Study Examines Gender Differences in Chronic Pain among Veterans
BACKGROUND:
Pain and its impact on physical and emotional functioning have been associated with prior traumatic experiences, low levels of social support, and higher levels of conflict. In particular, these variables have been linked with greater pain intensity, disability, and depressive symptom severity in persons with chronic pain. Notably, gender differences in traumatic exposure, social support, and interpersonal conflict have been observed among Veterans. Thus, this study examined a) gender differences in trauma, social support, and family conflict among Veterans with chronic pain, and b) whether these variables were differentially associated with pain severity, functioning, and depressive symptom severity as a function of gender. Using data from the Women Veterans Cohort Study survey, investigators studied OEF/OIF/OND male and female Veterans who were enrolled in VA healthcare between 9/01 and 9/12 – and who endorsed having pain for three months or longer. Self-report measures included: pain severity, functioning, depressive symptom severity, opioid use, exposure to traumatic life events, emotional and tangible support, and family conflict.
FINDINGS:
- Of the 662 Veterans who completed the survey, 460 (69%) reported experiencing pain for 3 months or longer (67% of men and 71% of women); 75% stated pain had been present more than one year.
- The most problematic sites of pain were: back (37%), joint (33%), headache (12%), and neck (9%).
- Men and women Veterans did not differ significantly in terms of pain severity, pain interference with function, depressive symptom severity, or use of prescription opioids.
- Relative to men, women Veterans reporting chronic pain evidenced higher rates of childhood interpersonal trauma (51% vs. 34%) and military sexual trauma (54% vs 3%), as well as lower levels of combat exposure.
- Being married was associated with greater pain-related functional difficulty for women and lower difficulty for men. Combat exposure was associated with pain-related functional difficulty for women but was unrelated for men. Childhood interpersonal trauma was more strongly associated with pain-related functioning among men. Family conflict was associated with greater pain-related functional difficulty and depressive symptoms for men, but was unrelated for women.
LIMITATIONS:
- The use of cross-sectional data in this study yielded information about associations but precluded predictive conclusions. This study did not assess receipt of VA services or other treatments that might have mitigated pain severity.
- Rates of endorsed military sexual trauma among men were extremely low and may have hampered efforts to detect gender as a moderator of this variable.
- The mild levels of pain and depressive symptoms endorsed by this population of Veterans, not all of whom were seeking treatment, suggests that results may not generalize to Veterans with more severe pain/distress.
IMPLICATIONS:
Gender may be a salient target of investigation when examining development of and/or adaptation to chronic pain, and is an important consideration in tailoring treatment programs to meet the needs of Veterans with chronic pain.
Driscoll M, Higgins D, Seng E, Buta E, Goulet J, Heapy A, Kerns R, Brandt C, and Haskell S. Trauma, Social Support, Family Conflict and Chronic Pain in Recent Service Veterans: Does Gender Matter? Pain Medicine. June 2015;16(6):1101-11.
