Çocukluk Çağı Travmalarının Madde Kullanım Bozukluklarındaki Rolü: Klinik ve Terapötik Yaklaşımlar
Özet
Bu kitap bölümü, çocukluk çağı travmalarının madde kullanım bozukluklarının (MKB) etiyolojisi, klinik seyri ve tedavisindeki kritik rolünü incelemektedir. MKB, yalnızca madde maruziyetiyle değil; gelişimsel, psikososyal ve biyolojik faktörlerin karmaşık etkileşimiyle gelişen bir rahatsızlıktır. Erken dönemde maruz kalınan istismar (tehdit) ve ihmal (yoksunluk) yaşantıları, gelişmekte olan stres yanıt sistemlerini, duygu düzenleme kapasitesini ve bağlanma örüntülerini kalıcı olarak bozabilmektedir. Bu nörogelişimsel kırılganlık, bireyin maddeyi içsel bir düzenleyici veya kendini tedavi etme aracı olarak kullanmasına zemin hazırlayabilmektedir. Klinik pratikte travma öyküsü olan bireylerde MKB'nin daha erken yaşta başladığı, daha şiddetli seyrettiği, çoklu madde kullanımının, psikotik belirtilerin ve intihar riskinin önemli ölçüde arttığı görülmektedir. Ayrıca bu tabloya sıklıkla majör depresyon ve anksiyete gibi komorbid bozukluklar eşlik edebilmektedir. Bu nedenle, bağımlılık tedavisinde hastaların yapılandırılmış araçlarla (örn. CTQ) sistematik olarak değerlendirilmesinin büyük önem taşımaktadır. Terapötik yaklaşımda öncelik güvenlik ve stabilizasyonun sağlanması olup, ardından EMDR gibi travma odaklı müdahalelerin entegre edilmesi önerilmektedir. Sonuç olarak, MKB tedavisinde travma duyarlı bakım uygulamaları tamamlayıcı bir seçenek değil, klinik standart olarak benimsenmelidir.
This book chapter examines the critical role of childhood trauma in the etiology, clinical course, and treatment of substance use disorders (SUD). SUD is a disorder that develops not only through substance exposure but also through the complex interaction of developmental, psychosocial, and biological factors. Early-life experiences of abuse (threat) and neglect (deprivation) can permanently disrupt developing stress response systems, emotion regulation capacity, and attachment patterns. This neurodevelopmental vulnerability may pave the way for an individual to use substances as an internal regulator or a self-medication tool. In clinical practice, it is observed that in individuals with a history of trauma, SUD begins at an earlier age, progresses more severely, and is associated with a significant increase in poly-substance use, psychotic symptoms, and suicide risk. Additionally, this presentation is frequently accompanied by comorbid disorders such as major depression and anxiety. Therefore, systematically assessing patients using structured tools (e.g., CTQ) holds great importance in addiction treatment. In the therapeutic approach, the priority is ensuring safety and stabilization, followed by the integration of trauma-focused interventions such as EMDR. Consequently, trauma-informed care practices in the treatment of SUD should be adopted not as a complementary option, but as a clinical standard.
Referanslar
Chilcoat HD, Breslau N. Trauma and substance use disorders. Archives of General Psychiatry. 1998;55(11): 993-1002. doi: 10.1001/archpsyc.55.10.913
Chandler GE, Kalmakis KA, Murtha T. Screening adults with substance use disorder for adverse childhood experiences. Journal of Addictions Nursing. 2018;29(3): 172-178. doi:10.1097/JAN.0000000000000233
Schindler A, Bröning S. A review on attachment and adolescent substance abuse: Empirical evidence and implications for prevention and treatment. Substance Abuse. 2015;36(3): 304-313. doi:10.1080/08897077.2014.983586
Fairbairn CE, Briley DA, Kang D, et al. A meta-analysis of longitudinal associations between substance use and interpersonal attachment security. Psychological Bulletin. 2018;144(5): 532-555. doi:10.1037/bul0000141
Hofmeyr A, Aydin C, Rimes KA. The role of trauma in substance use: Beyond PTSD. The Lancet Psychiatry. 2024;11(2): 163-175. doi:10.1016/S2215-0366(23)00392-1
Khantzian EJ. The theory of self-medication and addiction. Psychiatric Times. 2017;34(2).
