Association of posttraumatic stress disorder symptoms with migraine and headache after a natural disaster.

Mariana C Arcaya, Sarah R Lowe, Asad L Asad, S V Subramanian, Mary C Waters, Jean Rhodes
Author Information
  1. Mariana C Arcaya: Department of Urban Studies and Planning, Massachusetts Institute of Technology.
  2. Sarah R Lowe: Department of Psychology, Montclair State University.
  3. Asad L Asad: Department of Sociology, Harvard University.
  4. S V Subramanian: Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health.
  5. Mary C Waters: Department of Sociology, Harvard University.
  6. Jean Rhodes: Department of Psychology, University of Massachusetts Boston.

Abstract

OBJECTIVE: 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.
METHOD: 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.
RESULTS: 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.
CONCLUSIONS: 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

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Grants

  1. P01 HD082032/NICHD NIH HHS
  2. R01 HD046162/NICHD NIH HHS
  3. R01 HD057599/NICHD NIH HHS
  4. T32 MH013043/NIMH NIH HHS

MeSH Term

Adult
Disasters
Female
Humans
Male
Migraine Disorders
Prospective Studies
Stress Disorders, Post-Traumatic
Stress, Psychological
Survivors

Word Cloud

Created with Highcharts 10.0.0PTSDsymptomsmigraine/headachedisasterassociatedoddsfrequentmigraineheadachewhetherhigherpostdisaster[1posttraumaticstressdisordernaturalreportingintrusionavoidancehyperarousalsymptomclustersheadache/migrainesamplesurvivorsheightenedexperiencingheadachesmigraines95%confidenceinterval2OBJECTIVE:PreviousresearchshowsgeneralincreasetraumaticeventsQuestionsremainproducesindividualsafflictedespeciallylikelydeveloptestfollowingheadaches/migrainesdecomposeexamineuniquelyrelatedMETHOD:useprospectivelycollectedpre-dataexploreoverallHurricaneKatrinaaccountseverityhurricaneexposurecontrolbaselineproblemsreduceprobabilitysusceptibilityamongalreadysufferedconditionsexplainobservedassociationsRESULTS:standarddeviationchangescorecorrespondingtwice6468]troublepost-KatrinaperiodadditionalpointsubscaleM[SD]=161]55%0333]foundassociationCONCLUSIONS:CliniciansplannersawaremightriskepisodesintrusiveremindersmayaffectedPsycINFODatabaseRecordAssociation

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