74 Scientific Facts About Trauma and Addiction
[In-Depth Guide 2021]
So, what does science say about the relationship between trauma and addiction?
WELL. I’m glad you asked.
In this guide, I highlight the key takeaways from 74 wide-ranging scientific studies that document the ways in which trauma has been shown to be a foundational driver of addictive behaviours of all kinds.
There are thousands upon thousands of relevant studies out there, I tried to take a selective sample across a wide range of topics.
Important note: these studies document a clear link between trauma and addiction. But there are other variables at play. In the words of Gabor Mate: “Nobody’s saying that every traumatized person becomes addicted. I’m saying that every addicted person was traumatized.”
Please leave a comment if you think I’ve missed something or if you want to share your own experience!
Love, Ben.
General Studies on
Trauma and Addiction
We start off with a few studies that focus broadly on trauma and addiction and their relationship.
Before getting into the nitty gritty!
1. Being a lifetime alcohol or drug addict correlates with childhood abuse and PTSD
Researchers examined the relationship between childhood trauma, substance use and PTSD by interviewing a sample of 587 urban primary care patients.
They found “strong links” between childhood traumatisation and substance use disorder, which were jointly associated with a PTSD outcome.
Lifetime dependence among this highly traumatised population stood as follows: 39% alcohol, 34.1% cocaine, 6.2% heroin/opiates, and 44.8% marijuana.
Total childhood trauma correlated significantly with current PTSD symptoms, even after controlling for age, sex and adult trauma exposure. The greater the level of childhood trauma, the greater the PTSD symptoms. This was the case even when controlling for adult trauma, which highlights the significant impact of childhood trauma specifically.
They found that the level of substance use, particularly cocaine, strongly correlated with the levels of childhood physical, sexual and emotional abuse as well as current PTSD symptoms.
2. Even being indirectly exposed to traumatic events through work, hearing about others’ trauma or in the media is linked to addiction
Researchers set out to investigate specific links between types and levels of exposure to traumatic events and addiction. They collected data from 4,025 (2,012 men, 2,013 women) respondents on life events, substance use, behavioural addictions and sociodemographic data.
They found a strong association between direct exposure to traumatic life events and addictions to all substances and behaviours studied (alcohol, cannabis, sedatives, stimulants, gambling, gaming, pornography, compulsive sexual behaviour).
The risk of developing an addiction was approximately 2.5 times higher for those with direct exposure to trauma compared to those without.
They found also that indirect trauma was related to addiction. Indirect trauma is exposure to traumatization through one’s work (e.g. mental health professionals), learning about trauma experienced by others (e.g. spouse of war veteran) or through media coverage.
Those with indirect exposure are twice as likely to develop an addiction as those without.
In the case of sexual assault, the risk of substance addiction was found to be 3.7 times as high among those with both direct and indirect exposure.
In the studies own words: “Both direct and indirect exposure to trauma were found to be significantly related with risk of addiction.”
Study: The association between type of trauma, level of exposure and addiction, Addictive Behaviours, 2021
Specific Addictions
(Alcohol, drugs etc.)
Are all addictions potentially linked to trauma?
In this section we drill down into the many different ways that addiction shows up, from substances, to relationships, to behaviours.
This section covers: alcohol, drugs, sex/love, co-dependency, smoking, gambling, opioids, food addiction, eating disorders, internet, gaming, social media, ideology, conspiracy theories, workaholism, perfectionism, ‘street’ addiction, plastic surgery, exercise.
Alcohol Addiction
3. You are much more likely to drink heavily, be an alcoholic or marry an alcoholic if you experienced a traumatic childhood
Researchers set out to explore the relationship between multiple types of abuse and the risk of alcoholism as mediated by a history of parental alcohol abuse. They also wanted to gather insights into the intergenerational cycling of alcohol abuse by assessing the relationship of these experiences to the risk of marrying an alcoholic.
They used data from the first wave of the famous ‘Adverse Childhood Experiences’ survey, which included 9,508 participants (54% female, 46% male) to conduct the study.
They drew several conclusions:
ACEs correlate to alcohol abuse: each of the eight individual ACEs was associated with a higher risk alcohol abuse as an adult, both with and without a history of parental alcoholism
Parental alcoholism makes any correlation stronger: however, for any given ACE, the increase in the prevalence of alcohol abuse was always higher for those with a history of parental alcoholism
ACEs and alcohol abuse has an intergenerational aspect: the higher the ACE score, the likelier someone is to marry an alcoholic (women are generally more likely than men to do so). This “suggest[s] a self-perpetuating cycle that puts the next generation at risk for both ACEs and alcohol abuse”
The effect of ACEs is cumulative: experiencing multiple ACEs increases the severity of the alcohol-related outcome
Study: Adverse childhood experiences and personal alcohol abuse as an adult, Addictive Behaviours, 2002
4. Traumatised women drink more and stronger alcohol than those that are not
Researchers set out to investigate the impact of trauma on addiction and psychopathologies in women. They interviewed two groups of alcohol-dependent women to assess addiction severity as well as history of trauma, depression, anxiety, dissociation and other psychiatric issues.
Traumatised women consumed significantly more alcohol (18 drinks vs. 12 drinks) and preferred stronger drinks. 79% of the traumatised group drank daily versus 42% of the non-traumatised group.
Traumatised women also became more dissociated under the influence of alcohol than non-traumatised women, suggesting that they drink induce dissociation to cope with trauma. As the study, somewhat staidly, puts it: “Unfortunately, this defence mechanism is destructive.”
Drug Addiction
5. You are more likely to overdose on drugs if you experienced childhood trauma
Researchers looked to investigate the psychological and social factors that determine overdose risk among drug users. They set up a study to explore the relationship between non-fatal overdose and five forms of childhood maltreatment among a set of intravenous drug users (IDUs) in Vancouver, Canada.
They assessed 1,697 IDUs between December 2005 and May 2013. They found that 67% of participants reported at least one form of childhood trauma.
At each semi-annual follow-up with the participants, 4-9% would report a non-fatal overdose. They found a statistically significant positive association between non-fatal overdose and reporting an experience of childhood trauma.
6. Homeless people will start using drugs earlier if they experienced emotional abuse as a child
Researchers explored the impact of childhood trauma on the likelihood that respondents would use a drug before the age of 12. They interviewed 47 service users who interact with the Adult Integrated Homeless Team in Cork, Ireland.
They found that exposure to emotional abuse was associated with earlier age of first drug use.
7. You are two and a half times more likely to start using injection drugs if you experienced sexual abuse as a child
A study explored whether childhood sexual abuse predicts the initiation of injection drug use.
They took a cohort of “street-involved” youth between the ages of 14 and 26, who had never used injection drugs before. Of the 395 participants, 20.5% reported childhood sexual abuse. They then followed up with them (on average 16 months later) to see how many had started using injection drugs.
The researchers found that just over 11% had started using injection drugs. Their analyses revealed that the sexual abuse individuals nearly two-and-a-half times as likely to start injecting.
OK, but what can we do about it?
I offer Guided Somatic Inquiry sessions that help people
to uncover and unravel the pain that drives addiction.
Sex, Love and
Co-Dependency Addiction
8. Sex addicts are much more stressed and more depressed than average
A study from the Karolinska Institutet in Sweden set out to determine the relationship between ‘hypersexual disorder’ (sex addiction) and stress regulation. They assessed 67 male patients with hypersexual disorder and 39 healthy male volunteers.
The researchers gave the participants a drug to inhibit their physiological stress response then measured their stress hormones (cortisol and ACTH) the next morning.
Patients with hypersexual disorder had higher levels of stress hormones than healthy controls.
