MacDermid Joy C, Pouliopoulou Dimitra V, Walton David M, Kibble Angel, Bobos Pavlos
School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada.
Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada.
Can J Pain. 2025 May 28;9(1):2494582. doi: 10.1080/24740527.2025.2494582. eCollection 2025.
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.
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.
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 ( = 1.09, = .030) and gender discrimination ( = 1.10, = .033) were associated with higher PHQ-4 scores. Sexual harassment was not independently associated (OR = 1.57, = .354) with chronic pain, but was associated with increased anxiety and depressive symptoms ( = 1.06, = .016). Higher PHQ-4 scores were significantly associated with higher pain scores ( = 0.18, < .001).
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.
我们评估了加拿大军事人员和退伍军人中不同性别的风险，以及人口统计学、焦虑和抑郁症状、军事性创伤（MST）与严重疼痛之间的关联。
对328名患有慢性疼痛的退伍军人和军事人员进行横断面抽样调查，完成保密调查问卷，内容包括人口统计学、残疾情况、疼痛部位和强度，以及患者健康问卷（PHQ-4）。我们评估了不同性别的暴露情况（发生率、比值比）、MST与严重疼痛之间的关联（逻辑回归），以及与疼痛严重程度和PHQ-4之间的关联（线性回归），并对年龄、种族和教育程度进行了调整。
我们发现，男性和女性的慢性疼痛和残疾水平较高（6.8或6.9/10）、PHQ-4评分（6.6或6.2/12）以及SANE评分（11%或10%）。女性报告的MST暴露率高于男性（例如，性骚扰为69%，情感虐待为76%，而男性分别为8%和13%）。严重疼痛的几率不存在性别差异（比值比=1.05）。身体虐待（比值比=1.09，P=0.030）和性别歧视（比值比=1.10，P=0.033）与较高的PHQ-4评分相关。性骚扰与慢性疼痛无独立关联（比值比=1.57，P=0.354），但与焦虑和抑郁症状增加相关（比值比=1.06，P=0.016）。较高的PHQ-4评分与较高的疼痛评分显著相关（β=0.18，P<0.001）。
MST暴露在女性中更为常见，但MST与严重疼痛和PHQ-4评分之间的关联在不同性别中相似。作战创伤和职业创伤的差异可能会影响职业应激损伤和慢性疼痛。
