title: Sex differences in pain and psychological functioning in persons with limb loss.
abstract: Sex differences in pain are frequently reported in the literature. However, less is known about possible sex differences in the experience of pain secondary to a disability. The current study explored these issues in persons with limb loss (n = 335, 72% men) who were recruited as part of a postal survey. Participants provided ratings of phantom limb pain (PLP), residual limb pain (RLP), and general pain intensity. Participants also completed measures of pain-related interference, catastrophizing, coping, and beliefs. Results indicated that a greater proportion of males than females (86% vs 77%, respectively) reported the presence of PLP; however, this difference was no longer prominent when cause of limb loss was controlled. No sex differences were found in the presence of RLP, or in average intensity ratings of PLP or RLP. In contrast, females reported greater overall average pain intensity and interference than males. Females also endorsed significantly greater catastrophizing, use of certain pain-coping strategies, and beliefs related to several aspects of pain. This study did not find prominent sex differences in pain specific to limb loss. However, several sex differences in the overall biopsychosocial experience of pain did emerge that are consistent with the broader literature.
  
  
  CONCLUSIONS
  The current study contributes to the literature on sex differences in the experience of pain. Although males and females with limb loss did not significantly differ in their disability-specific pain, sex differences in their broader experience of pain were significant and are worthy of future clinical and empirical attention.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98195-6490, USA. ahirsh@u.washington.edu
authors.forename: Adam T
authors.initials: AT
authors.lastname: Hirsh
authors.forename: Tiara M
authors.initials: TM
authors.lastname: Dillworth
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Ehde
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jensen
mesh_terms: D000223:Adaptation, Psychological; D000671:Amputation, Surgical; D000673:Amputation, Traumatic / Q000150:complications / Q000523:psychology*; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000523:psychology*; D010147:Pain Measurement; D010591:Phantom Limb / Q000209:etiology / Q000523:psychology; D012727:Sex Characteristics