Toward a Better Understanding of the Relationship between Childhood Trauma and Psychiatric Disorders: Measurement and Impact on Addictive Behaviors

and Caretti recently published an interesting brief report in Psychiatry Investigation concerning the role of childhood trauma, dissociation, and alexithymia in alcohol dependence. 1 In their exploratory study, Craparo and colleagues found that people suffering from alcohol use disorder were exposed to a greater number of traumatic events in their childhood (sexual, physical and emotional abuse), and showed more dissociative experiences and higher levels of alexithymia, compared to a matched control group. Another interesting finding of the study concerned the negative correlation between the age of the first relational trauma and the severity of dissociative symptoms. This is consistent with a wealth of existing research emphasizing that adverse childhood experiences can alter the affect regulation circuits (alexithymia) and the possibility of integrating mental, somatic, and relational experiences (dissociation), thus constituting a risk-factor for the development of addic-tive disorders, including the so-called behavioral addictions such as pathological gambling 2 and Internet addiction. 3 The study by Craparo and colleagues provides additional evidence in a growing field for the influence exerted by negative childhood environment and relationships in the development of addictive disorders. As the literature indicates, people suffering from addictive disorders may in fact use substances or excessive behaviors as an external regulator and a self medication for their dysregulated feelings and painful states of mind. This then supports a psychopathological model according to which the earlier and more frequent the exposure to abuse for an individual , the higher the likelihood of deviation from normal development. In fact, both theoretical and empirical research states that early and frequent negative experiences in childhood , especially in the context of attachment relationships, can foster the onset of a developmental trauma disorder, 4 which entails significant alterations in different domains of psychological functioning, including attachment, biology, affect regulation , dissociation, behavioral control, cognition and self-concept. 5 Therefore, research findings are consistent in supporting developmental models for psychiatric disorders, whereby childhood neglect or abuse is an important causal factor, increasingly for a range of disorders. However, it is now necessary for research on the developmentally traumatic roots of addictive behaviors to make a quantum leap, in order to provide more detailed patterns of associations between childhood experiences and addictive behaviors in a search for more specific models. In doing this, a valid, reliable, comprehensive, and detailed assessment of child maltreatment becomes essential for increasing our understanding of the origins of addictive behaviors in addition …