Adverse Childhood Experiences and Frequent Headache by Adolescent Self-Report

Anto, Marissa; Jaffee, Sara R.; Tietjen, Gretchen E.; Mendizabal, Adys; Szperka, Christina L.

doi:10.1016/j.pediatrneurol.2021.04.004

Cited by 15 publications

(13 citation statements)

References 24 publications

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“…Similarly, others have observed cross-sectional relationships between the number of ACEs and headache but did not investigate migraine independently. 5,6 Within the present study, the magnitude of the observed direct associations between the number of ACEs and incident health-professional diagnosed migraine are consistent with the associations reported in the other pediatric studies. [3][4][5][6] Because the number of adverse events tapered off quickly following two, we could not examine associations beyond two or more stressors.…”

Section: Discussionsupporting

confidence: 91%

“…5,6 Within the present study, the magnitude of the observed direct associations between the number of ACEs and incident health-professional diagnosed migraine are consistent with the associations reported in the other pediatric studies. [3][4][5][6] Because the number of adverse events tapered off quickly following two, we could not examine associations beyond two or more stressors.…”

Section: Discussionsupporting

confidence: 91%

“…Cross-sectional evidence has demonstrated associations between ACEs and chronic pain, 3 including migraine and other headache disorders, in children and adolescents. [4][5][6] To our knowledge, to date, no study has provided longitudinal evidence for a relationship between reported ACEs and the onset of headache disorders before adulthood.…”

Section: Introductionmentioning

confidence: 99%

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Adverse childhood experiences and onset of migraine in Canadian adolescents: A cohort study

2022

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Background Adverse childhood experiences (ACEs) are cross‐sectionally associated with headache, including migraine, in pediatric populations. Objective The objective of this study was to determine whether ACEs are prospectively associated with incident health‐professional diagnosed migraine and prevalence of non‐migraine frequent headache in adolescence, either directly or indirectly through symptoms of depression and anxiety. Methods We used data from the National Longitudinal Survey of Children and Youth, a Canadian cohort study that followed children aged 0/1 at baseline, and the person most knowledgeable about them (PMK) until the child reached adolescence. The PMK reported on 14 ACEs (e.g., parental death) when the child was 4/5 and 6/7 years, and symptoms of depression and anxiety in late childhood (age 8/9 years), using a validated tool. Migraine (primary outcome) was ascertained via PMK report of a health‐professional diagnosis, and non‐migraine frequent headache (>1 time per week) was adolescent self‐report, both measured at age 14/15. We estimated direct and indirect effects (IEs) on the log‐odds scale through symptoms of depression and anxiety (mediator). We adjusted for sex, parental migraine, and economic deprivation. The analytic sample sizes were: n = 2058 (migraine) and n = 1730 (frequent headache). Results There were nunweighted = 71 respondents with migraine (3.4%, 71/2058) and nunweighted = 204 with non‐migraine frequent headache (11.8%, 204/1730). Most respondents experienced no ACEs (weighted percentage = 55.7), followed by 1 ACE (weighted percentage = 34.7) and greater than or equal to two ACEs (weighted percentage = 9.6), respectively. There were direct associations between experiencing one (odds ratio [OR] = 1.71, 95% confidence interval [CI]: 1.01–2.87) and equal to or greater than two (OR = 2.33, 95% CI: 1.13–4.80) ACEs and migraine, but not for non‐migraine frequent headache. There were no indirect relationships through symptoms of depression and anxiety for migraine (1 ACE: OR = 1.06, 95% CI: 0.99–1.13 and ≥2 ACEs: OR = 1.11, 95% CI: 0.98–1.28) or non‐migraine frequent headache (1 ACE: OR = 0.99, 95% CI: 0.95–1.03 and ≥2 ACEs: OR = 0.98, 95% CI: 0.90–1.07). Conclusions ACEs may confer an increased risk of migraine onset in adolescence. The association was not explained by symptoms of depression and anxiety in late childhood.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

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Adverse childhood experiences and onset of migraine in Canadian adolescents: A cohort study

2022

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“…For instance, parental symptoms have been associated with children’s acute, chronic, and experimental pain experiences, attributed, in part, to social learning, parental responsiveness to pain, or other potential mechanisms 31–34. Race, family stress, and adverse childhood experiences have also been associated with persistent, frequent, or multisite pain 17,35–38…”

mentioning

confidence: 99%

Biopsychosocial Attributes of Single-region and Multi-region Body Pain During Early Adolescence