Belsky J, Pluess M. Beyond diathesis stress: differential susceptibility to environmental influences. Psychological Bulletin. 2009;135(6): 885-908. doi:10.1037/a0017376
Slavich GM. Social Safety Theory: A biologically based evolutionary perspective on life stress, health, and behavior. Annual Review of Clinical Psychology. 2020;16: 265-295. doi:10.1146/annurev-clinpsy-032816-045159
Hostinar CE, Johnson AE, Gunnar MR. Early social deprivation and the social buffering of cortisol stress responses in late childhood: An experimental study. Developmental Psychology. 2015;51(11): 1597-1608. doi:10.1037/dev0000029
Teicher MH, Samson JA. Annual research review: Enduring neurobiological effects of childhood abuse and neglect. Journal of Child Psychology and Psychiatry. 2016;57(3): 241-266. doi:10.1111/jcpp.12507
McLaughlin KA, Sheridan MA, Lambert HK. Childhood adversity and neural development: Deprivation and threat as distinct dimensions of early experience. Neuroscience & Biobehavioral Reviews. 2014;47: 578-591. doi:10.1016/j.neubiorev.2014.10.012
Balbuena LD, Baetz M, Sexton JA, et al. Identifying long-term and imminent suicide predictors in a general population and a clinical sample with machine learning. BMC Psychiatry. 2022;22: 120. doi:10.1186/s12888-022-03702-y
Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine. 1998;14(4): 245-258. doi: 10.1016/s0749-3797(98)00017-8
McLaughlin KA, Sheridan MA. Beyond cumulative risk: A dimensional approach to childhood adversity. Current Directions in Psychological Science. 2016;25(4): 239-245. doi:10.1177/0963721416655883
Sheridan MA, McLaughlin KA. Dimensions of early experience and neural development: Deprivation and threat. Trends in Cognitive Sciences. 2014;18(11): 580-585. doi:10.1016/j.tics.2014.09.001
Swartz JR, Knodt AR, Radtke SR, et al. A neural biomarker of psychological vulnerability to future life stress. Neuron. 2015;85(3): 505-511. doi:10.1016/j.neuron.2014.12.055
Turecki G, Brent DA. Suicide and suicidal behaviour. The Lancet. 2016;387(10024): 1227-1239. doi:10.1016/S0140-6736(15)00234-2
Martins LC, Campos RC, Morujão IS. The mediating role of tolerance for psychological pain in the relationship of childhood trauma to suicidal ideation in individuals with a substance use disorder. The British Journal of Clinical Psychology. 2022;61(2): 197-213. doi:10.1111/bjc.12338
Angelakis I, Gillespie EL, Panagioti M. Childhood maltreatment and adult suicidality: A comprehensive systematic review with meta-analysis. Psychological Medicine. 2019;49(7): 1057-1078. doi:10.1017/S0033291718003823
Cao R, Chen L, Yang J, et al. Specific effects of five subtypes of childhood maltreatment on suicide behaviours in Chinese adolescents: The moderating effect of sex and residence. Epidemiology and Psychiatric Sciences. 2023;32: e25. doi:10.1017/S2045796023000604
Sumner JA, Colich NL, Uddin LQ, et al. Early experiences of threat, but not deprivation, are associated with accelerated biological aging in children and adolescents. Biological Psychiatry. 2019;85(3): 268-278. doi: 10.1016/j.biopsych.2018.09.008.
