Migraine and attachment type in children and adolescents: what is the role of trauma exposure?

Excerpt

Migraine and attachment insecurity in children and adolescents are often associated. The attachment system can significantly affect the emotional experience and clinical presentation of migraine. The prevalence of migraine in children and adolescent is about 7.7–9.1% and there is a recognized association between migraine and psychiatric comorbidities especially with anxiety disorders, mood disorders, and eating and sleep disorders [1]. Children and adolescents with migraine have an increased risk of developing major depressive episodes and consequently suicide. Furthermore, recent studies reported a significant relationship between migraine and insecure style of attachment. Bowlby defined attachment as a behavioral and cognitive system that regulates an individual’s sense of internal security. According to the most recent studies, traumatic experiences occurring to children with insecure attachment could trigger the activation of the stress mechanism due to the disorganization of the attachment style. Indeed, an increased cortisol secretion triggered by the hypophysis hypothalamus axis adrenal gland (HPA) activation might be responsible for anxiety dysregulation, increased intensity and frequency of headache attacks. Moreover, other researchers found that maltreatments and abuses during childhood increases vulnerability to develop migraine disorder in adulthood. Based on these premises, we have oriented our study on the following objectives: (1) to compare attachment type between children and adolescents with Migraine without Aura (MoA) and a healthy control group; (2) to compare the frequency of trauma exposure in both groups; (3) to examine whether there is a relationship between attachment and trauma impact in both groups; (4) to assess if attachment system or the exposure to trauma affect significantly the clinical presentation of migraine. …