An application of the biopsychosocial model for pain in Canadian Veterans Life After Service Studies 2019 survey

Chronic pain continues to be a highly prevalent condition among Canadian Veterans. This study applied the biopsychosocial framework to chronic pain, using different structural equation modelling solutions. This approach allowed for assessment of all factors simultaneously with a model with latent variables. One of the model solutions showed demographic variables do not predict chronic pain. However, these variables should be used to control the modelling process because of their statistical differences. Moreover, biological factors, such as an increased number of physical problems, increased the likelihood of having chronic pain. Psychosocial factors showed increased scores for not having chronic pain. Introduction: Chronic pain is highly prevalent and disruptive to the general population. Relative to civilians, Veterans are more likely to experience chronic pain due to occupational requirements during military service and associated psychological difficulties. The biopsychosocial model is a promising theoretical framework for understanding potential causes of chronic pain, as well as a path for implementing evidence-based interventions. Methods: This study applied the biopsychosocial framework to data from the Life After Service Studies 2019 survey by modelling biopsychosocial predictors of chronic pain and controlling for relevant participant and military demographics. The use of structural equation modelling solutions allowed the biopsychosocial model to be assessed simultaneously as a model with latent variables, rather than traditional regression or logistic analyses. Results: Biological factors and a combined psychological and social factor were related to an increased likelihood of having chronic pain. The three-model solution showed anxiety, posttraumatic stress disorder, suicidal ideation, and life stress were positively associated, while hypervigilance, alcohol use, social support, and labour force status was negatively related to the latent variable. Discussion: Results showed specific biopsychosocial factors were related to chronic pain through different structural equation modelling solutions. Understanding the contribution of biopsychosocial factors can inform evidence-based interventions and policy changes through multidisciplinary approaches. Introduction : La douleur chronique est tres repandue dans la population generale, et tres perturbatrice. Par rapport a la population civile, les veteran(e)s sont plus susceptibles de souffrir de douleurs chroniques en raison des exigences du metier de militaire et des difficultes psychologiques qui lui sont associees. Le modele biopsychosocial est un cadre theorique prometteur pour comprendre les causes potentielles de la douleur chronique, en meme temps qu'une voie propice a la mise en oe uvre d'interventions fondees sur des donnees probantes. Methodes : Cette etude applique l'approche methodologique biopsychosociale aux donnees de l'Enquete sur la vie apres le service militaire de 2019, en modelisant les predicteurs biopsychosociaux de la douleur chronique tout en controlant les variables liees aux donnees demographiques pertinentes des participant(e)s et des militaires. L'utilisation de solutions de modelisation par equation structurelle a permis d'evaluer simultanement le modele biopsychosocial en tant que modele a variables latentes plutot que modele classique d'analyses regressives ou logistiques. Resultats : Des facteurs biologiques et un facteur psychologique et social combine sont lies a une probabilite accrue de souffrir de douleur chronique. La solution a trois modeles montre que l'anxiete, le trouble de stress posttraumatique, les idees suicidaires et le stress de la vie sont positivement associes, tandis que l'hypervigilance, la consommation d'alcool, le soutien social et la situation sur le marche du travail sont negativement lies a la variable latente. Discussion : Au moyen de differentes solutions de modelisation par equation structurelle, les resultats montrent que des facteurs biopsychosociaux specifiques sont lies a la douleur chronique. Comprendre la contribution des facteurs biopsychosociaux permet d'influencer les interventions fondees sur des donnees probantes, de meme que les changements de politiques, a partir d'approches multidisciplinaires.