Kim-Spoon J, Brieant A. Psychopathology as long-term sequelae of maltreatment and socioeconomic disadvantage: Neurocognitive development perspectives. Development and Psychopathology. 2024: 1-13. doi:10.1017/S095457942400018X
Norman RE, Byambaa M, De R, et al. The long-term outcomes of childhood sexual abuse, physical abuse, and neglect: A systematic review and meta-analysis of epidemiological studies. PLoS Medicine. 2012;9(11): e1001349. doi:10.1371/journal.pmed.1001349
Laporte N, Ozolins A, Westling S, et al. Adverse childhood experiences as a risk factor for non-suicidal self-injury and suicide attempts in forensic psychiatric patients. BMC Psychiatry. 2023;23(1): 238. doi:10.1186/s12888-023-04724-w
Devries KM, Mak JY, Child JC, et al. Childhood sexual abuse and suicidal behavior: A meta-analysis. Pediatrics. 2014;133(5): e1331-e1344. doi:10.1542/peds.2013-2166
Stocchero BA, Rothmann LM, Portolan ET, et al. The consequences of childhood maltreatment on dual-diagnosis psychiatric conditions and clinical outcomes in substance use disorders: A systematic review and meta-analysis. Child Abuse & Neglect. 2024;158: 107085. doi:10.1016/j.chiabu.2024.107085
Ramírez M, Ugedo A, Fañanás L, et al. Scoping review of biological and psychosocial pathways that lead from childhood adversity to early-onset substance use. Frontiers in Psychiatry. 2025;16: 1612494. doi:10.3389/fpsyt.2025.1612494
Miller GE, Chen E, Zhou ES. If it goes up, must it come down? Chronic stress and the corrosive nature of pro-inflammatory cytokines. Psychological Bulletin. 2007;133(1): 25-45. doi:10.1037/0033-2909.133.1.25
Kuhlman KR, Horn SR, Chiang JJ, et al. Early life adversity exposure and circulating markers of inflammation in children and adolescents: A systematic review and meta-analysis. Psychoneuroendocrinology. 2018;89: 31-35. doi:10.1016/j.psyneuen.2017.12.015
Koob GF. Drug addiction: Hyperkatifeia/negative reinforcement as a framework for medications development. Pharmacological Reviews. 2021;73(1): 163-201. doi:10.1124/pharmrev.120.000083
Koob GF, Volkow ND. Neurocircuitry of addiction. Neuropsychopharmacology. 2010;35(1): 217-238. doi:10.1038/npp.2009.110
Melhem NM, Keilp JG, Porta G, et al. Blunted HPA axis activity in suicide attempters compared to those at high risk for suicidal behavior. Neuropsychopharmacology. 2016;41(6): 1447-1456. doi:10.1038/npp.2015.309
Young ES, Doom JR, Farrell AK, et al. Life stress and cortisol reactivity: An exploratory analysis of the effects of stress exposure across life on HPA-axis functioning. Development and Psychopathology. 2020;33(3): 827-838. doi:10.1017/S095457942000002X
Liu SX, Harris AC, Gewirtz JC. How life events may confer vulnerability to addiction: the role of epigenetics. Frontiers in Molecular Neuroscience. 2024;17: 1462769. doi:10.3389/fnmol.2024.1462769
Funchal GA, Schuch JB, Zaparte A, et al. Cocaine-use disorder and childhood maltreatment are associated with the activation of neutrophils and increased inflammation. Acta Neuropsychiatrica. 2024;36(2): 97-108. doi:10.1017/neu.2023.11
Mikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change. 3rd ed. New York: Guilford Press; 2019.
Schindler A. Attachment and substance use disorders-theoretical models, empirical evidence, and implications for treatment. Frontiers in Psychiatry. 2019;10: 727. doi:10.3389/fpsyt.2019.00727
Pasteuning JM, Broeder C, Broeders TAA, et al. Mechanisms of childhood trauma: an integrative review of a multimodal, transdiagnostic pathway. Neurobiology of Stress. 2025;37: 100737. doi:10.1016/j.ynstr.2025.100737
Tull MT, Gratz KL, McDermott MJ, et al. The role of emotion regulation difficulties in the relation between PTSD symptoms and the learned association between trauma-related and cocaine cues. Substance Use & Misuse. 2016;51(10): 1318-1329. doi:10.3109/10826084.2016.1168445
Haider A, Yang T, Jia-Jing C, et al. The impact of childhood maltreatment experiences on emotion regulation in Chinese methamphetamine-dependent inpatients: A mediation model. Clinical Psychology & Psychotherapy. 2025;32(6): e70197. doi:10.1002/cpp.70197
Rizk MM, Herzog S, Dugad S, et al. Suicide risk and addiction: The impact of alcohol and opioid use disorders. Current Addiction Reports. 2021;8(2): 194-207. doi:10.1007/s40429-021-00361-z
Clark SL, Dodd CG, Taylor L, et al. Characterizing patterns of substance use in trauma exposed youth. Journal of Psychiatric Research. 2023;167: 1-9. doi:10.1016/j.jpsychires.2023.09.020
Proctor LJ, Lewis T, Roesch S, et al. Child maltreatment and age of alcohol and marijuana initiation in high-risk youth. Addictive Behaviors. 2017;75: 64-69. doi:10.1016/j.addbeh.2017.06.021
Martínez-Mota L, Jiménez-Rubio G, Hernández-Hernández OT, et al. Influence of the type of childhood violence on cannabis abuse and dependence among adolescents: A systematic review and meta-analysis. Adicciones. 2020;32(1): 63-76. doi:10.20882/adicciones.1050
De la Peña-Arteaga V, Nogueira SO, Lynskey M, et al. The relationship between childhood physical and sexual abuse and adolescent cannabis use: A systematic review. Frontiers in Psychiatry. 2021;12: 631245. doi:10.3389/fpsyt.2021.631245
Dube SR, Fairweather D, Pearson WS, et al. Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine. 2009;71(2): 243-250. doi: 10.1097/PSY.0b013e3181907888.
