This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective: To examine the relationship of recalled adverse childhood experiences (ACEs) with migraine and episodic tension-type headache (ETTH).
Methods: We conducted a cross-sectional analysis of ACEs among 2007 American Migraine Prevalence and Prevention Study survey respondents with ETTH and migraine. We modeled headache type using logistic regression adjusting for sociodemographic variables (age, race, sex, income), depression, and anxiety, and headache day frequency using ordinal logistic regression with a proportional odds model.
Results: Participants had migraine (n = 8,305) or ETTH (n = 1,429). Rates of ACEs were significantly higher among respondents with migraine than ETTH for emotional neglect (24.5% vs 21.5%), emotional abuse (22.5% vs 16.7%), and sexual abuse (17.7% vs 13.3%). Odds of migraine vs ETTH were significantly higher for those reporting emotional neglect (odds ratio [OR] = 1.23, 95% confidence interval [CI] 1.07–1.42), emotional abuse (OR = 1.46, 95% CI 1.25–1.71), or sexual abuse (OR = 1.35, 95% CI 1.11–1.62) when adjusted for sociodemographics. Results remained significant only for emotional abuse when adjusting for depression and anxiety (OR = 1.33, 95% CI 1.13–1.57). Odds of migraine were higher with 2 (OR 1.52, 95% CI 1.25–1.86) vs 1 (OR 1.17, 95% CI 1.00–1.36) ACE, which held after adjusting for depression and anxiety. All forms of maltreatment were associated with higher headache day frequency category in migraine but results lost significance after adjusting for depression and anxiety.
Conclusions: ACEs are associated with a higher risk of migraine vs ETTH. Attenuation of the influence of ACEs by depression and anxiety suggests confounding or mediation, although results for emotional abuse were generally maintained.
GLOSSARY
- ACE=
- adverse childhood experience;
- AMPP=
- American Migraine Prevalence and Prevention;
- CI=
- confidence interval;
- CTQ=
- Childhood Trauma Questionnaire;
- DSM-IV=
- Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition);
- EM=
- episodic migraine;
- ETTH=
- episodic tension-type headache;
- ICHD-2=
- International Classification of Headache Disorders, second edition;
- OR=
- odds ratio;
- PHQ=
- Patient Health Questionnaire;
- PHQ-9=
- Patient Health Questionnaire–depression module
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received September 23, 2013.
- Accepted in final form September 8, 2014.
- © 2014 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