According to the researchers, sex addiction was “significantly associated” with hyperactive stress systems, even when adjusted for childhood trauma. In addition, the patients with hypersexual disorder reported “significantly more childhood trauma and depression symptoms compared to healthy volunteers.”
Study: HPA axis dysregulation in men with hypersexual disorder, Psychoneuroendocrinology, 2016
9. Avoiding or chasing sex compulsively are both linked with sexual abuse in childhood
Canadian researchers set out to study the relationship between childhood sexual abuse and adult sexual avoidance and compulsivity.
They assessed a sample of 686 adults using online questionnaires.
20% of women and 19% of men reported childhood sexual abuse, which was associated with more sexual avoidance and compulsivity than in those who did not report sexual abuse.
10. Sex addicts are generally males that are very distressed, have difficulty identifying emotions and had an insecure relationship with their caregivers
Researchers set out to examine the relationship between key psychological markers and sex addiction. They assessed 24,380 individuals with a range of questionnaires.
They found that sex addiction was associated with “being male, being younger, having a lower education level, being single, being an alcohol and nicotine user, psychiatric distress, low personal wellbeing, positive and negative affect, alexithymia, and anxious attachment.”
11. Co-dependency significantly related to childhood abuse and neglect
Researchers investigated the relationship between child abuse and neglect on the one hand and co-dependency on the other. They assessed a group of 102 nursing students in the USA using a series of questionnaires.
They found that “all forms of childhood abuse and neglect” were “significantly related” to total co-dependency score.
Smoking and Nicotine Addiction
12. Smokers are more likely to have reported at least one difficult childhood experience than non-smokers
Researchers used data from 25,809 participants from a questionnaire to assess the relationship between 8 adverse childhood experiences and how it relates to smoking status.
Each of the 8 ACEs was significantly associated with being a smoker, even after adjusting for demographic variables.
Those with over 5 ACEs were just over twice as likely to currently smoke and just under twice as likely to ever have smoked than those with zero ACEs.
Study: Adverse childhood experiences and smoking status in five states, Preventive Medicine, 2011
13. Smoking clearly linked to trauma in a metastudy of 62 other studies with PTSD being the causal link
Researchers reviewed 62 scientific studies on the relationship between smoking, trauma and PTSD.
Overall they found that “smoking rates are significantly higher among persons exposed to a traumatic event relative to those without such exposure. Moreover, smoking rates appear particularly high among persons with posttraumatic stress disorder.”
The greater the severity of the traumatic event, the greater the increases in smoking level, smoking onset, nicotine dependence and the transition from smoking to nicotine dependence.
The evidence suggests that PTSD is the key factor in the development of a smoking habit. In particular, the ‘hyperarousal’ symptoms of PTSD are positively related to smoking.
Gambling Addiction
14. Men with gambling addictions are more likely to have suffered childhood traumas
Psychologists at the University of Lincoln examined responses in a survey of over 3,000 men across a variety of life factors, including self-reported gambling behaviours as well as traumatic or stressful life events.
Problem gambling was associated with increased odds of childhood trauma and stressful life events in adulthood.
Over a quarter with pathological gambling problems witnessed violence in the home as a child versus 8% of non-problem gamblers. And 10% reported physical abuse versus 4% for non-problem gamblers.
The more serious the gambling problem, the higher the percentage of reported childhood trauma or stressful events in adulthood in all but two survey questions. This pattern remained even when accounting for other risk factors (e.g. substance abuse or homelessness).
Forensic psychologist Dr Amanda Roberts, from the University of Lincoln's School of Psychology, who led the study said: “We have found that among men in the United Kingdom, disordered gambling remains uniquely associated with trauma and life stressors in childhood and adulthood after adjusting for alcohol and drug dependence.”
Study: Gambling and negative life events in a nationally representative sample of UK men, Addictive Behaviours, 2017, see also Science Daily
Opioid Addiction
15. Opioid epidemic linked to emotional abuse more than other childhood traumas
The study, by the University of Vermont, gave 84 individuals with a history of problematic opioid use as well as childhood trauma a series of psychological tests to determine the link between adult opioid abuse and emotional abuse.
Participants were interviewed about their childhood experiences and then a variety of life factors were measured, including maltreatment experienced as children, opioid use and related life problems, addiction severity, impulsive behaviour and the severity of any PTSD symptoms.
Emotional abuse, positive urgency (the tendency to act rashly when experiencing positive emotions) and negative urgency (the tendency to act rashly when distressed) were found to be indicators of opioid use. The study suggests that these factors are directly related to post-traumatic stress disorder (PTSD) symptoms, which then are directly related to opioid use.
The severity of the PTSD was directly linked to the severity of the opioid problems.
Interestingly, emotional abuse, specifically, was much more strongly correlated with opioid use than sexual and physical abuse or other maltreatment such as neglect.
Food Addiction and Eating Disorders
16. Most people that suffer from anorexia, bulimia and binge eating have suffered trauma at the hands of someone else
Researchers examined the results of a survey of 2,382 men and 3,310 women that included data on PTSD and eating disorders.
They found that the “vast majority” of women and men with anorexia nervosa, bulimia nervosa, and binge eating disorder reported a history of interpersonal trauma.
Rates of PTSD were significantly higher among women and men with bulimia nervosa and binge eating disorder.
17. Women with food addictions much more likely to have suffered abuse in childhood
Researchers studied 57,000 adult participants, looking at physical and sexual child abuse histories (obtained in 2001) and current food addiction (2009).
They concluded that “a history of child abuse is strongly associated with food addiction in this population”.
Women who suffered physical or sexual abuse before the age of 18 years were almost twice as likely to have a food addiction in middle adulthood compared to those without.
Severe physical and sexual abuse were associated with roughly 90% increases in food addiction risk.
The authors caution that the findings are “exploratory” and will need to be replicated before drawing any conclusions about causality can be confirmed.
18. If you’re an adolescent or young adult with eating and weight problems you probably experienced a difficult childhood
Researchers studied a sample of mothers and their offspring (782 participants in total) over an 18-year period. They set out to examine whether maladaptive parental behavior, childhood abuse and neglect, other childhood adversities, and socioeconomic variables were associated with elevated risk for the development of problems with eating or weight during adolescence or early adulthood.
They found that a wide range of childhood adversities tend to be associated with higher risk of eating or weight problems.
Sexual abuse and physical neglect predicted higher risk for eating disorders (mostly bulimia). They also predicted fluctuations in weight, strict dieting and self-induced vomiting.
One of the main variables was “maladaptive paternal behaviour” (translation: their dad wasn’t great). This includes “low paternal affection, communication, time spent with the child”. Those who experienced three or more kinds of such behaviour were approximately three times as likely to have eating disorders during adolescence or early adulthood as those that didn’t.
Interestingly, there was no such correlation with maladaptive maternal behaviour.
19. Significant association between food addiction, binge-eating and childhood trauma in women
This study examined the independent association between childhood trauma and food addiction, as well as looking at people with both food addiction and binge eating compared to only one or the other.
The participants were 301 overweight and obese women who were seeking diet therapy.
Childhood trauma was “moderately and positively” associated with both food addiction and binge eating. The co-occurrence of food addiction and binge eating was associated with more severe childhood trauma, higher BMI as well as more severe anxiety and depression.
Internet, Gaming, Smartphone and
Social Media Addiction
20. The severity of your internet addiction depends on the severity of childhood trauma, depression and anxiety
Researchers investigated the relationship between internet addiction risk and the severity of childhood trauma, borderline personality, dissociation, depression and anxiety.
