Evaluating Sex Differences in Biomarkers of Chronic Pain Among Active-Duty Personnel: An Exploratory Analysis of a Pragmatic Clinical Trial With a SMART Design

Sotaro Shimada, Shannon Ledesma, Diane M. Flynn, Nathan Tintle, Jeffrey C. Ransom, Honor M. McQuinn, Tyler J. Snow, Nicholas Ieronimakis, Dahee Wi, Larisa A. Burke, Alana D. Steffen, Ardith Z. Doorenbos, College of Nursing, University of Illinois Chicago, Physical Performance Service line, Joint Base Lewis-McChord, Madigan Army Medical Center, Department of Clinical Investigation, Joint Base Lewis-McChord, Madigan Army Medical Center, Department of Anesthesiology and Pain Medicine, University of Washington

Biological Research For Nursing: Integrating Biobehavioral Research into Health Care

Published online on February 03, 2026

Abstract

Biological Research For Nursing, Volume 28, Issue 3, Page 384-394, July 2026.
Chronic pain affects approximately one-third of active-duty service members (ADSMs), yet effective treatment remains challenging. Salivary cortisol and urinary 8-hydroxy-2ʹ-deoxyguanosine (8-OHdG) are established non-invasive biomarkers of stress and ...