Functional difficulties mediate the association between exposure to adverse childhood experiences and headaches among children: Findings from a population-based study.
Functional difficulties mediate the association between exposure to adverse childhood experiences and headaches among children: Findings from a population-based study.
复制标题
功能障碍介导儿童不良童年经历与头痛之间的关联：一项基于人群的研究结果。
作者：
Baiden,Philip;Tarbet,Zachary;Chakravarty,Sreyashi;LaBrenz,CatherineA;Okumu,Moses
背景反向童年经历(ACEs)在一般人群中普遍存在，通常具有持久的神经和生理影响。以前的研究已经发现，暴露在A级药物、头痛和成年人的功能障碍之间存在联系。目的探讨ACEs暴露与儿童头痛之间的联系，以及功能障碍是否在这种联系中起中介作用。方法：这项横断面二次分析研究的数据来自2017-2018年全国儿童健康调查。这项研究分析的样本是40,953名3岁至17岁的儿童。结果根据家长报告，4.1%(1697/40,953)的儿童表示经常或严重头痛，9.5%(3906/40,953)的儿童接触过3次或更多的ACE。大约四分之一的儿童(23.4%；9601/40953)至少有一种功能障碍。结果表明，暴露于ACEs与功能障碍呈正相关(β=0.16，P&0.001，95%CI=0.15-0.17)，而功能障碍与头痛呈正相关(β=0.17，P<；0.001，95%CI=0.12-0.22)。间接效应的索贝尔检验显示，功能障碍部分中介了暴露于ACE和头痛之间的联系(β=0.027，P<；0.001，95%CI=0.022-0.029)。此外，年龄较大的儿童和有脑损伤的儿童报告更有可能经历头痛。结论本研究的发现表明，儿童暴露于ACE和头痛之间存在关联，而功能障碍在这种关联中起部分中介作用。
BackgroundAdverse childhood experiences (ACEs) are commonly observed in the general population and often have lasting neurological and physiological effects. Previous studies have found links between exposure to ACEs, headaches, and functional difficulties in adults. However, little is known about the mechanisms through which exposure to ACEs is associated with headaches among children.ObjectiveTo examine the association between exposure to ACEs and headaches in children, and whether functional difficulties mediate this association.MethodsData for this cross‐sectional secondary analysis study came from the 2017–2018 National Survey of Children's Health. The sample analyzed in this study was 40,953 children who were between ages 3 and 17 years. We adjusted for the complexity of the sampling design and used structural equation modeling to examine the mediating effect of functional difficulties in the association between exposure to ACEs and headaches.ResultsBased on parent reports, we found that 4.1% (1697/40,953) of the children reported frequent or severe headaches, and 9.5% (3906/40,953) were exposed to three or more ACEs. About one in four children (23.4%; 9601/40,953) had at least one functional difficulty. The results show that exposure to ACEs was directly positively associated with functional difficulties (β= 0.16,p< 0.001, 95% CI = 0.15–0.17), and functional difficulties were in turn positively associated with headaches (β= 0.17,p< 0.001, 95% CI = 0.12–0.22). The Sobel test of indirect effect showed that functional difficulties partially mediated the association between exposure to ACEs and headaches (β= 0.027,p< 0.001, 95% CI = 0.022–0.029). Also, older children and children with brain injury were more likely to report experiencing headaches.ConclusionsThe findings from this study suggest an association between exposure to ACEs and headaches among children, and functional difficulties partially mediate this association.