271 Turkish university students participated and were assessed through a series of standardised questionnaires.
The severity of internet addiction risk was correlated with higher scores across childhood trauma, borderline personality, dissociation, depression and anxiety. Among childhood trauma types, emotional abuse was the main predictor of internet addiction risk.
21. Internet addiction is a coping mechanism to deal with the psychological stress of trauma
Researchers gave questionnaires to 286 university students to assess childhood trauma, internet addiction and dissociative experiences.
Childhood trauma had an indirect effect on internet addiction through dissociative experiences and online dissociation.
General dissociation predicted online dissociation, which, in turn, resulted in internet addiction.
The researchers state that their findings support the role of internet addiction as a “maladaptive coping mechanism” for dealing with the psychological stress of childhood trauma.
22. Gaming addiction is linked to a difficult childhood, dissociation and insecurity in relationships
Researchers set out to explore the relationship between adverse childhood experiences, attachment styles, dissociation, and symptoms of gaming disorder (addiction to gaming).
They assessed the responses of 1,288 gamers across a variety of questionnaires that focused on their gaming habits and childhood trauma, dissociation and anxiety.
They found a significant association between gaming and these psychopathologies: “participants who score higher on ACEs, dissociation, and anxiety experienced in relationships also score higher on the gaming disorder scale.”
Regarding ACEs, they found that physical and emotional abuse as well as emotional neglect were most strongly associated with gaming disorder.
Regarding anxious attachment, they found that specific difficulties in relationships, i.e. fear of rejection and abandonment, is what creates the risk of gaming disorder.
Interestingly, dissociation (cutting yourself off from reality) was found to be most strongly associated with gaming disorder, suggesting that “escape” is a significant function of playing games.
23. The effect of using social media too much is comparable to using drugs
Researchers set out to assess how people who use Facebook excessively compared to those with substance use disorders on a psychological task used to measure decision-making.
They assessed 71 participants to measure their psychological dependence on Facebook, before asking them to complete the ‘Iowa Gambling Task’, used to measure decision-making capacities.
They found that “more severe, excessive [social networking site] use is associated with more deficient value-based decision making”. Specifically, these people make more risky decisions during the task.
Their result “further supports a parallel between individuals with problematic, excessive [social networking site] use, and individuals with substance use and behavioural addictive disorders”.
24. If you had an insecure relationship with your caregivers you are more susceptible to internet and social media addiction
Academics carried out a metastudy of 32 studies that explore attachment styles and its influence on internet and social media addiction.
Overall, they found a “significant positive association” between insecure attachment (both anxious and avoidant styles) and “more intensive and dysfunctional use of the internet and social media”.
Social media functions as a way of replacing and compensating for affection that is not received from family and peers. They state that their review “provides evidence that individuals high in attachment anxiety appear to use Facebook to alleviate their lack of attachment functioning.”
25. Addicted to your smartphone? Your behaviour may be linked to childhood trauma
The researchers examined the relevance of emotional intelligence and coping style to the link between children neglect/psychological abuse and smartphone addiction.
They gave questionnaires to 1,041 Chinese adolescents (aged 11 to 15) regarding their childhood, emotional intelligence, copying style and smartphone addiction.
They found a link between childhood trauma and smartphone addiction, with the impact on emotional intelligence and coping styles being the key enabler.
Ideology, Belief and
Worldview Addiction
26. Why do people believe in conspiracy theories? It is partly to do with an insecure relationship with their caregivers
Two joint studies by researchers at the University of Kent examined the relationship between attachment styles and belief in conspiracy theories.
They assessed 474 participants for attachment styles as well as their tendency to believe conspiracy theories, while controlling for demographic factors and other known predictors of conspiracy belief.
Participants with a more anxious attachment style had a greater tendency to believe in conspiracies. This held even when controlling for other variables.
Study: Anxious attachment and belief in conspiracy theories, Personality and Individual Differences, 2018
27. Why are people anti-vaccine? The answer is partly group defensiveness and low self-worth
Researchers set out to explore the extent to which ‘collective narcissism’ is associated with anti-science attitudes (e.g. anti-vaccination positions).
The researchers state that collective narcissism is an individual belief in the greatness of one’s ‘ingroup’ (e.g. nation) that comes from the need for external validation. It is associated with generally low feelings of self-worth and increases when personal control is threatened. They also noted that conspiracy theories tend to be fueled by “group-based defensiveness” (author’s note: i.e. fear).
They carried out a series of four studies to investigate the relationship between vaccination hesitancy and the way people feel about their national groups. They assessed different population samples through a variety of means: a general community sample (study 1), users of discussion forums that featured anti-vaccination topics (study 2), a national quota sample of youth (study 3), and finally a general national quota sample (study 4).
They found that “national narcissism … significantly related to the support for a voluntary vaccination policy as well as to beliefs in conspiracy theories about vaccines.”
National identification by itself did not correlate in the same way, showing that it is “not the mere strength of ingroup positivity, but rather the group-based defensiveness that is linked to anti-vaccination attitudes”.
28. Believing that your own group is ‘exceptional’ and being hostile to other groups is associated with belief in conspiracy theories
The researchers conducted two studies to examine “gender conspiracy beliefs” (the idea that gender-equality activism is an ideology secretly designed to harm traditional values) and the psychological attributes that engender them.
They assessed levels of conspiracy belief as well as levels of ‘collective narcissism’ (a belief that one’s own group is exceptional and that this is not sufficiently recognised by others)
They found that Catholic collective narcissism was a “robust predictor” of gender conspiracy beliefs. “Catholic narcissism” predicts a conviction that certain social movements and activists conspire to undermine traditional social arrangements (the so-called “gender conspiracy”).
Additionally, the conspiracy beliefs were the pathway between the Catholic collective narcissism and outgroup hostility.
29. A sense that your group is threatened and collective fear makes you more likely to believe conspiracy theories
Researchers set out to investigate how intergroup threat and social identity (in this case as a Muslim) affected belief in conspiracy theories.
They used data collected from 139 Indonesian Muslim students.
They found that “high intergroup threat” triggered “greater belief in conspiracy theories”, particularly when participants’ Muslim identity was strong.
They found that “collective angst” was the link between the group threat and the influence on belief.
30. Collective trauma can trigger greater belief in conspiracy theories
Researchers investigated whether groups that suffer from personal and group deprivation (in this case: a Muslim minority in the Netherlands) are more susceptible to conspiracy theories than the majority.
Personal deprivation is “not feeling regarded as a full-fledged member of society” and group deprivation is the “perception that one’s minority group as a whole is deprived of equal opportunities”.
They state that they anticipated that “Muslim minorities in Dutch society would experience both forms of deprivation” (i.e. personal and group).
They studied conspiracy theories that are identity-relevant (e.g. Muslim community as victim; Jewish people as perpetrators) and identity-irrelevant (e.g. economic conspiracies; the moon landings were fake).
They found that Muslims believed both relevant and irrelevant conspiracy theories more strongly than non-Muslims.
Note: these differences could not be attributed to the contents of Islamic faith as ethnic minority status had the same effect independent of Muslim identity.
They state that “both feelings of deprivation were strong predictors of conspiracy beliefs. These findings suggest that both forms of deprivation independently contribute to a perception of the social and political system as rigged, stimulating belief in both identity‐relevant and irrelevant conspiracy theories.”
Study: Increased conspiracy beliefs among ethnic and Muslim minorities, Applied Cognitive Psychology, 2018
Workaholism and Perfectionism
31. If you’re a workaholic it could be linked to insecurity in relationships and dependence on others
Researchers examined the links between attachment, perfectionism and job engagement and workaholism. They gave 139 workers a series of questionnaires to assess these categories.
