Associations of chronic pain and PTSD factors among military personnel: An exploration of the mutual maintenance model

LAY SUMMARY The authors explored the relationship between chronic pain and posttraumatic stress disorder (PTSD) among Canadian Armed Forces (CAF) service members and Veterans. They examined the mutual maintenance model (MMM), which states that certain thoughts, feelings, and behaviours in chronic pain maintain PTSD, and certain aspects of PTSD maintain chronic pain. The authors investigated the MMM factors maintaining these disorders among 233 CAF service members and Veterans who completed an online survey and found that intrusive trauma memories were associated with chronic pain. Anxiety was associated with PTSD. The more hyper-alert participants were, the more severe their pain was and the more their pain interfered with their lives. The findings did not entirely align with MMM predictions. Instead, only intrusive trauma memories were associated with chronic pain, only anxiety was associated with PTSD, and only hyper-alertness was associated with pain severity and interference. Even though this study cannot establish causation, it suggests that these factors may exacerbate chronic pain and PTSD.