{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T03:49:44Z","timestamp":1785037784863,"version":"3.55.0"},"reference-count":46,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"unspecified","delay-in-days":82,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006751","name":"U.S. Army","doi-asserted-by":"publisher","award":["U01MH087981"],"award-info":[{"award-number":["U01MH087981"]}],"id":[{"id":"10.13039\/100006751","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["U01MH087981"],"award-info":[{"award-number":["U01MH087981"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["HU0001-15-2-0004"],"award-info":[{"award-number":["HU0001-15-2-0004"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291726103584_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The impact of combat injury on the development of chronic pain and mental health concerns in combat-exposed populations is unknown. This study examined associations of combat injury and injury\u2013related pain with pain-related factors and mental health outcomes, and potential mediation of the relation between combat injury and mental health outcomes by pain-related factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726103584_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pain interference, pain catastrophizing, pain intensity, post-traumatic stress disorder (PTSD), and major depressive episode (MDE) were assessed in (1) a probability sample of US Army soldiers and veterans cross-sectionally and (2) US Army soldiers before and 1, 3, and 9\u00a0months after deployment to Afghanistan. Associations among these variables were modeled using logistic regression and multiple mediation analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726103584_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5003 service members with cross-sectional data, combat injury\u2013related pain was associated with increased odds of clinically significant pain intensity (OR=2.69), pain interference (OR=3.69), MDE (OR=2.17), and PTSD (OR=3.96) relative to pain from other injuries and conditions. Among 4645 service members assessed pre- and post-deployment, combat injury was associated with increased odds of new-onset pain interference (OR=2.78), pain catastrophizing (OR=2.75), PTSD (OR=4.06), and MDE (OR=2.56) 3\u00a0months post-deployment, and PTSD (OR=2.86) and MDE (OR=1.74) 9\u00a0months post-deployment. Pain-related factors mediated the relations of combat injury with post-deployment PTSD and MDE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726103584_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combat injury is associated with greater odds of pain interference, pain catastrophizing, PTSD, and MDE compared to other sources of pain in a cohort of US service members. Efforts to address pain-related factors following combat injury may mitigate the risk of subsequent chronic pain and mental health disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291726103584","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T04:50:07Z","timestamp":1774327807000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Combat injury, pain, and mental health outcomes in US Army service members"],"prefix":"10.1017","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9702-6191","authenticated-orcid":false,"given":"Marcus G.","family":"Wild","sequence":"first","affiliation":[{"name":"VISN 17 COE: Veterans Integrated Services Network 17 Center of Excellence for Research on Returning War Veterans"},{"name":"Central Texas Veterans Health Care System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2716-5441","authenticated-orcid":false,"given":"Laura","family":"Campbell-Sills","sequence":"additional","affiliation":[{"name":"University of California San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Sun","sequence":"additional","affiliation":[{"name":"University of California San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4831-2305","authenticated-orcid":false,"given":"Ronald C.","family":"Kessler","sequence":"additional","affiliation":[{"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9480-1412","authenticated-orcid":false,"given":"David M.","family":"Benedek","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1861-9173","authenticated-orcid":false,"given":"Robert J.","family":"Ursano","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8408-1247","authenticated-orcid":false,"given":"Sonia","family":"Jain","sequence":"additional","affiliation":[{"name":"University of California San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murray B.","family":"Stein","sequence":"additional","affiliation":[{"name":"University of California San Diego"},{"name":"University of California San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"S0033291726103584_r8","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(02)00471-2"},{"key":"S0033291726103584_r39","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.7.4.524"},{"key":"S0033291726103584_r26","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291709991310"},{"key":"S0033291726103584_r15","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2024.3039"},{"key":"S0033291726103584_r35","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-024-08803-w"},{"key":"S0033291726103584_r18","doi-asserted-by":"publisher","DOI":"10.1037\/a0016906"},{"key":"S0033291726103584_r37","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-7358(00)00071-4"},{"key":"S0033291726103584_r27","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2019.1608717"},{"key":"S0033291726103584_r46","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.15842"},{"key":"S0033291726103584_r25","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000003094"},{"key":"S0033291726103584_r9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2025.104775"},{"key":"S0033291726103584_r11","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnab287"},{"key":"S0033291726103584_r2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2009.01517.x"},{"key":"S0033291726103584_r13","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2005.11.018"},{"key":"S0033291726103584_r24","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-009-0981-1"},{"key":"S0033291726103584_r28","doi-asserted-by":"publisher","DOI":"10.1037\/ser0000506"},{"key":"S0033291726103584_r30","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usac232"},{"key":"S0033291726103584_r31","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291707001389"},{"key":"S0033291726103584_r33","unstructured":"R Core Team, R. 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