They made a distinction between adaptive perfectionism (personal standards and organisational skills) and maladaptive perfectionism (self-doubt, focus on failure and parental expectations).
They found a “significant positive correlation” between “non-safe” (i.e. anxious or dependent) attachment and workaholism.
Maladaptive perfectionism was found to be “close to significant” in forming the link between attachment style and workaholism. The researchers think the small sample size is hiding the significance of this relationship, stating that “had this study included more than eleven maladaptive perfectionists, the results would have been significant.”
32. Workaholics have more negative emotions than non-workaholics! (But mindfulness helps)
Researchers collected data from 400 working adults in the USA through Amazon Mechanical Turk, assessing levels of workaholism, mindfulness and negative affect.
They found that workaholism was positively related to negative affect, while mindfulness was negatively related to negative affect.
33. Perfectionism can be an attempt to deal with PTSD-driven rumination: i.e. that voice in your head!
This study looks to examine whether there is a relationship between PTSD and perfectionism. It also tried to see if rumination was the mediator of any relationship between the two.
The researchers assessed a sample of 30 participants who were in treatment for PTSD. The researchers found that perfectionism and PTSD symptoms were “significantly correlated”. Rumination was a “significant mediator” of this relationship.
34. You try to hide your imperfections to regain a sense of control following traumatic and uncontrollable events
Researchers assessed 537 undergraduate students to explore the links between perfectionism and various categories of childhood adversity.
They found that childhood adversity was significantly associated with “socially prescribed” perfectionism (SPP: perceiving that others are demanding perfection of you) as well as “nondisplay of imperfection” (avoiding verbal disclosures of imperfection).
Childhood abuse (emotional, physical or sexual) uniquely predicted socially-prescribed perfectionism, while childhood family dysfunction was positively associated with nondisplay of imperfection.
The authors comment on how perfectionism develops in childhood: “individuals acquire perfectionistic tendencies and behaviors as a means of regaining a sense of personal control following traumatic or uncontrollable events and avoiding the recurrence of similar experiences (e.g., “If I am/appear perfect or flawless, I won't be punished/ridiculed/abused/rejected/abandoned ever again”)”.
35. Your sense of being defective or deficient can be linked to an insecure relationship with your caregivers as a child
Researchers explored how attachment anxiety and avoidance as well as “perceived defectiveness” (AKA deficiency stories: deeply held negative beliefs about ourselves) mediated the associations between adverse parenting and perfectionism traits in a sample of 344 undergraduate students.
Adverse parenting was associated with “socially prescribed perfectionism” (SPP: perceiving that others are demanding perfection of you) and “perfectionistic self-presentation (PSP: needing to appear to be perfect).
Attachment anxiety and avoidance were associated with “self-oriented perfectionism” (SOP: requiring oneself to be perfect), SPP and PSP. Neither were associated with “other-oriented perfectionism” (requiring others to be perfect).
They found that different types of attachment style led to different kinds of perfectionism.
Attachment anxiety and “perceived defectiveness” were “significant mediators” of the path from adverse parenting to SOP (needing to be perfect), SPP (feeling others need you to be perfect) and PSP (needing to appear to be perfect).
Avoidant attachment and perceived defectiveness significantly mediated the path between adverse parenting and “nondisclosure of imperfection” (not expressing any perceived weaknesses or flaws or doing anything that might reveal them).
They state that “these data suggest that negative self-models link adverse experiences with trait perfectionism and perfectionistic self-presentation”. Translation: adverse experiences result in deeply-held negative beliefs about ourselves that then prompt perfectionistic traits as a coping mechanism.
Other Behavioural Addictions
36. You can get addicted to criminal and gang-related behaviour in exactly the same way as to other behaviours
Researchers set out to explore the validity of the concept of “street addictions” to explain criminal and gang-related behaviour by interviewing former gang members in Syracuse, New York and comparing their responses to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) addiction typology framework.
The researchers conducted 12 in-depth interviews with individuals who have been involved in gangs, street crime, violence, drug dealing and the criminal justice system. 11 of the 12 men had histories of heavy alcohol and drug use. They described the addictive draw of the streets. Here are a few samples of many quoted in the study:
“The sight of yellow police tape gives me a rush. My heart is beating, my hands sweating. I’m not scared - I’m excited.”
“I mean the sight, the smell, the feel, well the memory of how a gun feels in my hands...I mean I’m done with it, but damn there’s a longing there.”
“When I hear gunshots I run - run toward the sound of where they’re coming from. I want in...I want to see what’s going on...I want in. It’s like someone tripped a switch in my brain.”
After they decided to quit street life, they described persistent efforts to resist the addictive draw of the streets (“I will hear the gunshots, sirens and my body feels like it wants to be in the action.”)
The behaviour of the participants mirrors process and behavioral addictions, as set out in the DSM-V including preoccupation, tolerance, loss of control, cravings, withdrawal, using it to escape problems, lying to conceal behaviour and negative consequences. They also highlighted turning points in their life stories and subsequent ‘recovery’.
The researchers concluded that “the type of ‘‘street action’’ explored in this study can also create an alluring ‘‘rush’’ that draws young unemployed men, and to a lesser extent young women, into the action of the streets”.
They concluded that the model of ‘street addiction’ better explains the men’s behaviour than alternative theories of criminal and gang-related behaviour, such as anti-social and deviant behaviour.
37. Getting addicted to plastic surgery is linked to childhood trauma
Dr. Constantian is a renowned plastic surgeon who specialises in nasal surgery. He noticed that some of his patients would be very unhappy with the outcome of their plastic surgery procedure, even when the results were exactly what they had wanted, responding with profound anger and disappointment.
Suspecting that trauma was involved, he surveyed 217 of these ‘unhappy’ patients using an adapted version of the Adverse Childhood Experiences survey (ACE).
According to The Fix, in Constantian’s study, he found that “80% of surveyed plastic surgery patients had one or more Adverse Childhood Experience”. He states on his blog that the prevalence of emotional abuse among these patients was 50%. Emotional neglect stood at 40%. Sexual trauma is over 20%. Levels of drug abuse in the family, alcoholism, and mental illness are much higher than in the general population.
In two academic studies he assessed one hundred rhinoplasty patients, “50 of whom originally had dorsal humps, 21 of whom had straight, functional noses, and 29 of whom had subjectively normal noses but underwent multiple rhinoplasties. This latter group fulfills criteria for body dysmorphic disorder.”
He found that “[c]ompared with patients with hump noses, patients with normal noses were 2.9 times more likely to be demanding, 2.5 times more likely to be depressed, had undergone three times more rhinoplasties and other aesthetic operations, and were 3.8 times more likely to have confirmed trauma histories. Patients who had undergone more than three operations were 92.7 percent women; 85 percent originally had straight noses and had undergone an average of 7.56 rhinoplasties and 5.78 aesthetic operations; 85.4 percent had histories of abuse or neglect.”
He notes that “[a] trauma (abuse/neglect) history was the most significant mediator between patient satisfaction and number of operations and the most prominent factor driving surgery in patients with milder deformities.”
38. People who are addicted to exercise struggle to recognise emotions
Researchers explored the relationship between exercise addiction and alexithymia by studying a sample of 137 men and women from a selection of sports centres in Italy.
They found a strong statistical correlation between exercise addiction and alexithymia (although these two attributes did not overlap completely: not all gym-goers with alexithymia get addicted and not all exercise addicts are alexithymic).
They found that more mechanical exercises (such as weight lifting or running) were preferred by alexithymic exercise addicts compared to forms of exercise that require more attentive body awareness such as dancing or pilates.
