Childhood Emotional Abuse Linked To Opioid Addiction Later in Life
Investigators from the University of Vermont have found that childhood emotional abuse appears to be linked to adult opioid addiction and other substance-related problems in those who have post-traumatic stress disorder (PTSD) and also exhibit impulsivity.
Moreover, a history of emotional child abuse and negative urgency are both associated with PTSD symptoms, which are also related to substance-related problems. As a result, this implies that PTSD may play a critical role in the development of substance use disorders.
Head researcher Matthew Price, PhD., assistant professor, Department of Psychological Science, University of Vermont (Burlington) to Medscape Medical News:
“People in our sample reported all types of abuse history, but emotional abuse was more relevant to future opioid misuse than the other forms of abuse.”
“Emotional abuse was associated with strong negative urgency, which contributed to the severity of PTSD. Severe PTSD can lead to greater agitation and, in turn, to self-medication with opioids.”
Childhood Mistreatment is Common Among Opioid Users
A history of emotional child abuse, as well physical and sexual abuse, are commonly reported by by those who misuse opioids as adults.
Psychology Today describes negative urgency as “a personality predictor of externalizing behavior characterized by neuroticism, low conscientiousness, and disagreeableness.”
That is, negative urgency is a personality trait related to impulsivity and is the tendency to act rashly when experiencing negative affect. Positive urgency is thus acting rashly in response to positive affect.
About the Study
Researchers examined and cross-referenced the outcome of a series of psychological tests given to 84 adults who had used heroin or had abused prescription painkillers for more than one year. Several instruments were used to evaluate their mental health, substance use/abuse patterns, and history of trauma.
Of those participants who reported PTSD symptoms and mistreatment in childhood, more than two-thirds (67.9%) were diagnosable as current PTSD.
Researchers then examined the relationship between childhood mistreatment, urgency traits, PTSD symptoms, and substance-related problems. They found the following:
- Emotional child abuse, negative urgency, positive urgency and PTSD were all indicators of opioid-related problems.
- Other types of abuse (i.e. physical abuse) were not related to PTSD or opioid-related problems.
- Negative urgency and emotional child abuse both had significant indirect paths to opioid-related problems via PTSD
“People who have a tendency to lash out make bad choices when upset, which contributes to worse PTSD symptoms, leading to increased substance use.”
That is, mistreatment in childhood and negative urgency are both linked to PTSD, which is in turn linked to severe substance-related problems.
Dr. Price also stressed the critical role of emotional versus physical abuse in the development of PTSD:
“In physical abuse, it is easier to recognize that the perpetrator is at fault. But in emotional abuse, the perpetrator attacks the victim’s character…The victim internalizes the message and feels at fault, making emotional abuse more insidious than physical abuse.”
“Therapeutic strategies successfully used for physical or sexual abuse are less effective in those who have been emotionally abused.”
About Post-Traumatic Stress Disorder
According to the National Institute of Mental Health, PTSD is a condition that develops in some people who have experienced a particularly scary or dangerous event.
It is very normal for people who experience trauma to experience intense reactions, such as fear or sadness.
Those who develop PTSD, however, do not recover from the initial shock, and tend to feel anxiety and frightened over events long after the danger has passed.
Signs and Symptoms
Symptoms usually begin within three months of the precipitating event(s), but some may begin months or years later. Symptoms last more than 30 days and interfere with normal functioning and relationships. There is no timeline for the condition – in some people the condition becomes chronic, and they will suffer for years.
Do You or Someone You Know Have PTSD?
PTSD is most often diagnosed by a person who works professionally with mental illness, such as a psychiatrist.
Persons with PTSD have suffered for more than a month from the following:
- At least one re-experiencing symptom, such as flashbacks or nightmares
- At least one avoidance symptom, such as avoiding places, events, or objects that serve as reminders
- At least two arousal/reactivity symptoms, such as being easily startled and on edge
- At least two cognition and mood symptoms, including having negative feelings about oneself such as guilt or blame
As a reminder, it is normal to experience some of these symptoms after a stressful event – even weeks after. This is known as acute stress disorder. However, if the symptoms last long-term (over one month) and begin to interfere with normal functioning, it may be PTSD. PTSD is also associated with other mental illness problems, such as depression and substance abuse.
~ G. Nathalee Serrels, M.A., Psychology
Rebecca Mirhashema, Holley C. Allena, Zachary W. Adamsb, Katherine van Stolk-Cookea, Alison Legranda, Matthew Price. The intervening role of urgency on the association between childhood maltreatment, PTSD, and substance-related problems. http://dx.doi.org/10.1016/j.addbeh.2017.02.012