{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:34:14Z","timestamp":1777854854353,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"15-16","license":[{"start":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T00:00:00Z","timestamp":1556841600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Interpers Violence"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>In some settings, it may be difficult to differentiate between a confounder and a mediator. For instance, the observed association of self-reported childhood psychological abuse (CPA) with onset of chronic obstructive pulmonary disease (COPD) and migraine may be confounded by current mood\/psychological state (e.g., the subjective evaluation of one\u2019s own affective state), as well as mediated by an individual\u2019s psychopathological symptoms. In this study, we propose the \u201cindependence hypothesis,\u201d which could prove meaningful to explore in data that lack prospective or objective indices of CPA. We used cross-sectional data from wave VI (2007-2008) of the Troms\u00f8 Study, Norway ( N = 12,981). The associations between CPA and COPD and migraine were assessed with Poisson regression models. CPA was associated with a 46% increased risk of COPD (relative risk [RR] = 1.46, 95% confidence interval [CI]: [1.02, 1.90]) and a 28% increased risk of migraine in adulthood (RR = 1.28, 95% CI: [1.04, 1.53]), independent of age, sex, parental history of psychiatric problems\/asthma\/dementia, smoking, respondent\u2019s mood\/psychological state, and mental health. These findings suggest that the association between retrospectively reported CPA and COPD and migraine is not driven entirely by respondent\u2019s mood\/psychological state and mental health. Assessing the independent effect of self-reported CPA on COPD and migraine in retrospective studies may prove more meaningful than exploring the mediating role of mental health. Here, we provide the analytical rationale for assessing the independent effect in settings where it is difficult to differentiate between a confounder and a mediator. Moreover, we provide a theoretical rationale for assessing the independent effect of retrospectively reported childhood adversity on health and well-being.<\/jats:p>","DOI":"10.1177\/0886260519844773","type":"journal-article","created":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T04:30:50Z","timestamp":1556857850000},"page":"NP8706-NP8723","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Confounding, Mediation, or Independent Effect? Childhood Psychological Abuse, Mental Health, Mood\/Psychological State, COPD, and Migraine"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3212-592X","authenticated-orcid":false,"given":"Mashhood Ahmed","family":"Sheikh","sequence":"first","affiliation":[{"name":"Oslo University Hospital, Norway"},{"name":"UiT The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,5,3]]},"reference":[{"key":"bibr1-0886260519844773","doi-asserted-by":"publisher","DOI":"10.1037\/0033-295X.103.4.670"},{"key":"bibr2-0886260519844773","doi-asserted-by":"publisher","DOI":"10.1300\/J229v07n04_02"},{"key":"bibr3-0886260519844773","doi-asserted-by":"publisher","DOI":"10.1016\/j.psc.2005.10.004"},{"key":"bibr4-0886260519844773","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.07.022"},{"key":"bibr5-0886260519844773","doi-asserted-by":"publisher","DOI":"10.1111\/biom.12248"},{"key":"bibr6-0886260519844773","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(98)00017-8"},{"key":"bibr7-0886260519844773","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-6494.1988.tb00895.x"},{"key":"bibr8-0886260519844773","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.2004.00218.x"},{"key":"bibr9-0886260519844773","volume-title":"Introduction to mediation, moderation, and conditional process analysis: A regression-based approach","author":"Hayes A. 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