Arcaya Mariana C, Lowe Sarah R, Asad Asad L, Subramanian S V, Waters Mary C, Rhodes Jean
Department of Urban Studies and Planning, Massachusetts Institute of Technology.
Department of Psychology, Montclair State University.
Health Psychol. 2017 May;36(5):411-418. doi: 10.1037/hea0000433. Epub 2016 Dec 8.
Previous research shows that migraine and general headache symptoms increase after traumatic events. Questions remain about whether posttraumatic stress disorder (PTSD) produces migraine/headache symptoms, or if individuals afflicted by migraine/headache are especially likely to develop PTSD. We test whether PTSD symptoms following a natural disaster are associated with higher odds of reporting frequent headaches/migraines postdisaster. We decompose PTSD into intrusion, avoidance, and hyperarousal symptom clusters to examine which, if any, are uniquely related to headache/migraine postdisaster.
We use prospectively collected pre- and postdisaster data to explore whether overall PTSD symptoms and symptom clusters are associated with migraine/headache in a sample of Hurricane Katrina survivors. We account for severity of hurricane exposure and control for baseline migraine and headache problems to reduce the probability that heightened PTSD susceptibility among those who already suffered from the conditions could explain observed associations.
PTSD symptoms were associated with higher odds of experiencing frequent headaches or migraines with a standard deviation change in PTSD score corresponding to over twice the odds (95% confidence interval [1.64, 2.68]) of having trouble with frequent headaches or migraines in the post-Katrina period. Each additional point on the intrusion subscale (sample M [SD] = 1.6 [1.1]) was associated with 55% higher odds of reporting frequent headache/migraine (95% confidence interval [1.03, 2.33]), but we found no association with avoidance or hyperarousal symptoms.
Clinicians and disaster planners should be aware that disaster survivors might be at heightened risk of migraine/headache episodes, and those experiencing intrusive reminders may be most affected. (PsycINFO Database Record
先前的研究表明，创伤性事件后偏头痛和一般性头痛症状会增加。关于创伤后应激障碍（PTSD）是否会引发偏头痛/头痛症状，或者偏头痛/头痛患者是否特别容易患上创伤后应激障碍，仍存在疑问。我们测试自然灾害后的创伤后应激障碍症状是否与灾后报告频繁头痛/偏头痛的较高几率相关。我们将创伤后应激障碍分解为侵入性、回避性和过度警觉症状群，以检查哪些症状群（如果有的话）与灾后头痛/偏头痛有独特关联。
我们使用前瞻性收集的灾前和灾后数据，探讨卡特里娜飓风幸存者样本中创伤后应激障碍的总体症状和症状群是否与偏头痛/头痛相关。我们考虑了飓风暴露的严重程度，并控制了基线偏头痛和头痛问题，以降低那些已经患有这些疾病的人创伤后应激障碍易感性增加可能解释观察到的关联的可能性。
创伤后应激障碍症状与经历频繁头痛或偏头痛的较高几率相关，创伤后应激障碍评分的标准差变化对应于卡特里娜飓风后频繁头痛或偏头痛出现问题几率的两倍多（95%置信区间[1.64, 2.68]）。侵入性子量表上每增加一分（样本均值[标准差]=1.6[1.1]），报告频繁头痛/偏头痛的几率就会增加55%（95%置信区间[1.03, 2.33]），但我们未发现与回避性或过度警觉症状有关联。
临床医生和灾难规划者应意识到，灾难幸存者可能面临偏头痛/头痛发作风险增加，而那些经历侵入性回忆的人可能受影响最大。（PsycINFO数据库记录
