From childhood trauma to alcohol use disorder severity - significance of depressive symptoms and expectations towards analgesic effects of alcohol.

Aims: The objective of the current study was to describe and analyse associations between childhood emotional abuse, severity of depressive symptoms, and analgesic expectations of drinking in individuals with alcohol use disorder (AUD).

Methods: A total of 240 individuals aged 43.85 ± 11.0 with severe AUD entering an inpatient, abstinence-based, and drug-free treatment program were assessed. The data on AUD severity, depressive symptoms, expectations towards the analgesic effects of alcohol and childhood emotional trauma was collected using questionnaire measures. The PROCESS SPSS macro for serial mediation with bootstrapping was used to test whether current severity of depressive symptoms and expectations towards analgesic effects of alcohol use serially mediated the association between childhood emotional abuse on AUD symptom severity.

Results: There was evidence for two simple mediated effects, whereby the severity of depressive symptoms mediated the association between childhood emotional abuse on AUD symptom severity, and expectations towards analgesic effects of alcohol mediated the association between childhood emotional abuse on AUD symptom severity. There was also evidence to support serial mediation whereby both severity of depressive symptoms and expectations towards analgesic effects of alcohol mediated the association between childhood emotional abuse on AUD symptom severity.

Conclusions: It might be clinically relevant to address experiences of childhood emotional trauma, as well as individual expectations of analgesic effects of alcohol, in AUD treatment programs.