Study: Exercise Addiction and Alexithymia, Journal of Psychology and Behavioral Science, 2015
The Tao of
Addiction Recovery
Learn the principles behind the Drunken Buddha approach to addiction recovery.
Adverse Childhood Experiences and Childhood Trauma
“All addictions — alcohol or drugs, sex addiction or internet addiction, gambling or shopping — are attempts to regulate our internal emotional states because we’re not comfortable, and the discomfort originates in childhood.”
Childhood trauma is where it all begins.
These studies show clearly the powerful link between painful experiences that happen to us when we’re small and the measures we take later on in life to medicate that pain (addiction being only one long-term consequence).
39. If you experienced many difficult events in childhood you are 7 and 11 times more likely to be addicted to alcohol and drugs, respectively.
The classic ACE study explored the relationship between traumatic childhood events and later negative life outcomes across 14,000 individuals.
The higher the ACE score, the greater the level of substance use and abuse.
Having four or more ACEs increased the risk of smoking by 2-4 times, the risk of alcoholism increased by 7 times, illicit drug use by 4.5 and injected drug use by just over 11 times.
40. Childhood trauma strongly linked to lifetime addiction
Researchers examined the prevalence of childhood trauma in a sample of 46 male inpatients with substance abuse disorder, controlling for posttraumatic stress disorder.
Interviews revealed that 77% had been exposed to severe childhood trauma. 58% had lifetime PTSD.
They concluded that “[t]he total number of lifetime substance dependence disorders was strongly positively associated with total childhood trauma exposure.”
This relationship remained even when controlling for demographics, family history of alcohol problems, combat exposure and lifetime PTSD.
41. The stressful effects of ACEs date back to 1900, transcending secular changes in alcohol availability, advertising and health campaigns
The relationship between total ACEs and the early initiation of alcohol use was studied among four generations, dating back to 1900. The researchers retrospectively assessed 8,417 members of an adult health maintenance organization in California.
They found that all individual ACEs, except physical neglect, increased the risk of ever using alcohol. Individual ACEs increased by two- to three-fold the risk of starting to drink by age 14.
The researchers comment that “[t]he persistent graded relationship between the ACE score and initiation of alcohol use by age 14 for four successive birth cohorts dating back to 1900 suggests that the stressful effects of ACEs transcend secular changes, including the increased availability of alcohol, alcohol advertising, and the recent campaigns and health education programs to prevent alcohol use.”
42. Impulsivity and compulsivity are consequences of childhood trauma and increase the risk of addiction
Researchers at the University of Cambridge compared 50 cocaine-dependent individuals, their non-drug-dependent siblings and 50 unrelated healthy volunteers.
The cocaine-dependent individuals and their siblings displayed lower cognitive functioning, greater impulsivity and reduced emotional functioning. What’s more, these traits were “significantly associated with the degree of childhood abuse in the sibling pairs.”
This suggests that the trauma-induced cognitive deficits and impulsivity are, in the words of the study, “a predisposing risk factor for the development of drug dependence.” However, the siblings did not develop drug dependence, so there are other factors at play.
As the lead research, Dr. Ersche commented: “Not all individuals with these personality traits would have had a traumatic upbringing. Nor does everyone with these traits develop an addiction. However, our findings show that some people are particularly at risk and their upbringing may have contributed to it.”
43. Trauma and stress in childhood makes rats more vulnerable to cocaine
Researchers at Yale tested 14 adult rats, eight of which had been isolated from their mother, siblings and nest for one hour a day for the first week of their life (the other six had not).
At three months, a ‘cocaine lever’ was introduced. The isolated rats learned to self-administer cocaine more quickly, and in exchange for lower doses, than the non-isolated rats.
There was no difference between the groups with a control lever that instead distributed food pellets, showing that the isolation effect is specific to cocaine.
"Using well-established animal models, we’ve found strong evidence that early life stress enhances vulnerability to drug addiction," said Therese A. Kosten, assistant professor of psychiatry at Yale School of Medicine.
44. Experiencing violence and/or accidents in childhood makes people more likely to use drugs
Researchers at Columbia University assessed a sample of nearly 10,000 US adolescents (aged 13-18) and examined whether childhood ‘potentially traumatic events’ (PTEs) were associated with illicit drug use.
36% of the sample reported PTEs prior to the age of 11. This was associated with higher risk of use of marijuana, cocaine, prescription drugs, ‘other’ drugs as well as ‘multiple’ drugs. Interpersonal violence was associated with all drug use outcomes. Accidents and unspecified events were associated with higher risk for marijuana, cocaine, and prescription drug use.
45. You’re brain’s connections are weakened by childhood trauma, making you more susceptible to addiction
At the Neuroscience 2018 conference, Sarita Silveria and her team presented research showing how childhood trauma increases the risk of alcohol addiction by impacting critical brain networks during adolescence.
Researchers assessed brain scans from 396 individuals, aged 12-22, all with different degrees of childhood trauma and compared it to their drinking behaviour.
The results showed that the connections in the areas of the brain important for sustained cognitive control are weakened by childhood trauma.
Study: SfN18: The adolescent brain, mental health and substance abuse, SfN Neuroscience 2018, 2018
46. Among prisoners, those with childhood trauma are more likely to also be addicts
Researchers assessed 312 prisoners with substance abuse issues alongside 591 without by getting them to complete an interview and a series of psychometric tests.
The participants with addiction problems scored higher for childhood trauma (as well as psychoticism, neuroticism, impulsivity, hostility, low resilience and suicidal ideation).
Post-Traumatic Stress (Disorder)
and Addiction
Post-traumatic stress (sometimes classified as a disorder) is a condition triggered by stressful or distressing events.
These studies suggest that PTSD can act as the bridge between the original traumatic event (or series of events) and addictive behaviours.
The traumatic event creates a kind of permanent stress in the system that people (understandably) seek relief from.
47. PTSD causes addictive behaviour, which makes PTSD symptoms worse, leading to an addictive cycle
Researchers conducted a metastudy of many studies relating to PTSD and substance use disorder.
They made several comments on the relationship between PTSD and substance use disorder.
Among men with PTSD alcohol dependence is the most common co-occurring disorder
Among women with PTSD it is the third most common (after depression and anxiety)
Among combat veterans with PTSD, 75% are dependent on alcohol
22-43% of persons with PTSD have lifetime substance use disorders (compared to 8-24% among persons without PTSD)
Up to 42.5% of patients in substance abuse treatment have PTSD
According to the researchers “most published data” on the relationship between PTSD and substance use supports the idea that substance use follows trauma exposure and the development of PTSD.
They note that substances provide “acute symptom relief”. And if you cease taking the substance you can go into a “hyperaroused state” with worse PTSD symptoms, which leads to more substance use to self-medicate the symptoms. The addictive cycle is unleashed.
48. PTSD is the key catalyst for addiction: traumatic events that do not result in PTSD don’t increase the risk of addiction
Researchers set out to explore the causal relationships between PTSD, exposure to traumatic events and drug use disorders. They assessed 1,007 adults and then followed up 3 and 5 years later.
They found that PTSD represents a 4.5x higher risk of drug dependence. Critically, exposure to traumatic events that did not result in PTSD did not increase the risk of drug dependence. I.e. the relationship between trauma and substance dependence is specific to PTSD.
They found no evidence that pre-existing drug dependence increased the risk of subsequent trauma exposure or PTSD.
49. High incidence of PTSD among cocaine addicts
Researchers interviewed 91 cocaine dependent individuals that were in treatment, exploring their substance use, trauma history and PTSD symptoms.
42.9% of participants met the criteria for lifetime PTSD. Individuals with PTSD had more severe cocaine dependence and significantly higher rates of exposure to trauma than those without.
