Biopsychosocial determinants of chronic pain amongst Canadian Armed Forces veterans
| dc.contributor.author | Buhler, Jeremiah | |
| dc.contributor.examiningcommittee | El-Gabalawy, Renee (Clinical Health Psychology) | en_US |
| dc.contributor.examiningcommittee | Reynolds, Kristin (Psychology) | en_US |
| dc.contributor.examiningcommittee | Tkachuk, Gregg (Clinical Health Psychology) | en_US |
| dc.contributor.examiningcommittee | Hawkins, Brent (University of North Carolina at Wilmington) | en_US |
| dc.contributor.supervisor | Holens, Pamela | |
| dc.date.accessioned | 2023-01-09T15:13:55Z | |
| dc.date.available | 2023-01-09T15:13:55Z | |
| dc.date.copyright | 2023-01-06 | |
| dc.date.issued | 2022-10-05 | |
| dc.date.submitted | 2023-01-06T22:36:44Z | en_US |
| dc.degree.discipline | Psychology | en_US |
| dc.degree.level | Doctor of Philosophy (Ph.D.) | en_US |
| dc.description.abstract | Chronic pain is a significant health concern in Canada and abroad. While greater prevalence rates are found among military veterans as compared to the general population, little research has explored psychosocial factors associated with chronic pain amongst Canadian Armed Forces (CAF) veterans. Recently, a revised biopsychosocial (BPS) model of chronic pain for military veterans has been proposed to provide a conceptual framework for understanding the dynamic interactions between BPS factors and persistent pain within US veteran samples. This thesis employed a mixed methods approach to explore determinants of chronic pain amongst CAF veterans. The first study utilized both the Canadian Community Health Survey Canadian Forces Supplement (CCHS- CFS; 2002), and the associated follow-up survey, Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey 2018 (CAFVMHS; 2018). Cross-sectional logistic regression analyses found depression, anxiety, PTSD, and social support to be associated with increased odds of chronic pain conditions (OR) in a sample of CAF veterans (N = 1,905). Contrary to the proposed BPS model, work stress and AUD were not associated with persistent pain in this sample. Longitudinal analyses showed that only depression was associated with new onset chronic pain. Study 2 applied qualitative methods, informed by constructivist grounded theory, to examine CAF veteran perceptions on the development and maintenance of their chronic pain in relation to BPS and cultural factors. Fifteen male veterans described the initial causes and contributing factors of chronic pain as being influenced by physiological causes (i.e., injury, wear and tear, and inadequate medical care) and barriers to treatment seeking (i.e., perceived impacts on career, stigma, and internalized warrior ethos). Themes describing current contributing factors included chronic conditions, psychosocial influences (i.e., PTSD, depression, and stress), and difficulties obtaining coverage for healthcare services. A mixed-methods convergent design was employed to examine the convergence and divergence between studies. Analyses revealed concurrent findings on most biological conditions, as well as depression and PTSD. However, notable divergence was observed between studies on anxiety, social support, and stress. Findings from both studies highlight the burden of chronic pain on this vulnerable population and emphasized the role of psychosocial and cultural factors in the development and exacerbation of persistent pain. Implications of these findings and direction for future research are discussed. | en_US |
| dc.description.note | February 2023 | en_US |
| dc.description.sponsorship | Deer Lodge Centre Foundation | en_US |
| dc.identifier.uri | http://hdl.handle.net/1993/37071 | |
| dc.language.iso | eng | en_US |
| dc.rights | open access | en_US |
| dc.subject | chronic pain | en_US |
| dc.subject | veteran | en_US |
| dc.subject | military | en_US |
| dc.subject | Canadian Armed Forces | en_US |
| dc.subject | biopsychosocial model | en_US |
| dc.title | Biopsychosocial determinants of chronic pain amongst Canadian Armed Forces veterans | en_US |
| dc.type | doctoral thesis | en_US |
| local.subject.manitoba | no | en_US |
| oaire.awardTitle | UMGF | en_US |
| project.funder.identifier | https://doi.org/10.13039/100010318 | en_US |
| project.funder.name | University of Manitoba | en_US |