault can be a life-changing traumatic event that can lead to posttraumatic stress or posttraumatic stress disorder (PTSD; Smith & Pick, 2015). In one undergraduate sample, 22% of students reported experiencing sexual assault at some point during college (Mellins et al., 2017). The #MeToo movement has increased awareness of the impact of sexual violence (MeToo, 2018). However, for many, sexual assault assessments are still a difficult medium in which to disclose their experiences (Cook et al., 2011). In this literature review, I examine one assessment measure of sexual victimization, the strengths and limitations of this measure, and sexual assault assessments for minority groups.
Definition of Sexual Assault
The broad definition of sexual assault makes it difficult to create a universal assessment for sexual victimization. The Rape, Abuse & Incest National Network (RAINN, 2019) defines sexual assault as: “sexual contact or behavior that occurs without the consent of the victim.” This includes attempted rape, unwanted sexual touching, rape, or other sexual acts such as oral penetration. However, sexual assault assessments and research studies do not always accurately encompass these prevailing definitions.
Another difficulty is that most of the studies in this area focus on college students or veterans; this makes it difficult to generalize to community populations (for reviews, see Owens et al., 2005; Mellins et al., 2017; Littleton et al., 2018; Anderson et al., 2018). Furthermore, no matter the assessment instrument selected, participants may not disclose for a multitude of reasons: they do not feel their experiences are representative within the question; discomfort with the interviewer; shame; and fear surrounding confidentiality and consequences of disclosure (e.g., stigma, blame, or disbelief; Testa, Livingston, & Koss, 2004).
With the aforementioned issues and other concerns in detecting sexual victimization in assessments and interviews, researchers need to focus on validating measures of sexual assault with empirical techniques (Cook et al., 2011). It has been observed that approximately 41% of violence (including sexual violence) researchers will create their own assessment without providing psychometric data on the measure or disclosing information regarding the definitions for the assessment’s constructs (White, Yuan, & Cook, 2013). This approach makes it difficult to replicate these studies and reliably use their measures. Despite the importance of sexual assault assessments and associated research, there are few validated and reliable scales widely used in studies. I will explore one of the more researched assessment tools, the Sexual Experiences Survey (SES; Koss et al., 1982) and its revision (Koss et al., 2007) further.
Sexual Experiences Survey
The SES(Koss et al., 1982) was considered the “gold standard” for assessing sexual experiences by using behavioral questions. This approach of using behavioral questions rather than asking direct questions requiring participants to label their experiences as an assault has been shown to be a more reliable way of assessing for sexual assault (Anderson et al., 2018; Littleton et al., 2018; Davis et al., 2014). The original SES has strong internal consistency (a= .74 women; a= .89 men) and test-retest reliability within a two-week period of 93% (Koss & Gidycz, 1985). The survey consists of 10 items in a yes/no format and includes female victimization and male perpetration.
The measure was restructured in 2007 (SES-R; Koss et al.) to be gender neutral with a more detailed description of coercion tactics that a perpetrator may use during sexual assault. While the questions are intended to be primarily gender-neutral, there are questions that reference non-universal genitalia, e.g., vaginal penetration (Koss et al., 2007). The questions are behaviorally described based on various forms of specific assault, e.g. “Someone fondled, kissed, or rubbed up against the private areas of my body (lips, breast/chest, crotch or butt) or removed some of my clothes without my consent (but did not attempt sexual penetration).” Other improvements included language revisions, distinctions between different types of assault, frequency of assault, and alcohol or drug-facilitated assaults. The assessment focuses on the type of assault (i.e., unwanted sexual contact, attempted but not completed non-consensual penetration, completed rape) and the method of assault (i.e., verbal coercion, physical force, incapacitation through use of drugs/substances, and threat or use of physical harm). The assessment also delineates age of victimization by asking participants to indicate if the assault occurred after the age of 14 or within the past 12 months.
Strengths
The SES-R performs moderately well when assessing individuals with sexual assault histories (Littleton et al., 2018). This instrument has also been used to assess sexual victimization of battered women compared to the Revised Conflict Tactics Scale (CTS2; Moreau et al., 2014). The SES-R’s behavior-oriented questions have also been helpful in combating underreporting of sexual victimization that is a challenge among other sexual assault measures.
