Citation
Tietjen, Gretchen; Karmakar, Monita; Elhai, Jon; & Amialchuk, Aliaksander (2016). Exploring the Effect of Childhood Abuse on Migraine, Depression and Anxiety Using Structural Equation Modeling. Neurology.Abstract
Objective: To test an integrated model examining the effect of childhood abuse on migraine, depression and anxiety correcting for the covariance among these conditions. Background: Literature shows that childhood abuse is associated with migraine, anxiety and depression. These comorbid outcomes have heretofore been studied independently, rather than simultaneously in an integrated model. Methods: We analyzed data from 14,484 adults in Wave 4 of Add Health study. Participants were queried regarding abuse (emotional, physical and sexual) during childhood and diagnoses of migraine, depression and anxiety. A structural equation model (SEM) was used to examine impact of history of childhood abuse on migraine, depression and anxiety. We used weighted least squares estimation with a mean and variance adjusted (WLSMV) chi-square. A tetrachoric covariance matrix, with probit regression coefficients was used to estimate path coefficients and factor loadings. Wald chi-square tests were used to examine if there was a significant difference in pathways from each of the types of abuse to the outcome variables. Results: About 14[percnt] (n=2,061) of respondents reported history of migraine. Participants with migraine (vs. no migraine) reported significantly higher rates of childhood abuse overall (60.5[percnt] vs 49[percnt]); including emotional (57.6[percnt] vs 45.5[percnt]; Χ2(1)=104.47, p<0.01), sexual (8.3[percnt] vs 4.6[percnt]; Χ2(1)=43.84, p<0.01) and physical (22.3[percnt] vs 17.9[percnt]; Χ2(1)=21.98, p<0.01) abuse. SEM analysis revealed that childhood abuse had a significant direct impact on each outcome (migraine, anxiety and depression) through a latent abuse factor (goodness of fit indices: CFI=0.994, TLI=0.985, RMSEA=0.023). Subgroup analysis by race and gender showed the same effects, indicating the homogeneity of the results. Examination of relative effects of different abuse types on depression, anxiety and migraine revealed that emotional and sexual abuse (but not physical abuse) had a significant impact on migraine, depression and anxiety. Conclusion: Childhood abuse has significant direct impact on migraine, depression and anxiety.URL
http://www.neurology.org/content/86/16_Supplement/P2.207.shortReference Type
Conference proceedingBook Title
NeurologyAuthor(s)
Tietjen, GretchenKarmakar, Monita
Elhai, Jon
Amialchuk, Aliaksander