50. More severe PTSD makes people more likely to drop out of addiction treatment
Researchers set out to determine why drug addicts would drop out of addiction treatment prematurely.
They analysed the profiles of 1,082 patients at a large addiction service across alcohol use disorder, drug use disorder, PTSD, anxiety disorders, major depressive disorder to see if they could predict treatment termination.
Those at highest risk of dropping out were characterised by severe drug use, severe psychopathology (especially PTSD), but, interestingly, low alcohol use. The lowest-risk were those with severe alcohol use but low drug us as well as low psychopathology.
They concluded that: “[t]hese results provide converging evidence that illicit drug severity and psychiatric severity, and particularly PTSD, were associated with premature termination.”
51. Combat veterans use alcohol to get relief from the symptoms of PTSD
Researchers interviewed 61 Vietnam combat veterans to measure the course over time of PTSD symptoms and how they relate to symptoms of substance abuse and the effects of alcohol and other substances on PTSD.
They found that the onset of alcohol and substance abuse “typically was associated with the onset of symptoms of PTSD, and the increase in use paralleled the increase of symptoms.”
These patients also report that alcohol, marijuana, heroin and benzodiazepines decreased symptoms of PTSD.
Physical Trauma
Physical trauma is not mentioned anywhere near as much as its emotional/psychological counterpart.
But it’s still a relevant avenue of exploration, with physical trauma being a potential catalyst for addiction (and vice versa, with addicts more likely to accidentally hurt themselves physically).
(Pssst….OK, I’ll be honest. This section is a little thin. I’ll beef it up in the next update.)
52. Teenagers with a traumatic brain injury use drugs more than those without
Researchers used data covering 6,383 participants from the 2011 Ontario Student Drug Use and Health Survey by the Centre for Addiction and Mental Health to determine the relationship between traumatic brain injury (TBI) and drug use.
TBI was defined as “any hit or blow to the head that resulted in the teenager being knocked out for at least five minutes or spending at least one night in hospital due to symptoms associated with the head injury”.
So, something quite unpleasant.
They found strong associations between TBI and substance use. As reported on Science Daily, the research showed that, in the past 12 months, teens with a history of TBI said they were:
2 times more likely to have engaged in binge drinking
2.5 times more likely to smoke daily
3.8 times more likely to have used crystal meth
3.8 times more likely to have used non-prescribed tranquilizers or sedatives
2.8 times more likely to have used ecstasy
2.7 times more likely to have used non-prescribed opioid pain relievers
2.6 times more likely to have used hallucinogens
2.5 times more likely to have used cocaine
2.5 times more likely to have used LSD
2.1 times more likely to have used non-prescribed ADHD drugs
Plus, those with a history of TBI had greater odds of experiencing “harmful” drinking, cannabis problems and drug problems compared to those without.
Sex-Specific Differences
Studying sex differences is tricky. What we mean by ‘man’ or ‘woman’ (and the binary itself) are heavily influenced by culture as well as biology. There are also multiple ways of approaching and categorising sex differences, with different results depending on how you slice it.
Plus, exactly why there are differences (regarding addiction) between men and women is a complicated topic, with myriad biological, social, cultural and political factors that must be considered. This would go well beyond what I’m trying to do here. They are often considered in the original studies that I link to here, so have a read!
Basically, the following studies are not the Final Truth™ on this topic, but still provide helpful indications that gender/sex is a useful (indeed, necessary) lens through which to view addiction and recovery.
53. Women get addicted faster and are more susceptible to relapse than men
A literature review of the scientific data on sex differences in addiction highlights several key differences at various stages of the addiction cycle.
Overall:
Men engage in more drug taking and more alcohol consumption and present higher levels of misuse. But these differences are declining (see study 54)
There appear to be “relatively minor” differences due to the female menstrual/estrous cycle
Binge/intoxication stage:
For all substances, women who become addicted progress through the stages of initial use to dependence faster than men (except possibly alcohol, where evidence is mixed)
Withdrawal/negative affect (i.e. hangover?) stage:
Evidence suggests that women have greater sensitivity to alcohol withdrawal than men with ‘elevated negative affect’ after ‘high-dose drinking’ (I think they mean hangovers) lasting longer for women than men
Women report increased negative emotion during withdrawal and have higher levels of stress hormones
Preoccupation/anticipation stage:
Women generally show a greater propensity to relapse for most drugs compared to men, with shorter periods of abstinence between relapses
For alcohol, cocaine and nicotine, stress-induced relapse is a greater risk for women than men
Women show greater cue-induced craving and relapse for cocaine
Their review emphasises that there are “not only significant differences in the phenotypes of females and males in the domain of addiction but emphasizes the paucity of data to date in our understanding of those differences.”
Note: there is a lot of nuance that I haven’t been able to capture here, I would recommend reading the original study if you’re interested, which contains a lot of commentary and detail.
Study: Sex Differences in Animal Models: Focus on Addiction, Pharmacological Reviews, 2016
54. Historically, men drink more alcohol than women but the gap is closing as access increases for women
Evidence suggests that men drink more alcohol than women but that this gap is closing as improved gender equality (ish) gives women and girls greater access to substances (possibly through changing social and work roles) and reduces the stigma around drinking for women.
Researchers compared men and women across four age groups for four alcohol-related behaviours: largest ever amount of drinks, binge drinking frequency, alcohol dependence and alcohol abuse.
The results showed “substantial … differences in gender differences between the oldest and youngest cohorts for all alcohol variables”.
A researcher commented in a separate literature review: “among the oldest cohort of women (born in 1913–1932), only 2% reported a lifetime prevalence of frequent binge drinking, whereas in the youngest cohort of women (born in 1968–1984), 16% reported a lifetime prevalence of frequent binge drinking. Furthermore, among the oldest cohort, the odds of binge drinking in men was 10.55-times higher than in women, but for the youngest cohort, the odds of binge drinking in men was 2.66-times higher than in women”.
Gender differences in risk of frequent binge drinking and alcohol dependence decreased by a factor of four, alcohol abuse by about 2.65. The difference in ‘lifetime largest drinks’ was only a slight reduction.
Men still drink more, but the change suggests any difference is due to culture rather than biology: “Despite the decreases in gender differences in cohorts shown above, the prevalence of all alcohol disorders remained higher in men than women in all birth cohorts.”
Note: there is a lot of nuance that I haven’t been able to capture here, I would recommend reading the original study if you’re interested, which contains a lot of commentary and detail.
55. Women have two to three times higher rate of PTSD than men (among substance use patients)
In a research review in the American Journal on Addictions, academics found that 30-59% of women substance abusers also have PTSD. This most commonly came from repetitive childhood physical and/or sexual assault.
Rates of PTSD for men with substance abuse are two to three times lower, most commonly deriving from combat or crime trauma.
56. PTSD and depression more strongly associated with alcoholism in women than men
Researchers interviewed 133 adolescents (55 female, 78 male) with substance abuse and 86 (44 female, 42 male) without.
PTSD (as well as depression) symptoms were more strongly associated with alcohol dependence in women than in men.
The study states: “...in a group of adolescents, a history of sexual abuse increased the risk of problem drinking to 20 times the normal rates of alcohol abuse for both sexes. However, females were much more likely to have been sexually abused than males and consequently the symptoms of PTSD were more common for female than male alcohol abusers”.
57. Women becoming addicted to drugs may be a different process than with men
Male and female rats had access to a lever that dosed them with cocaine and simultaneously triggered a light (an environmental cue).
When female rats had high hormone levels they were more susceptible to associating the environmental cue (the light) with cocaine. And just the cue alone is enough to increase activity in the areas of the brain responsible for motivation (for seeking the drug, in this case).
