Asked veterans their:
- Age 
- Race/ethnicity
- Highest level of education during time of service 
- Form of entry into the military
- Branch 
- Length of service 
- Number of tours 
- Rank  
- Combat exposure 

Demographic Questionnaire: MST & RE Study 

The Quick Inventory of Depressive Symptomatology-Self Report is a 16 item scale utilized by researchers to measure symptoms of depression. Each item on the scale  reflects the 9 DSM–IVs symptom domains and is based on an item-by-item severity scale of 0 to 3.

QIDS-SR

The Generalized Anxiety Disorder-7 is a 7 item scale used to assess anxiety. 

GAD-7

The Insomnia Severity Index is a 7 item scale which measures:

- Severity of insomnia
- Satisfaction with sleep pattern
- Effect of sleep on daytime and social functioning
- Concern about current sleep

Items are rated on a 5-point Likert Scale with 0 (no problem) to 4 (very severe problem), yielding a total score from 0 to 28.

MST was measured using a 7 item Sexual Harassment Scale from the Deployment Risk and Resilience Inventory-2. This scale measures:

- Exposure to sexual harassment (i.e., rumors regarding sexual behavior, crude sexual remarks)
- Threats for not engaging in sexual activities
- Sexual assault (i.e., unwanted sexual touching, attempted touching/rape, and/or rape) from unit members, leaders, or civilians during military service 

Item responses range from 0 (never), to 3 (many times).

Sexual Harrassment Scale 

Restrictive emotionality was measured utilizing the RE subscale of the Gender Role Conflict Scale. It consists of 10 items on a 6-point Likert scale ranging from 1 (strongly disagree), to 6 (strongly agree). This scale was used to assess participants' difficulty and/or reluctance to express emotions.

GRCS-RE

The PTSD Checklist for the DSM-5 is a 20-item scale used by researchers to measure participant's symptoms of PTSD. Responses were scored on a 5 point Likert scale with points ranging from 0 (not at all), to 4 (extremely).

PLC-5

- Demographic Questionnaire
- Sexual Harassment Scale  
- GRCS-RE 
- PCL-5
- QIDS-SR
- GAD-7
- ISI

Saint Louis University

- Background
- Type
- Participants
- Measures Utilized
- Statistical Analysis
- Results & Conclusions
- Limitations
- Implications
- Further Directions for Research

Aspects of MST & RE in Veterans Study

Rivera, L. A., Liang, C. T. H., Johnson, N. L., & Chakravorty, S. (2022). Military sexual trauma: Exploring the moderating role of restrictive emotionality among male veterans. Psychological Trauma: Theory, Research, Practice, and Policy, 14(3), 410–420. https://doi.org/10.1037/tra0000647

Military Sexual Trauma: Exploring the Moderating Role of Restrictive Emotionality Among Male Veterans

Restrictive emotionality (RE) in men who have been exposed to military sexual trauma (MST) has been found by researchers to exacerbate self-reported symptoms of PTSD, depression, and insomnia. This study pushes to incorporate the evaluation of RE in clinical assessments so clinicians can best determine how to treat male veterans suffering from trauma.

Background of Study

The study design implemented by researchers for this study was: 
- Quantitative 
- Cross-Sectional  
- Analytical
- Retrospective 
- Non-experimental

MST & RE Type of Study 

- 134 U.S. male veterans 
- 18-75 years old (mean age of 55)
- Mostly black (44%) and non-Hispanic white (41%)
- Average length of service = 57 months
- Receiving behavioral health treatment at the VA
- Not under the influence of controlled substances


Participants of MST & RE Study 

Measures Utilized in MST & RE Study 

- SPSS 25 managed missing data and check multivariate normality
- PROCESS v3.3 regression analytic method tested the main effects of MST on insomnia severity, PTSD, depressive, and anxiety symptoms, as well as the interaction effects of MST and RE on mental health outcomes
- PROCESS v3.3 also conducted 4 regression analyses using the 4 previously mentioned dependent variables, restrictive emotionality as the moderator variable, and combat exposure (CE) and age as the 2 covariates

Statistical Analysis in MST & RE Study 

- MST is linked to PTSD symptoms and sleep-related concerns
- MST was not associated with depressive or anxiety symptoms 
- RE was positively associated with the development of mental illness 
- RE moderated the relationship between MST and PTSD symptoms, depressive symptoms, and insomnia, but not anxiety symptoms after controlling for CE and age

Results & Conclusions: MST & RE

- Study only utilized treatment-seeking veterans 
- Connivence sampling method reduced generalizability 
- Type and length of treatment being received was not accounted for 
- Passage of time after trauma was not accounted for 
- Unreliability of self-reporting
- Small sample size could have limited statistical power
- Men who completed the survey on the computer may have been more forthcoming with answers 

Limitations in MST & RE Study 

- RE has a negative influence on men's mental health during therapy, which requires the explicit discussion of emotions 
- Clinicians could moderate RE by including self-report measures which assess changes in identifying and expressing emotions following treatment
- Treatment such as CBT helps clients identify how gender role socialization shaped their beliefs and attitudes about emotions and helps them think more flexibly by identifying the pros and  cons of expressing their emotions. 
- Male clinicians may also model and mirror appropriate expressions of emotions through disclosing their own emotional experiences with male clients
- Likewise, helping veterans learn to not restrict their emotions with other men may help them improve the quality of their support systems

Implications of MST & RE Study

Further research could be conducted regarding how masculine cultural norms - like RE - impact mental health outcomes in victims of MST. Likewise, researchers should investigate how MST effects:
- LGBT+ individuals
- Those suffering from eating disorders
- Individuals from diverse racial/ethnic backgrounds

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