Kiburi SK, Molebatsi K, Obondo A, et al. Adverse childhood experiences among patients with substance use disorders at a referral psychiatric hospital in Kenya. BMC Psychiatry. 2018;18(1): 197. doi:10.1186/s12888-018-1780-1
Fernandes GS, Spiers A, Vaidya N, et al. Adverse childhood experiences and substance misuse in young people in India: results from the multisite cVEDA cohort. BMC Public Health. 2021;21(1): 1920. doi:10.1186/s12889-021-11892-5
Rakovski C, Lalli M, Gu J, et al. Childhood maltreatment as a predictor of substance use/misuse among youth: A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews. 2024;166: 105873. doi:10.1016/j.neubiorev.2024.105873
Turner S, Mota N, Bolton J, et al. Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and Anxiety. 2018;35(9): 851-860. doi:10.1002/da.22771
McHugh RK, Votaw VR, Sugarman DE, et al. Sex and gender differences in substance use disorders. Clinical Psychology Review. 2018;66: 12-23. doi:10.1016/j.cpr.2017.10.012
Peltier MR, Verplaetse TL, Mineur YS, et al. Sex differences in stress-related alcohol use. Neurobiology of Stress. 2019;10: 100149. doi:10.1016/j.ynstr.2019.100149
Armoon B, SoleimanvandiAzar N. Prevalence and risk factors of suicide attempt among people with substance use disorders: A systematic review and meta-analysis. Journal of Addictive Diseases. 2021;39(4): 516-527. doi:10.1080/10550887.2021.1912572
Bumaguin DB, Narváez JCM, Schuch JB, et al. Parental pattern, childhood trauma, and impulsivity contribute to the severity of crack cocaine addiction: a cluster analysis. Revista Brasileira de Psiquiatria. 2025;47: e20243645. doi:10.47626/1516-4446-2024-3645
Leza L, López-Goñi JJ, Arteaga A, et al. Prevalence and differential profiles of people with adverse childhood experiences in treatment for substance use disorder. The Spanish Journal of Psychology. 2025;28: e7. doi:10.1017/SJP.2025.6
Sinha R. Chronic stress, drug use, and vulnerability to addiction. Annals of the New York Academy of Sciences. 2008;1141: 105-130. doi:10.1196/annals.1441.030
Volkow ND, Jones EB, Einstein EB, et al. Prevention and treatment of opioid misuse and addiction: A review. JAMA Psychiatry. 2019;76(2): 208-216. doi:10.1001/jamapsychiatry.2018.312
Zhang S, Lin X, Liu J, et al. Prevalence of childhood trauma measured by the short form of the Childhood Trauma Questionnaire in people with substance use disorder: A meta-analysis. Psychiatry Research. 2020;294: 113524. doi:10.1016/j.psychres.2020.113524
Gürbüzer N, Güler MC, Tör IBH. Methamphetamine use disorder and inflammation: A case-control study. Psychiatry Investigation. 2024;21(5): 513-520. doi:10.30773/pi.2023.0199
Alameda L, Rodriguez V, Carr E, et al. A systematic review on mediators between adversity and psychosis: potential targets for treatment. Psychological Medicine. 2020;50(12): 1966-1976. doi:10.1017/S0033291720002421
Catone G, Marwaha S, Kuipers E, et al. Bullying victimisation and risk of psychotic phenomena: Analyses of British national survey data. The Lancet Psychiatry. 2015;2(7): 618-624. doi:10.1016/S2215-0366(15)00055-3