It is important to note that the SES-R has allowed researchers to study the effects of alcohol use on sexual victimization while incapacitated, the type of perpetration that is most seen when under the influence of substances. Incapacitation is the most common type of perpetration reported within a college sample, regardless of gender (Mellins et al., 2017). The SES-R is able to capture these events that may otherwise go unacknowledged by the victim.
Limitations
Even though the SES-R is used frequently in research, there are several limitations. One limitation involves inconsistency; including participants endorsing specific items on the SES-R but not necessarily at follow-up (one to four weeks re-test; Littleton et al., 2018). This pattern does not appear when responding to rape or sexual assault questions that include physical force (Littleton et al., 2018). Another limitation is the lack of psychometric data for culturally diverse populations (Gillmore et al., 2016), despite the high prevalence of victimization among minority groups (e.g., Edwards et al., 2015; Bryant-Davis, Ullman, Tsong, Tillman, & Smith, 2010) and the need for large, unmet care among these individuals. Furthermore, scoring the SES-R may not account for the wide range of experiences that women report (Davis et al., 2014).
Conclusion
The #MeToo movement has increased the amount of public attention on sexual assault and has allowed for people to discuss their experiences more openly. The SES-R, which is widely used in research, provides a measure to assess for a wide range of sexual assault experiences. However, there are issues with the SES-R of which administrators need to be aware. Sexual assault assessment measures tend not be normed with diverse samples and minority populations are typically not used to validate assessment measures despite the high prevalence of violence in these groups. Future research should continue to explore and improve the psychometric properties of these measures with older adults and minority groups.
References
Anderson, R. E., Cahill, S. P., & Delahanty, D. L. (2016). The psychometric properties of the sexual experiences survey-short form victimization (SES-SFV) and characteristics of sexual victimization experiences in college men. Psychology of Men & Masculinity,1,25-34.
Bryant-Davis, T., Ullman, S. E., Tsong, Y., Tillman, S., & Smith, K. (2010). Struggling to survive: Sexual assault, poverty, and mental health outcomes of African American women. American Journal of Orthopsychiatry, 80,61-70.
Cook, S. L., Gidycz, C. A., Koss, M. P., & Murphy, M. (2011). Emerging issues in the measurement of rape victimization. Violence Against Women,17,201–218.
Davis, K. C., Gilmore, A. K., Stappenbeck, C. A., Balsan, M. J., George, W. H., & Norris, J. (2014). How to score the sexual experiences survey: a comparison of nine method. Psychology of Violence,4, 445-461.
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Koss, M. P., Abbey, A., Campbell, R., Cook, S., Norris, J., Testa, M., Ullman, S., West, C., & White, J. (2007). Revising the SES: A collaborative process to improve assessment of sexual aggression and victimization. Psychology of Women Quarterly,31, 357-370.
Koss, M. P., & Gidycz, C. A. (1985). Sexual Experiences Survey: Reliability and validity. Journal of Consulting and Clinical Psychology, 53,422-423.
Koss, M. P., & Oros, C. J. (1982). The Sexual Experiences Survey: An empirical instrument investigating sexual aggression and victimization. Journal of Consulting and Clinical Psychology, 50,455-457.
Littleton, H., Layh, M., Rudolph, K., & Haney, L. (2018). Evaluation of the Sexual Experiences Survey–Revised as a screening measure for sexual assault victimization among college students. Psychology of Violence. Advance online publication.
Mellins, C. A., Walsh K., Sarvet A. L., Wall M., Gilbert L., Santelli J.S., et al. (2017). Sexual assault incidents among college undergraduates: Prevalence and factors associated with risk. PLoS ONE 12(11): e0186471. https://doi.org/10.1371/journal.pone.0186471
Moreau, C., Boucher, S., Hebert, M., & Lemelin, J. (2015). Capturing sexual violence experiences among battered women using the revised sexual experiences survey and revised conflict tactics scales. Archives of Sexual Behavior,44,223-231.
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Rape, Abuse, and Incest National Network (2009). Sexual assault. Retrieved fromhttps://www.rainn.org/articles/sexual-assault
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Kayleigh Watters received her master’s degree from Pepperdine University in clinical psychology with an emphasis in marriage family therapy. She is now a second-year doctoral student at Palo Alto University’s PhD clinical psychology program where she is beginning her training as a trauma-focused researcher and clinician. Currently, she is working at a dual diagnosis substance use and mental health clinic as a psychology doctoral student.
