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.