Department of Neurology, Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania.
Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania.
Pediatr Neurol. 2021 Aug;121:51-55. doi: 10.1016/j.pediatrneurol.2021.04.004. Epub 2021 Apr 16.
The association between exposure to adverse childhood experiences (ACEs) and increased headache in adults has been well characterized. Childhood adversity and its effect on headache in children have not been as robustly investigated. This study examines the relationship of self-reported ACEs to frequent headache in an adolescent cohort.
We performed a retrospective cohort study using data from the National Longitudinal Study of Adolescent to Adult Health Wave I (n = 20,745) to examine self-reported ACE exposures and their relationship to frequent headache.
The study population was composed of 20,745 participants; 50.6% male and 49.4% female. The mean age of respondents was 15.9 years (range 12 to 21 years, standard error: 0.12 years). Frequent headache was reported in 29.3% of respondents, and 45% of respondents reported one or more ACE exposures. For each increase in cumulative ACE score, odds of frequent headache increased by 1.22 (95% confidence interval [CI] 1.15 to 1.30). The ACEs that individually showed an association with frequent headache after adjusting for demographic factors were lack of maternal warmth (odds ratio [OR] 1.40, 95% CI 1.12 to 1.74, P = 0.002), lack of paternal warmth (OR 1.47, 95% CI 1.20 to 1.81, P < 0.001), paternal alcoholism (OR 1.21, 95% CI 1.05 to 1.40, P = 0.007), suicide attempt of family member (OR 1.51, 95% CI 1.22 to 1.87, P < 0.001), and living in an unsafe neighborhood (OR 1.22, 95% CI 1.06 to 1.39, P = 0.004).
Several ACE exposures were associated with frequent headache in adolescents. An increase in cumulative ACE exposure increased the odds of having frequent headache.
暴露于不良儿童经历(ACEs)与成年人头痛增加之间的关联已得到充分描述。儿童时期的逆境及其对儿童头痛的影响尚未得到充分研究。本研究检查了自我报告的 ACE 与青少年头痛发作频繁之间的关系。
我们使用来自全国青少年纵向健康研究波 I(n=20745)的数据进行了回顾性队列研究,以检查自我报告的 ACE 暴露及其与频繁头痛的关系。
研究人群由 20745 名参与者组成;男性占 50.6%,女性占 49.4%。受访者的平均年龄为 15.9 岁(范围 12 至 21 岁,标准误差:0.12 岁)。29.3%的受访者报告有频繁头痛,45%的受访者报告有一个或多个 ACE 暴露。累积 ACE 评分每增加 1 分,频繁头痛的几率增加 1.22(95%置信区间[CI]1.15 至 1.30)。在调整人口统计学因素后,与频繁头痛相关的 ACE 分别为缺乏母爱(比值比[OR]1.40,95%CI1.12 至 1.74,P=0.002)、缺乏父爱(OR 1.47,95%CI1.20 至 1.81,P<0.001)、父亲酗酒(OR 1.21,95%CI1.05 至 1.40,P=0.007)、家庭成员自杀企图(OR 1.51,95%CI1.22 至 1.87,P<0.001)和生活在不安全社区(OR 1.22,95%CI1.06 至 1.39,P=0.004)。
几项 ACE 暴露与青少年频繁头痛有关。累积 ACE 暴露增加会增加频繁头痛的几率。