{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:36:44Z","timestamp":1784302604029,"version":"3.55.0"},"reference-count":58,"publisher":"SAGE Publications","issue":"17-18","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>\n                    U.S. Service members and Veterans (SM\/V) experience elevated rates of traumatic brain injury (TBI), chronic pain, and other non-pain symptoms. However, the role of non-pain factors on pain interference levels remains unclear among SM\/Vs, particularly those with a history of TBI. The primary objective of this study was to identify factors that differentiate high\/low pain interference, given equivalent pain intensity among U.S. SM\/V participating in the ongoing Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) national multi-center prospective longitudinal observational study. An explainable machine learning was used to identify key predictors of pain interference conditioned on equivalent pain intensity. The final sample consisted of\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 1,577 SM\/Vs who were predominantly male (87%), and 83.6% had a history of mild TBI(s) (mTBI), while 16.4% were TBI negative controls. The sample was categorized according to pain interference level (Low: 19.9%, Moderate: 52.5%, and High: 27.6%). Both pain intensity scores and pain interference scores increased with the number of mTBIs (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001), and there was evidence of a dose response between the number of injuries and pain scores. Machine learning models identified fatigue and anxiety as the most important predictors of pain interference, whereas emotional control was protective. Partial dependence plots identified that marginal effects of fatigue and anxiety were associated with pain interference (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001), but the marginal effect of mTBI was not significant in models considering all variables (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &gt; 0.05). Non-pain factors are associated with functional limitations and disability experience among SM\/V with an mTBI history. The functional effects of pain may be mediated through multiple other factors. Pain is a multi-dimensional experience that may benefit most from holistic treatment approaches that target comorbidities and build supports that promote recovery.\n                  <\/jats:p>","DOI":"10.1089\/neu.2024.0126","type":"journal-article","created":{"date-parts":[[2024,6,22]],"date-time":"2024-06-22T08:43:32Z","timestamp":1719045812000},"page":"1621-1630","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The Impact of Non-Pain Factors on Pain Interference Among U.S. Service Members and Veterans with Symptoms of Mild Traumatic Brain Injury"],"prefix":"10.1177","volume":"42","author":[{"given":"Eamonn","family":"Kennedy","sequence":"first","affiliation":[{"name":"Informatics, Decision-Enhancement and Analytic Sciences Center, Virginia Salt Lake City Health Care System, Salt Lake City, Utah, USA."},{"name":"Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Manhapra","sequence":"additional","affiliation":[{"name":"Hampton VA Medical Center, Hampton, Virginia, USA."},{"name":"Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8925-1321","authenticated-orcid":false,"given":"Shannon R.","family":"Miles","sequence":"additional","affiliation":[{"name":"Mental Health and Behavioral Sciences Service, James A. Haley Veterans\u2019 Affairs Hospital, Tampa, Florida, USA."},{"name":"Department of Psychiatry &amp; Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0059-3454","authenticated-orcid":false,"given":"Sarah","family":"Martindale","sequence":"additional","affiliation":[{"name":"Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Research and Academic Affairs Service Line, W.G. (Bill) Hefner VA Healthcare System, Salisbury, North Carolina, USA."},{"name":"Department of Physiology &amp; Pharmacology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3655-3411","authenticated-orcid":false,"given":"Jared","family":"Rowland","sequence":"additional","affiliation":[{"name":"Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Research and Academic Affairs Service Line, W.G. (Bill) Hefner VA Healthcare System, Salisbury, North Carolina, USA."},{"name":"Department of Neurobiology &amp; Anatomy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helal","family":"Mobasher","sequence":"additional","affiliation":[{"name":"Informatics, Decision-Enhancement and Analytic Sciences Center, Virginia Salt Lake City Health Care System, Salt Lake City, Utah, USA."},{"name":"Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Myers","sequence":"additional","affiliation":[{"name":"Informatics, Decision-Enhancement and Analytic Sciences Center, Virginia Salt Lake City Health Care System, Salt Lake City, Utah, USA."},{"name":"Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samin","family":"Panahi","sequence":"additional","affiliation":[{"name":"Informatics, Decision-Enhancement and Analytic Sciences Center, Virginia Salt Lake City Health Care System, Salt Lake City, Utah, USA."},{"name":"Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Walker","sequence":"additional","affiliation":[{"name":"PM &amp; R Service, Richmond Veterans Affairs Medical Center (VAMC), Richmond, Virginia, USA."},{"name":"Department of Physical Medicine and Rehabilitation (PM&amp;R), Virginia Commonwealth University, Richmond, Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4196-7763","authenticated-orcid":false,"given":"Mary Jo","family":"Pugh","sequence":"additional","affiliation":[{"name":"Informatics, Decision-Enhancement and Analytic Sciences Center, Virginia Salt Lake City Health Care System, Salt Lake City, Utah, USA."