title: Self-Reported Pain in Male and Female Iraq/Afghanistan-Era Veterans: Associations with Psychiatric Symptoms and Functioning.
abstract: OBJECTIVE
  To examine pain symptoms and co-occurring psychiatric and functional indices in male and female Iraq/Afghanistan-era veterans.
  
  
  METHODS
  Self-reported data collection and interviews of Iraq/Afghanistan-era veterans who participated in a multisite study of postdeployment mental health.
  
  
  METHODS
  Veterans were enrolled at one of four participating VA sites.
  
  
  METHODS
  Two thousand five hundred eighty-seven male and 662 female Iraq/Afghanistan-era veterans.
  
  
  METHODS
  Nonparametric Wilcoxon rank tests examined differences in pain scores between male and female veterans. Chi-square tests assessed differences between male and female veterans in the proportion of respondents endorsing moderate to high levels of pain vs no pain. Multilevel regression analyses evaluated the effect of pain on a variety of psychiatric and functional measures.
  
  
  RESULTS
  Compared with males, female veterans reported significantly higher mean levels of headache ( P  < 0.0001), muscle soreness ( P  < 0.008), and total pain ( P  < 0.0001), and were more likely to report the highest levels of headache ( P  < 0.0001) and muscle soreness ( P  < 0.0039). The presence of pain symptoms in Iraq/Afghanistan-era veterans was positively associated with psychiatric comorbidity and negatively associated with psychosocial functioning. There were no observed gender differences in psychiatric and functional indices when levels of pain were equated.
  
  
  CONCLUSIONS
  Although female Iraq/Afghanistan-era veterans reported higher levels of pain than male veterans overall, male and female veterans experienced similar levels of psychiatric and functional problems at equivalent levels of reported pain. These findings suggest that pain-associated psychological and functional impacts are comparable and consequential for both male and female veterans.
authors.affiliation: Research and Development.|Mental Health Service Line.|Department of Psychiatry and Behavioral Sciences.|VA Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, North Carolina.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Naylor
authors.affiliation: Department of Psychiatry and Behavioral Sciences.|VA Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, North Carolina.
authors.forename: H
authors.initials: H
authors.lastname: Ryan Wagner
authors.affiliation: Department of Psychiatry and Behavioral Sciences.|VA Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, North Carolina.
authors.forename: Mira
authors.initials: M
authors.lastname: Brancu
authors.affiliation: Health Services Research & Development, Durham Veterans Affairs Medical Center, Durham, North Carolina.
authors.forename: Megan
authors.initials: M
authors.lastname: Shepherd-Banigan
authors.affiliation: Mental Health Service Line.|Department of Psychiatry and Behavioral Sciences.|VA Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, North Carolina.
authors.forename: Eric
authors.initials: E
authors.lastname: Elbogen
authors.affiliation: Department of Psychology, Old Dominion University, Norfolk, Virginia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Kelley
authors.affiliation: Mental Health Service Line.
authors.forename: Teresa
authors.initials: T
authors.lastname: Fecteau
authors.affiliation: Health Services Research & Development, Durham Veterans Affairs Medical Center, Durham, North Carolina.|Division of General Internal Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: Karen
authors.initials: K
authors.lastname: Goldstein
authors.affiliation: Research and Development.|Department of Psychiatry and Behavioral Sciences.|VA Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, North Carolina.
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Kimbrel
authors.affiliation: Research and Development.|Mental Health Service Line.|Department of Psychiatry and Behavioral Sciences.|VA Mid-Atlantic Mental Illness, Research Education and Clinical Center (MIRECC), Durham, North Carolina.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Marx
authors.affiliation: Department of Psychiatry and Behavioral Sciences.|Department of Veterans Affairs, Mental Health Services, Washington, DC, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Strauss
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology* / Q000523:psychology*; D057566:Self Report; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Female; Function; Gender; Male; Mental Health; Pain Disorder; Veteran