Baekkerud SH, Sømhovd MJ, Martinussen LM. Violence - suicide and suicidal ideation as sequelae of trauma in substance use disorder inpatients. Scandinavian Journal of Psychology. 2023;64(3): 288-293. doi:10.1111/sjop.12891
Pompili M, Erbuto D, Innamorati M, et al. The relationship between mental pain, suicide risk, and childhood traumatic experiences: Results from a multicenter study. The Journal of Clinical Psychiatry. 2022;83(4): 21m14176. doi:10.4088/JCP.21m14176
Govender T, Vidal-Ribas P, Yu J, et al. Adverse childhood experiences and risk of suicide and substance-related mortality through middle adulthood. Journal of Affective Disorders. 2025;369: 1201-1208. doi:10.1016/j.jad.2024.10.085
Hughes K, Bellis MA, Sethi D, et al. Adverse childhood experiences, childhood relationships and associated substance use and mental health in young Europeans. European Journal of Public Health. 2019;29(4): 741-747. doi:10.1093/eurpub/ckz037
Mortier P, Yang X, Altwaijri YA, et al. The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors - Results from the World Mental Health International College Student Initiative. Psychiatry Research. 2025;350: 116555. doi:10.1016/j.psychres.2025.116555
Icick R, Karsinti E, Brousse G, et al. Childhood trauma and the severity of past suicide attempts in outpatients with cocaine use disorders. Substance Abuse. 2022;43(1): 623-632. doi:10.1080/08897077.2021.1975875
Bahji A. Navigating the Complex intersection of substance use and psychiatric disorders: A comprehensive review. Journal of Clinical Medicine. 2024;13(4): 999. doi:10.3390/jcm13040999
Hinckley JD, Adams ZW, Dellucci TV, et al. Co-occurring trauma- and stressor-related and substance-related disorders in youth: A narrative review. Medical Research Archives. 2024;12(8). doi:10.18103/mra.v12i8.5688
Fan J, Liu W, Xia J, et al. Childhood trauma is associated with elevated anhedonia and altered core reward circuitry in major depression patients and controls. Human Brain Mapping. 2021;42(2): 286-297. doi:10.1002/hbm.25222
Wolitzky-Taylor K (ed.). Treating comorbid substance use and emotional disorders: CBT: Science into practice. Switzerland: Springer Nature Switzerland; 2022.
Tang S, Ports KA, Zhang K, et al. Adverse childhood experiences, internalizing/externalizing symptoms, and associated prescription opioid misuse: A mediation analysis. Preventive Medicine. 2020;134: 106034. doi:10.1016/j.ypmed.2020.106034
Bernstein DP, Fink L, Handelsman L, et al. Initial reliability and validity of a new retrospective measure of child abuse and neglect. The American Journal of Psychiatry. 1998;155(8): 1083-1088.
Aslan SH, Alparslan ZN. Çocukluk örselenme yaşantıları ölçeğinin bir üniversite öğrencisi örnekleminde geçerlik, güvenirlik ve faktör yapısı. Türk Psikiyatri Dergisi. 1999;10(4): 275-285.
Şar V, Öztürk E, Hakan FA, et al. Çocukluk çağı travmaları ölçeği'nin (ççtö) Türkçede geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi. 2012;23(3): 177-184.
Gündüz A, Yaşar AB, Gündoğmuş İ, et al. Çocukluk çağı olumsuz yaşantılar ölçeği Türkçe formunun geçerlilik ve güvenilirlik çalışması. Anadolu Psikiyatri Dergisi. 2018;19(1): 68-75.