The study concludes that: “together, these factors may combine to produce a unique state for females in which drugs and conditioned cues interact, thus enhancing addiction vulnerability and relapse.”
Erin Calipari, an assistant professor of pharmacology in the Vanderbilt Center for Addiction Research stated: "Women becoming addicted to drugs may be a fundamentally different process than men. It's important to understand this, because it's the first step in developing treatments that are actually effective."
Additional material: ScienceDaily
58. The brains of male and female rats addicted to alcohol change in different ways
The study, by the Scripps Research Institute, was designed to examine sex-specific differences in brian changes that may be responsible for driving alcohol abuse among those with PTSD.
They studied how male and female rats responded to traumatic stress and alcohol. While both sexes responded to stressful events and alcohol access by increased drinking and common PTSD behaviours (social avoidance, defensive behaviour etc.) there were key differences in how their brains changed.
Males exhibited a specific immune system protein that females did not. Likewise, there were differences in patterns of a neurotransmitter known as GABA, which fosters relaxation and is a known factor in alcohol dependence.
Michael Steinman, co-lead author remarked in Neuroscience News that “[t]his may be important because there is growing awareness that medicines could potentially have different levels of effectiveness in male and female patients and understanding the biology that explains why these differences exist could improve outcomes.”
Intergenerational and
Collective Trauma
Intergenerational and collective trauma is swiftly emerging as a deep field of study and a critical lens through which to understand much of the conflict in the world today (including addiction).
Broadly, these terms refer to trauma shared by a group of people that can be passed on from generation to generation.
59. Collective trauma contributes to alcohol abuse in American Indians
Researchers investigated the link between discrimination, historical loss, enculturation (the degree to which someone is embedded in traditional cultural practices and maintains a strong cultural identity) and substance abuse among American Indians.
Historical loss encompassed 12 points: loss of land, language, culture and traditional spiritual ways; loss of family and family ties; loss of self-respect; loss of trust; loss of people through early death; and loss of children’s respect for elders and traditional ways.
They interviewed 452 parents/caregivers (351 women, 101 men), measuring their perception of discrimination, historical loss as well as to what extent they meet the criteria for alcohol abuse.
The study concludes that “alcohol abuse is strongly associated with historical loss”.
Perceived discrimination was strongly associated with historical loss, which, in turn, was associated with alcohol abuse among women.
Enculturation had a protective effect against alcohol abuse, but it is limited.
The authors note that “historical loss is much on the minds of some American-Indian adults and they attribute negative emotional responses to it. Alcohol may serve to reduce intrusive thoughts or feelings related to historical loss.”
60. Half of American Indians think about historical loss, which correlates with addiction and anxiety
Researchers aimed to evaluate the extent to which thoughts of historical loss and associated symptoms are influenced by current trauma, PTSD, cultural identification, substance dependence, affective/anxiety disorders and conduct/antisocial personality disorder.
They assessed 306 American Indian adults living on reservations using semi-structured interviews.
Over half thought about historical losses “at least occasionally”, causing distress. How often someone did so was associated with not being married, high degree of Native Indian heritage and high cultural identification.
Substance dependence (as well as affective/anxiety disorder) was correlated with historical loss symptoms.
61. Historical trauma higher among urban American Indians than those on reservations
The researchers studied historical trauma (via historical loss and its symptoms) in a sample of 120 urban American Indians.
Their results revealed that urban Indians report higher levels of historical trauma compared with their reservation-based counterparts, and historical trauma was found to predict substance use.
At the same time, frequent thoughts about historical loss were associated with family cohesion.
Mechanisms of Trauma
and Addiction
Why is trauma linked to addiction?
What are the mechanisms which perpetuate trauma?
How does addictive behaviour medicate trauma symptoms?
What is the role of thoughts and feelings?
62. We use alcohol to reduce not only negative but also positive emotions
Researchers wanted to explore how populations with PTSD used alcohol to intentionally reduce not only negative emotions but also positive emotions.
They collected data from 320 trauma-exposed, substance-using individuals. They found that individuals with greater PTSD symptom severity reported higher alcohol use to down-regulate negative emotions (despondency, anger) and positive emotions, all of which were, in turn, linked with greater alcohol misuse.
63. Difficulty controlling emotions and behaviour could be the causal link between childhood trauma and addiction
Researchers set out to examine the associations between childhood abuse, emotional dysregulation and probably PTSD among 93 substance use disorder patients in residential treatment.
Compared to those without PTSD, patients with probable PTSD reported more severe childhood abuse as well as much higher levels of emotional dysregulation, impulsivity when distressed and lack of emotional clarity.
The researchers found significant associations between childhood physical and emotional (but not sexual) abuse and aspects of emotional dysregulation.
They also state that impulsivity (i.e. difficulty controlling behaviours when distressed) accounts for the link between childhood abuse and PTSD symptoms.
64. Traumatic memories make drugs more appealing, making people susceptible to addiction
Researchers set out to examine the nature of traumatic memories with regard to PTSD and addiction.
They set up an experiment with rats that had learned to associate an electric shock to the foot with a certain scent. When reminded of the experience, these rats showed a greater freeze response and spent more time in an area where they had previously received a dose of morphine.
Interestingly, by activating different dopamine receptors, the effect was either nullified or enhanced.
The results suggest that changes to dopamine signals may be a mechanism by which traumatic memories predispose people to addiction by increasing their sensitivity to the rewarding effects of drugs.
Additional materials: Science Daily
65. Childhood trauma makes your nervous system and immune system more sensitive
They exposed the mice to a scary male, which altered parts of an area of their brain that deals with reward (and drug-seeking) and made their nervous system more sensitive to cocaine.
Next, they looked at the human participants. Those who had experienced childhood maltreatment had greater levels of immune system activation. Cocaine addicts who experienced childhood maltreatment had the highest levels.
The study suggests that childhood adversity triggers immune system activation, in both humans and mice, leading to permanent changes in the sensitivity of the nervous system and, as a result, an increased susceptibility to the effects of cocaine in adulthood.
Interestingly, preventing this immune system activation (using pharmacological interventions) prevented the cocaine susceptibility from developing in later life.
66. Chronic stress impairs your dopamine production and makes the world appear more threatening
The researchers took 34 volunteers, half of which already had experienced high levels of psychosocial stress throughout their lives, while the other half experienced low levels.
They exposed the volunteers to acute stress and measured their levels of dopamine, the brain’s motivation/reward chemical, which is activated to help us respond to stressful situations appropriately.
Those with low lifetime stress exposure produced levels of dopamine proportional to the degree of threat present. Those with high lifetime stress exposure had an exaggerated perception of the threat as well as impaired dopamine production. The same finding applied also to blood pressure and stress hormone levels.
Lead author Dr. Bloomfield commented in Daily Science: "[t]his study can't prove that chronic psychosocial stress causes mental illness or substance abuse later in life by lowering dopamine levels, but we have provided a plausible mechanism for how chronic stress may increase the risk of mental illnesses by altering the brain's dopamine system."
67. How you think about traumatic events determines the level of stress you experience
The study was the first of its kind to conduct a multivariate analysis of whether psychological factors affect mental health. The researchers assessed 32,827 respondents who completed an open-access series of questionnaires hosted by the BBC exploring the causes and consequences of stress.
They found that traumatic or abusive experiences strongly predicted higher levels of anxiety and depression. But these relationships were determined also by “psychological processes”, i.e. how people thought about the experiences they lived through, including lack of adaptive coping, rumination and self-blame.
The study concludes that “psychological processes determine the causal impact of biological, social and circumstantial risk factors on mental health”.
