Children who have experienced traumatic events, such as abuse, neglect, financial adversity or their parents’ divorce, may be more likely to develop headaches as adults, according to a study published in the American Academy of Neurology’s medical journal Neurology.

The study included 28 surveys, with a total of 154,739 participants in 19 countries.

31% of all participants reported at least one traumatic event in childhood and 16% were diagnosed with primary headaches. The researchers found that people who had experienced one or more traumatic events in their childhood were 48% more likely to develop headache disorders than those who had not experienced such traumatic events.

They also found that as the number of traumatic childhood events increased, so did the likelihood of headaches.

People who had experienced one type of traumatic event had a 24% increased risk of a headache disorder compared to those who had not experienced childhood trauma, while those who had experienced four or more types of traumatic event were more than twice as likely to have a headache disorder.

The researchers also looked at the association between types of childhood traumatic events. Events were categorized as threat trauma (physical or sexual or emotional abuse, threat of violence, or severe family conflict) and deprivation trauma (neglect, financial adversity, incarcerated household member, divorce, death of a parent, member with mental illness, chronic disability/illness, alcohol or substance abuse).

Threat trauma was associated with a 46% increase in headaches, with experiencing physical and sexual abuse associated with an even greater risk for headaches (60%), and deprivation trauma with a 35% increase in headaches, with those experiencing childhood neglect having almost triple the risk of headache disorders.

“Our meta-analysis confirms that childhood traumatic events are important risk factors for headache disorders in adulthood, including migraine, tension-type headaches, cluster headaches, and chronic or severe headaches. This is a risk factor that we cannot ignore,” says study author Kathryn Kreatsoulas of the Harvard THChan School of Public Health.