},{"name":"Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2018.07.006"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usab199"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2019.12.009"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2019.1658590"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002153"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.abj0320"},{"issue":"2","key":"e_1_3_5_8_2","first-page":"25","article-title":"Assessment of common comorbidity phenotypes among older adults with knee osteoarthritis to inform integrated care models","volume":"5","author":"Lentz TA","year":"2021","unstructured":"Lentz TA, , Hellkamp AS, , Bhavsar NA, et al. Assessment of common comorbidity phenotypes among older adults with knee osteoarthritis to inform integrated care models. Mayo Clin Proc Innov Qual Outcomes, 2021; 5(2):25.","journal-title":"Mayo Clin Proc Innov Qual Outcomes"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/ar3449"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000027"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.08.010"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2003.08.001"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.137.5.535"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.59.8.795"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1037\/a0035514"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2018.02.013"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6736a2"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2016.06.009"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-009-0981-1"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0192623"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000518"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20130372"},{"key":"e_1_3_5_23_2","unstructured":"Main CJ Keefe FJ Jensen MP et al. Fordyce\u2019s behavioral methods for chronic pain and illness: Republished with invited commentaries 2014."},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2019.04.015"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/2049463713493264"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2018.1492740"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2016.1219061"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2018.1479041"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2016.04.029"},{"issue":"2","key":"e_1_3_5_30_2","first-page":"173","article-title":"Pain and psychology-a reciprocal relationship","volume":"17","author":"Vadivelu N","year":"2017","unstructured":"Vadivelu N, , Kai AM, , Kodumudi G, et al. Pain and psychology-a reciprocal relationship. Ochsner J, 2017; 17(2):173\u2013180.","journal-title":"Ochsner J"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000529"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2014.3433"},{"issue":"6","key":"e_1_3_5_33_2","first-page":"CP1","article-title":"Management of Concussion\/m TBIWG. VA\/DoD Clinical practice guideline for management of concussion\/mild traumatic brain injury","volume":"46","year":"2009","unstructured":"Management of Concussion\/m TBIWG. VA\/DoD Clinical practice guideline for management of concussion\/mild traumatic brain injury. J Rehabil Res Dev, 2009; 46(6):CP1\u201368.","journal-title":"J Rehabil Res Dev"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001199-199309000-00010"},{"key":"e_1_3_5_35_2","volume-title":"Behavioral Risk Factor Surveillance System","author":"Rolle-Lake L","year":"2023","unstructured":"Rolle-Lake L, , Robbins E. Behavioral Risk Factor Surveillance System. StatPearls. Treasure Island (FL), 2023."},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1002\/jts.21868"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000149"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usaa249"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617714000320"},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102410379890"},{"key":"e_1_3_5_41_2","first-page":"35","article-title":"Measures in health psychology: A user\u2019s Portfolio","volume":"1","author":"Schwarzer R","year":"1995","unstructured":"Schwarzer R, , Jerusalem M. Measures in health psychology: A user\u2019s Portfolio. Causal and Control Beliefs, 1995; 1:35\u201337.","journal-title":"Causal and Control Beliefs"},{"key":"e_1_3_5_42_2","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000131"},{"key":"e_1_3_5_43_2","doi-asserted-by":"publisher","DOI":"10.1177\/1073191113508807"},{"key":"e_1_3_5_44_2","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22059"},{"key":"e_1_3_5_45_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_3_5_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"e_1_3_5_47_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15-0903"},{"key":"e_1_3_5_48_2","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0b013e318230fb17"},{"key":"e_1_3_5_49_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1010933404324"},{"key":"e_1_3_5_50_2","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1013203451"},{"key":"e_1_3_5_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2014.12.004"},{"key":"e_1_3_5_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.09.004"},{"key":"e_1_3_5_53_2","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.12526"},{"key":"e_1_3_5_54_2","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2013.01.0006"},{"key":"e_1_3_5_55_2","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2009.01.0006"},{"key":"e_1_3_5_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2020.12.063"},{"key":"e_1_3_5_57_2","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2016.1219055"},{"key":"e_1_3_5_58_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002800"},{"key":"e_1_3_5_59_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2023.0381"}],"container-title":["Journal of Neurotrauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/neu.2024.0126","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2024.0126","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2024.0126","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:45:23Z","timestamp":1777675523000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/neu.2024.0126"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":58,"journal-issue":{"issue":"17-18","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1089\/neu.2024.0126"],"URL":"https:\/\/doi.org\/10.1089\/neu.2024.0126","relation":{},"ISSN":["0897-7151","1557-9042"],"issn-type":[{"value":"0897-7151","type":"print"},{"value":"1557-9042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]}}}