Document Type


Publication Date




Publication Title

Pain Medicine








Objective. To examine pain symptoms and co-occurring psychiatric and functional indices in male and female Iraq/Afghanistan-era veterans.

Design. Self-reported data collection and interviews of Iraq/Afghanistan-era veterans who participated in a multisite study of postdeployment mental health.

Setting. Veterans were enrolled at one of four participating VA sites.

Subjects. 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.


2017 American Academy of Pain Medicine. This work is written by US Government employees and is in the public domain in the US. Gold open access.

Original Publication Citation

Naylor, J. C., Wagner, H. R., Brancu, M., Shepherd-Banigan, M., Elbogen, E., Kelley, M., . . . Veter, V. A. M.-A. M. W. (2017). Self-reported pain in male and female Iraq/Afghanistan-era veterans: Associations with psychiatric symptoms and functioning. Pain Medicine, 18(9), 1658-1667. doi:10.1093/pm/pnw308