Association of Post-Traumatic Stress Disorder Symptoms with Migraine and Headache after a Natural Disaster

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Previous research shows that migraine and general headache symptoms increase after traumatic events. Questions remain about whether post-traumatic 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 post-disaster. We decompose PTSD into intrusion, avoidance, and hyperarousal symptom clusters to examine which, if any, are uniquely related to headache/migraine post-disaster.


We use prospectively collected pre- and post-disaster 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.


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% CI: 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 mean [SD]: 1.6 [1.1]) was associated with 55% higher odds of reporting frequent headache/migraine (95% CI: 1.03, 2.33), but we found no association with avoidance or hyperarousal symptoms.


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.

Publisher's Version

Last updated on 04/25/2017