title: Recalled maltreatment, migraine, and tension-type headache: results of the AMPP study.
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.
authors.affiliation: From the Department of Neurology (G.E.T.), University of Toledo, OH; Department of Neurology (D.C.B., R.B.L.), Albert Einstein College of Medicine, Bronx; Montefiore Headache Center (D.C.B., R.B.L.), Bronx, NY; and Vedanta Research (K.M.F., D.S., M.L.R.), Chapel Hill, NC. gretchen.tietjen@utoledo.edu.
authors.forename: Gretchen E
authors.initials: GE
authors.lastname: Tietjen
authors.affiliation: From the Department of Neurology (G.E.T.), University of Toledo, OH; Department of Neurology (D.C.B., R.B.L.), Albert Einstein College of Medicine, Bronx; Montefiore Headache Center (D.C.B., R.B.L.), Bronx, NY; and Vedanta Research (K.M.F., D.S., M.L.R.), Chapel Hill, NC.
authors.forename: Dawn C
authors.initials: DC
authors.lastname: Buse
authors.affiliation: From the Department of Neurology (G.E.T.), University of Toledo, OH; Department of Neurology (D.C.B., R.B.L.), Albert Einstein College of Medicine, Bronx; Montefiore Headache Center (D.C.B., R.B.L.), Bronx, NY; and Vedanta Research (K.M.F., D.S., M.L.R.), Chapel Hill, NC.
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Fanning
authors.affiliation: From the Department of Neurology (G.E.T.), University of Toledo, OH; Department of Neurology (D.C.B., R.B.L.), Albert Einstein College of Medicine, Bronx; Montefiore Headache Center (D.C.B., R.B.L.), Bronx, NY; and Vedanta Research (K.M.F., D.S., M.L.R.), Chapel Hill, NC.
authors.forename: Daniel
authors.initials: D
authors.lastname: Serrano
authors.affiliation: From the Department of Neurology (G.E.T.), University of Toledo, OH; Department of Neurology (D.C.B., R.B.L.), Albert Einstein College of Medicine, Bronx; Montefiore Headache Center (D.C.B., R.B.L.), Bronx, NY; and Vedanta Research (K.M.F., D.S., M.L.R.), Chapel Hill, NC.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Reed
authors.affiliation: From the Department of Neurology (G.E.T.), University of Toledo, OH; Department of Neurology (D.C.B., R.B.L.), Albert Einstein College of Medicine, Bronx; Montefiore Headache Center (D.C.B., R.B.L.), Bronx, NY; and Vedanta Research (K.M.F., D.S., M.L.R.), Chapel Hill, NC.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Lipton
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D018781:Tension-Type Headache / Q000453:epidemiology* / Q000523:psychology