Hoeboer CM, Bodor N, Oprel DAC, et al. Validation of the childhood trauma questionnaire (ctq) in the context of trauma-focused Treatment. Child Maltreatment. 2026;31(1): 153-164. doi:10.1177/10775595251328611
Cloitre M, Courtois CA, Ford JD, et al. The ISTSS expert consensus treatment guidelines for complex PTSD in adults. Chicago: International Society for Traumatic Stress Studies; 2012.
Grummitt L, Kelly E, Barrett E, et al. Targets for intervention to prevent substance use in young people exposed to childhood adversity: A systematic review. PLoS One. 2021;16(6): e0252815. doi:10.1371/journal.pone.0252815
Herman JL. Trauma and recovery. NY: Basic Books; 2015.
Roberts NP, Lotzin A, Schäfer I. A systematic review and meta-analysis of psychological interventions for comorbid post-traumatic stress disorder and substance use disorder. European Journal of Psychotraumatology. 2022;13(1): 2041831. doi:10.1080/20008198.2022.2041831
Logsdon E, Cornelius-White JHD, Kanamori Y. The effectiveness of EMDR with individuals experiencing substance use disorder: A meta-analysis. Journal of EMDR Practice and Research. 2023;17(1): 21-32. doi:10.1891/EMDR-2022-0046
Martínez-Fernández DE, Fernández-Quezada D, Garzón-Partida AP, et al. The effect of eye movement desensitization and reprocessing (EMDR) therapy on reducing craving in populations with substance use disorder: A meta-analysis. Brain Sciences. 2024;14(11): 1110. doi:10.3390/brainsci14111110
Seok JW, Kim K, Kim JU. Therapeutic effects of eye movement desensitization and reprocessing for substance use disorders: A meta-analysis of addiction-related and emotional symptoms. Frontiers in Psychiatry. 2025;16: 1660046. doi:10.3389/fpsyt.2025.1660046
Najavits LM. Seeking Safety: A treatment manual for PTSD and substance abuse. NY: Guilford Press; 2015.
Kelly TM, Daley DC. Integrated treatment of substance use and psychiatric disorders. Social Work in Public Health. 2013;28(3-4): 388-406. doi:10.1080/19371918.2013.774673
Di Nicola M, Pepe M, Montanari S, et al. Childhood sexual abuse and suicide attempts in patients with substance use disorders: The mediating role of emotion dysregulation. Child Abuse & Neglect. 2024;151: 106731. doi:10.1016/j.chiabu.2024.106731
Mahon D. A systematic review of trauma informed care in substance use settings. Community Mental Health Journal. 2025;61(4): 734-753. doi:10.1007/s10597-024-01395-z
Referanslar
Chilcoat HD, Breslau N. Trauma and substance use disorders. Archives of General Psychiatry. 1998;55(11): 993-1002. doi: 10.1001/archpsyc.55.10.913
Chandler GE, Kalmakis KA, Murtha T. Screening adults with substance use disorder for adverse childhood experiences. Journal of Addictions Nursing. 2018;29(3): 172-178. doi:10.1097/JAN.0000000000000233
Schindler A, Bröning S. A review on attachment and adolescent substance abuse: Empirical evidence and implications for prevention and treatment. Substance Abuse. 2015;36(3): 304-313. doi:10.1080/08897077.2014.983586
Fairbairn CE, Briley DA, Kang D, et al. A meta-analysis of longitudinal associations between substance use and interpersonal attachment security. Psychological Bulletin. 2018;144(5): 532-555. doi:10.1037/bul0000141
Hofmeyr A, Aydin C, Rimes KA. The role of trauma in substance use: Beyond PTSD. The Lancet Psychiatry. 2024;11(2): 163-175. doi:10.1016/S2215-0366(23)00392-1
Khantzian EJ. The theory of self-medication and addiction. Psychiatric Times. 2017;34(2).