Senger-Carpenter¹,

Scott

Isaman³

et al. 2022

The Clinical Journal of Pain

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Objectives: Multi-region pain during adolescence is associated with a higher symptom burden and lower quality of life. The purpose of this study was to describe and compare the biopsychosocial attributes of single-region and multi-region pain among healthy young adolescents. Materials and Methods: We analyzed data from 10,320 children aged 10.6 to 14 years who self-reported pain in the Adolescent Brain and Cognitive Development Study. Pain was coded as single-region or multi-region based on body map data. Results: One in 5 young adolescents indicated recent multi-region pain. Sequential regression supported improved model fit when psychological and sociocultural factors were added to a biological model of pain; however, these models improved the classification of multi-region but not single-region pain. A significant interaction effect of sex and puberty remained constant across models with increased odds of pain at each advancing pubertal stage for both sexes compared with prepuberty, but no difference between girls and boys at late puberty (adjusted odds ratio [OR]=2.45 [1.72, 3.49] and adjusted OR=1.63 [1.20, 2.23], respectively). Psychological factors improved the classification of multi-region pain with significant effects of anxiety, somatic symptoms, and somnolence. Finally, compared with White and non-Hispanic children, Black and Hispanic children were less likely to report pain (adjusted OR=0.70 [0.61, 0.80]; adjusted OR=0.88 [0.78, 0.99], respectively) but had significantly higher pain interference when pain was present (adjusted OR=1.49 [1.29, 1.73] and adjusted OR=1.20 [1.06, 1.35], respectively). Discussion: Pain is a biopsychosocial phenomenon, but psychological and sociocultural features may be more relevant for multi-region compared with single-region pain during early adolescence.

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“…Further limitations among the morass of cross-sectional studies in adults included incomplete characterization of types, frequency, and temporal sequence of ACEs and headache. Studies of ACEs and headache in children and adolescents are fewer, [10][11][12][13][14][15][16][17] and although they minimize some of the limitations of adult studies, potential obstacles to getting valid information remain. Youthful participants, for instance, may be reluctant to report abuse due to fear of punishment or rejection, and their parents may deny maltreatment because they are unaware, or wish to shield themselves or perpetrators in the household from blame, thus leading to underestimation of the prevalence of ACEs.…”

mentioning

confidence: 99%

The relationship of childhood adversity and migraine and the value of prospective studies

Tietjen

2022

Headache

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The relationship of childhood adversity and migraine and the value of prospective studiesThe first report of a link between childhood maltreatment and recurrent headache appeared over 30 years ago, in a small study of adult women recounting a history of childhood sexual abuse. 1 Several studies confirming an association of headache and contact (sexual and/or physical) abuse followed, 2-5 but it was another 20 years before the scope of investigation of this particular association was expanded to include emotional childhood abuse, as well as exposure to traumatizing household dysfunction (family member substance abuse, mental illness, incarceration, witnessing maternal battering, and parental separation/divorce). 6 The results from the 2010 analysis of the large, landmark Adverse Childhood Experiences (ACE) study dataset demonstrated that frequent headache was associated with each of the eight types of ACEs evaluated, particularly emotional abuse, and that there was a dose-response relationship between cumulative ACE score and prevalence/risk of headache in adults. 6 The American Migraine Prevalence and Prevention study that followed in 2015, 7 was the first publication to use International Classification of Headache Disorders criteria in a nationally representative sample evaluating the maltreatment-headache link while also controlling for depression and anxiety. The queries on maltreatment only encompassed emotional neglect, emotional abuse, and sexual abuse, but, nevertheless, results demonstrated that, compared with adults with episodic tension-type headache, adults with migraine were more likely to recall abuse and neglect in childhood. The American Migraine Prevalence and Prevention study, 7 most preceding it, 1-6 and two large adult population-based studies that followed it, 8,9 corroborated the associations of adverse childhood events with adult headache/migraine. All, however, have been limited by their retrospective design, and with this the looming specter of recall bias, particularly How to cite this article: Tietjen GE. The relationship of childhood adversity and migraine and the value of prospective

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Adverse Childhood Experiences and Frequent Headache by Adolescent Self-Report

Cited by 15 publications

References 24 publications

Adverse childhood experiences and onset of migraine in Canadian adolescents: A cohort study

Adverse childhood experiences and onset of migraine in Canadian adolescents: A cohort study

Biopsychosocial Attributes of Single-region and Multi-region Body Pain During Early Adolescence

The relationship of childhood adversity and migraine and the value of prospective studies

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