Lay Summary

Principal Investigator: Don Richardson

Chronic pain is defined as pain which lasts for a period of three or more months. Veterans represent one demographic which are of higher risk of developing chronic pain and mental health conditions. Almost half (41%) of Canadian Armed Forces (CAF) Veterans who were released from service between 1998-2015 reported experiencing chronic pain. Another study found that 85% of Regular Force CAF Veterans with at least one mental health condition also reported chronic pain. Research suggests that the common co-occurrence of these disorders may be due to Veterans having a shared vulnerability to such which leads to the mutual maintenance of both disorders. For example, posttraumatic stress disorder (PTSD) symptoms may worsen chronic pain symptoms and vice-versa. Researchers have also found that there may be gender-specific differences in how Veterans experience chronic pain and disorders such as PTSD; however, the reasoning behind these differences is minimally understood.

Our study aimed to provide a greater understanding of the association between chronic pain and mental health conditions in CAF Veterans, and the possible influence of gender on these associations. We utilized clinical self-report data from 1,798 mental health treatment-seeking Veterans and currently serving CAF members who consented for their data to be used in research.

Age was a significant predictor of pain severity in individuals with PTSD symptoms. Overall, we found that symptoms of depression, PTSD, and all PTSD symptom clusters other than avoidance were significantly associated with pain severity and pain interference with life. These associations were replicated in women, while in men, avoidance symptoms were associated with both pain severity and interference.

Overall, our study identified that among CAF Veterans seeking mental health treatment, those with greater PTSD symptoms also had higher levels of pain severity and interference. Further, these effects were minimally influenced by gender; however, there was a notable gender-based difference observed regarding how chronic pain interacts with expressions of PTSD symptom clusters (i.e., avoidance). Ultimately, these findings can be used to better inform clinicians in optimally treating individuals with PTSD and/or chronic pain and may indicate future research directions.