Do Personality Traits Mediate the Relationship Between Childhood Abuse and Migraine? An Exploration of the Relationships in Young Adults Using the Add Health Dataset.

BACKGROUND: Personality traits (especially neuroticism) and childhood maltreatment have been independently related to many negative health outcomes later in life, including migraine. Studies have also shown the association between childhood maltreatment and maladaptive personality traits. The mediating role of personality traits on the relationship between childhood maltreatment and depression, psychological distress, and alcohol dependence has been extensively studied. However, this type of mediation has not been studied in the case of the development of migraine. This study investigated (1) the main effects of childhood abuse on personality traits, and of personality traits on migraine, and (2) the mediating role of neuroticism, on the relationship between childhood abuse and migraine in young adults. METHOD: We analyzed retrospective, cross-sectional data from 13,493 adults aged 24-32 years in Wave 4 of the National Longitudinal Survey of Adolescent Health ("Add Health") data set. Participants were queried regarding maltreatment (emotional, physical, and sexual) during childhood, current Big Five personality traits (using mini International Personality Item Pool), current depression (using Center for Epidemiologic Studies-Depression Scale), perceived stress (Using Cohen's Perceived Stress Scale), and diagnosis of migraine by a health care provider. Linear and logistic regressions were used to assess the main effects of childhood maltreatment on the five personality traits (openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism) and the main effect of the personality traits on self-reported provider diagnosis of migraine. A structural equation model (SEM) was used to examine the mediating role of neuroticism on the relationship between childhood maltreatment and migraine. RESULTS: Linear regression models showed that childhood abuse independently predicted increased neuroticism (ß = 0.338, SE=±0.05, P < .001), and increased openness to experiences (ß = 0.341, SE = ±0.06, P < .001) after adjusting for socio-demographic characteristics, current depression, and perceived stress. Logistic regression to examine the main effect of personality traits on migraine revealed that only neuroticism had a significant effect (OR = 1.07, 95%CI = 1.04-1.10) after controlling for childhood abuse, socio-demographic characteristics, current depression, and perceived stress. Our regression analyses showed that neuroticism, but not openness to experience, was a potential mediator for the relationship between childhood abuse and migraine. SEM confirmed significant mediation of the relationship between childhood abuse and migraine through neurotic personality traits (goodness of fit indices: CFI = 0.992, TLI = 0.979, RMSEA = 0.025), unadjusted for socio-demographic variables, depression, and stress. In addition to the indirect effect (ß = 0.039, P < .01) of childhood abuse on migraine through neuroticism, there was also a significant direct effect (ß = 0.143, P < .01) of childhood abuse on migraine. After adjusting for socio-demographic variables, other personality types, depression, and stress, both the direct effect (ß = 0.127; P < .01) of childhood abuse on migraine and the indirect effect (ß = 0.09; P < .01) of childhood abuse on migraine through neuroticism were attenuated, but remained significant. CONCLUSION: Childhood abuse is associated with personality and migraine. An estimated 21% of the total effect of childhood abuse on migraine could be explained by mediation through neuroticism in the unadjusted model. In the fully adjusted model, an estimated 8.7% of the total effect could be explained by mediation, although, self-reported data limit the ability to draw firm conclusions.

Emotional Abuse History and Migraine Among Young Adults: A Retrospective Cross-Sectional Analysis of the Add Health Dataset.

OBJECTIVES: To define and examine the relationship between self-reported childhood abuse and migraine among young adults. BACKGROUND: Headache and migraine have been linked to childhood abuse in numerous studies, but there is incomplete characterization of headache types, and limited assessment of abuse types and frequency. Only one population-based study has examined the relationship between emotional abuse and migraine. None have investigated the temporal relationship between onset of abuse and of migraine. METHODS: We analyzed data from 14,356 adults aged 24-32 years in Wave 4, which is a cross-sectional subset of the longitudinal Add Health study. Participants were queried regarding abuse (emotional, physical and sexual) during childhood, diagnosis of migraine, depression and anxiety by healthcare providers, and symptoms of current depression. We used logistic regression to estimate the association between childhood abuse and migraine, controlling for socio-demographic factors, current depression, and lifetime diagnosis of anxiety and depression. RESULTS: About 14% (n = 2040) of respondents reported migraine. Participants with migraine (vs no migraine) reported significantly higher rates of childhood abuse overall (60.6% vs 48.9%), including emotional (57.8% vs 45.4%), sexual (8.4% vs 4.6%) and physical (22.4% vs 17.9%) abuse. Emotional abuse had a stronger association with migraine (odds ratio [OR] 1.62; 95% confidence interval [CI] 1.43-1.85) when compared with physical (OR 1.06; 95% CI 0.89-1.68) and sexual abuse (OR 1.06; 95% CI 0.93-1.68), adjusting for socio-demographic factors. The emotional abuse-migraine association remained even when controlling for lifetime diagnosis of depression and anxiety (OR 1.37; 95% CI 1.19-1.57) and for current depression (OR 1.47; 95% CI 1.30-1.67). The odds of migraine increased with increasing number of abuse types reported. There was a U-shaped distribution of odds of migraine associated with frequency of occurrences of emotional abuse, peaking at one time (OR 1.65; 95% CI 1.34-2.03) and ≥ six times (OR 1.77; 95% CI 1.49-2.10). CONCLUSIONS: Emotional abuse during childhood contributed more than physical or sexual abuse to the development of migraine. There is a dose-response relationship with increasing number of abuse types associated with rising odds of migraine. In addition, the relationship between the frequency of emotional abuse and the odds of migraine follows a U-shape pattern.

The effect of marijuana use in adolescence on college and graduate degree attainment.

We estimate the long-term effect of using marijuana in adolescence on college and graduate degree attainment measured approximately 20 years later. We rely on the first two waves (1994-1996) and the fifth wave (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health and estimate instrumental variables models that exploit the network structure at the second degree by using marijuana use status of friends of friends who are not themselves friends of the respondent in order to instrument for the respondent's marijuana use. Our models also include school and grade fixed effects. Marijuana use in adolescence leads to a large reduction in the likelihood of college and graduate degree attainment by the time respondents are aged 33-43 years old.