Associations between military sexual trauma and chronic pain in men and women active military members and veterans.

INTRODUCTION

We evaluated gendered risks and the associations between demographics, anxiety, and depressive symptoms, military sexual trauma (MST), and severe pain in Canadian military personnel and veterans.

METHODS

A cross-sectional sample of 328 veterans and military members with chronic pain completed confidential surveys, including demographics, disability, pain location, and intensity, as well as a Patient Health Questionnaire (PHQ-4). We evaluated gendered exposures (rates, odds ratios), associations between MST and severe pain (logistic regression), and associations with pain severity and PHQ-4 (linear regression), adjusting for age, race, and education.

RESULTS

We found high levels of chronic pain and disability for women and men (6.8 or 6.9/10), PHQ-4 scores (6.6 or 6.2/12), and SANE scores (11% or 10%). Women reported higher exposure to MST (e.g. 69% for sexual harassment, 76% for emotional abuse) than men (8% and 13%). Odds of severe pain were not gendered (OR = 1.05). Physical abuse (β = 1.09, p = .030) and gender discrimination (β = 1.10, p = .033) were associated with higher PHQ-4 scores. Sexual harassment was not independently associated (OR = 1.57, p = .354) with chronic pain, but was associated with increased anxiety and depressive symptoms (β = 1.06, p = .016). Higher PHQ-4 scores were significantly associated with higher pain scores (β = 0.18, p < .001).

CONCLUSIONS

MST exposures are much more common among women, but the associations of MST with severe pain and PHQ-4 scores are similar across genders. Differences in operational trauma and occupational trauma may influence occupational stress injuries and chronic pain.