This is huge: how you think about what happens determines its impact on your mental (and therefore emotional) health!
68. Heavy drinking rewires our brain making it harder to recover after a traumatic experience
Researchers took two groups of mice, one of which received doses of alcohol (equivalent to double the human legal driving limit) while the other were given none. All the mice were then given mild electric shocks at the sound of a brief tone in order to train them to fear it.
They then played the tone without delivering the shock. The ‘alcohol-free’ mice gradually lost their fear of the tone. The mice who had been given lots of alcohol would freeze at the playing of the tone, even long after the shocks had stopped.
The study states: “[t]hese findings suggest alcohol may increase risk for trauma-related anxiety disorders” and that “chronic history of alcohol abuse may increase risk of persistent fear after psychological trauma”.
This closes the circle: trauma makes people (well, mice, possibly people) susceptible to addiction, which then makes people susceptible to trauma.
69. Traumatic memories are kept in place and reinforced by stress hormones
Researchers at the International Graduate School of Neuroscience in Bochum investigated the effect of the stress hormone cortisol on memory retrieval in a three-day study.
On the first day participants were shown a series specific geometric shapes along with an unpleasant shock. On the second day, some were given a cortisol pill, others a placebo. Next, they were shown only one of the shapes associated with the shock (but not given a shock). On the third day, their memory of the shapes was tested.
The participants who were given the stress hormone remembered the shock-associated shape particularly well. The cortisol reinforced the traumatic memory.
Prof Dr Oliver Wolf, one of the researchers, commented in Science Daily: “The results may explain why certain undesirable memories don't fade, for example in anxiety and PTSD sufferers.”
Study: Effects of Cortisol on Reconsolidation of Reactivated Fear Memories, Neuropsychopharmacology, 2015
70. Expecting alcohol to provide relief and believing that you can’t say ‘no' to a drink makes contributes to the risk of alcoholism
Researchers wanted to investigate the variables that make the association between PTSD and alcohol addiction more likely.
They investigated sex, avoidance coping, tension-reduction expectancies (translation: do you expect alcohol to relax you?) and ‘emotional-relief drinking-refusal self-efficacy’ (translation: do you believe that you can say no to a drink when you’re stressed?) among 144 undergraduates.
They found a significant positive relationship between PTSD symptoms and alcohol addiction only in males who both strongly expected alcohol to relax them and also believed that they wouldn’t be able to say no to a drink when stressed.
71. Being unable to control an event makes it more painful and traumatic
The degree to which someone can control a traumatic event has a major impact on the effect of that event.
Animals that are exposed to uncontrollable foot shocks display greater levels of stress hormones than those that are exposed to shocks they can escape.
During uncontrollable trauma the brain produces endorphins to numb the pain of the event. After the event, endorphin levels gradually decrease leading to a period of endorphin withdrawal that can last from hours to days. This period is marked by emotional stress and can contribute to other symptoms of PTSD.
Researchers hypothesise that “[b]ecause alcohol use increases endorphin activity, drinking following trauma may be used to compensate this endorphin withdrawal and thus avoid the associated emotional distress”.
The emotional and physical numbing effects of the alcohol compensate for the increased emotional pain that comes from the trauma.
72. Separating baby monkeys from their mothers doubles their alcohol consumption
Twenty-two rhesus monkeys were separated into two groups: one group was separated from their mother and other adults for the first six months of life while the other control group was not.
The peer-reared group were more fearful and less exploratory than the mother-reared group. Both groups were then given access to a sweet alcoholic solution (7%, if you were wondering) and a sweet, non-alcoholic solution.
Monkeys that were raised by their peers demonstrated “chronically high levels of anxious-like behaviours” and consumed alcohol at double the rate of the mother-reared monkeys.
However, if mother-raised monkeys were separated from all social support, they started to drink alcohol at nearly the same rate as the peer-reared monkeys.
In all cases, the measurements of stress were correlated with alcohol consumption.
The researchers conclude that “early experiences that result in increased levels of anxious-like behaviors can have a major impact on alcohol consumption” and that the study “directly links rearing-induced differences in behaviour to stress-induced changes in alcohol consumption.”
73. Intergenerational trauma can change some genes that are related to stress and the immune system
Researchers studied the genome and gene expression of 77 offspring of Holocaust survivors, using 15 subjects as a control.
They found that forty-two genes related to immune cell function that were “differentially expressed” (this refers to differences between genes that are statistically significant) in the children of Holocaust survivors.
I’ll be honest. I couldn’t keep up with all the science chat on this one. So I’ll just quote the authors’ conclusions. They found that the changes had previously been described in relation to “intergenerational transmission of stress effects.”
The most significant change was in a gene called “MMP-8”, which is involved in “stress-regulated wound healing and inflammation”.
In the abstract they state that “[o]ffspring of trauma survivors are more likely to develop PTSD, mood, and anxiety disorders and demonstrate endocrine and molecular alterations compared to controls”.
74. Mothers’ substance use is a pathway for the transmission intergenerational trauma
Researchers at Ghent University used in-depth qualitative interviews with 23 mothers with substance use disorders to gather information on their parenting experiences and parent-child bonding (for both their children and parents).
The researchers discovered how trauma affected the mothers’ lives and, subsequently, impacted their parenting, transmitting intergenerational trauma.
They identified five latent mechanisms of intergenerational trauma transmission:
Early interpersonal childhood trauma experiences in mothers
Trauma as a precursor of substance use
Substance use as a (self-fooling) enabler of parental functioning
Continued substance use impacting their capacity to be a good parent
Dysfunctional parenting and its impact on the children
They describe these as prominent stages that build upon each other. They warn, however, that they should not be interpreted linearly and should be regarded as “coexisting parts of the complex lived experiences of these mothers.”
They found that the mothers did not feel attached or safe in the world due to early interpersonal trauma. They would use substances to cope with these painful feelings, which may have increased the risk of suboptimal parenting, perpetuating the cycle of trauma by jeopardising secure attachment in their children’s lives.
Problematic substance abuse and related parental dysfunction can result in mechanisms by which insecure attachment and trauma are transmitted across generations.
The researchers concluded that “participants reported to have experienced emotional abuse and neglect as a child, resulting in insecure attachment and high parental stress. The long-lasting relational effects of childhood interpersonal trauma may impede parents’ capacity, increasing the risk of abusive or neglectful behavior towards their own children and maintain the risk of intergenerational cycles of trauma.”
Later on they continue: “experiences of early interpersonal trauma can affect parental functioning negatively, leading to adverse experiences in second generations. Parents who have traumatic histories themselves and consequential disruptive attachment styles tend to communicate these dysfunctions to their own children who may later develop disruptive attachment patterns.”
Other researchers commented that the findings confirm the “high prevalence of intergenerational trauma among families impacted by maternal substance use.”
That’s all folks.
Did I miss anything? Do you know of any studies or angles on the topic that should be included? Want to share your own experiences?
Leave a comment below!
Peace,
Ben
Pssst. Btw. Want a hand getting to the bottom of your addictive tendencies?
I help people go into their bodies (where the drivers of addiction are) to defuse their suffering.
I help people in addiction recovery to get to the root of the pain that is driving them bonkers so they can live in greater freedom.
There are two ways to find out if I can help.
Learn more about Somatic Inquiry, the modality I use to uncover and unravel the drivers of addiction. Or book a quick chat with me to see if we would be a good fit.
I wouldn’t trade what Somatic Inquiry has given me for anything in the world. I’ve put together an introduction to Somatic Inquiry to help you figure out whether I’m barking mad or legit.
Book a free 30-minute call with me to discuss where you’re at, to find out a bit more about me and see if I might be able to help you. No pressure. No commitment.