Belsky J, Pluess M. Beyond diathesis stress: differential susceptibility to environmental influences. Psychological Bulletin. 2009;135(6): 885-908. doi:10.1037/a0017376
Slavich GM. Social Safety Theory: A biologically based evolutionary perspective on life stress, health, and behavior. Annual Review of Clinical Psychology. 2020;16: 265-295. doi:10.1146/annurev-clinpsy-032816-045159
Hostinar CE, Johnson AE, Gunnar MR. Early social deprivation and the social buffering of cortisol stress responses in late childhood: An experimental study. Developmental Psychology. 2015;51(11): 1597-1608. doi:10.1037/dev0000029
Teicher MH, Samson JA. Annual research review: Enduring neurobiological effects of childhood abuse and neglect. Journal of Child Psychology and Psychiatry. 2016;57(3): 241-266. doi:10.1111/jcpp.12507
McLaughlin KA, Sheridan MA, Lambert HK. Childhood adversity and neural development: Deprivation and threat as distinct dimensions of early experience. Neuroscience & Biobehavioral Reviews. 2014;47: 578-591. doi:10.1016/j.neubiorev.2014.10.012
Balbuena LD, Baetz M, Sexton JA, et al. Identifying long-term and imminent suicide predictors in a general population and a clinical sample with machine learning. BMC Psychiatry. 2022;22: 120. doi:10.1186/s12888-022-03702-y
Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine. 1998;14(4): 245-258. doi: 10.1016/s0749-3797(98)00017-8
McLaughlin KA, Sheridan MA. Beyond cumulative risk: A dimensional approach to childhood adversity. Current Directions in Psychological Science. 2016;25(4): 239-245. doi:10.1177/0963721416655883
Sheridan MA, McLaughlin KA. Dimensions of early experience and neural development: Deprivation and threat. Trends in Cognitive Sciences. 2014;18(11): 580-585. doi:10.1016/j.tics.2014.09.001
Swartz JR, Knodt AR, Radtke SR, et al. A neural biomarker of psychological vulnerability to future life stress. Neuron. 2015;85(3): 505-511. doi:10.1016/j.neuron.2014.12.055
Turecki G, Brent DA. Suicide and suicidal behaviour. The Lancet. 2016;387(10024): 1227-1239. doi:10.1016/S0140-6736(15)00234-2
Martins LC, Campos RC, Morujão IS. The mediating role of tolerance for psychological pain in the relationship of childhood trauma to suicidal ideation in individuals with a substance use disorder. The British Journal of Clinical Psychology. 2022;61(2): 197-213. doi:10.1111/bjc.12338
Angelakis I, Gillespie EL, Panagioti M. Childhood maltreatment and adult suicidality: A comprehensive systematic review with meta-analysis. Psychological Medicine. 2019;49(7): 1057-1078. doi:10.1017/S0033291718003823
Cao R, Chen L, Yang J, et al. Specific effects of five subtypes of childhood maltreatment on suicide behaviours in Chinese adolescents: The moderating effect of sex and residence. Epidemiology and Psychiatric Sciences. 2023;32: e25. doi:10.1017/S2045796023000604
Sumner JA, Colich NL, Uddin LQ, et al. Early experiences of threat, but not deprivation, are associated with accelerated biological aging in children and adolescents. Biological Psychiatry. 2019;85(3): 268-278. doi: 10.1016/j.biopsych.2018.09.008.
Kim-Spoon J, Brieant A. Psychopathology as long-term sequelae of maltreatment and socioeconomic disadvantage: Neurocognitive development perspectives. Development and Psychopathology. 2024: 1-13. doi:10.1017/S095457942400018X
Norman RE, Byambaa M, De R, et al. The long-term outcomes of childhood sexual abuse, physical abuse, and neglect: A systematic review and meta-analysis of epidemiological studies. PLoS Medicine. 2012;9(11): e1001349. doi:10.1371/journal.pmed.1001349
Laporte N, Ozolins A, Westling S, et al. Adverse childhood experiences as a risk factor for non-suicidal self-injury and suicide attempts in forensic psychiatric patients. BMC Psychiatry. 2023;23(1): 238. doi:10.1186/s12888-023-04724-w
Devries KM, Mak JY, Child JC, et al. Childhood sexual abuse and suicidal behavior: A meta-analysis. Pediatrics. 2014;133(5): e1331-e1344. doi:10.1542/peds.2013-2166
Stocchero BA, Rothmann LM, Portolan ET, et al. The consequences of childhood maltreatment on dual-diagnosis psychiatric conditions and clinical outcomes in substance use disorders: A systematic review and meta-analysis. Child Abuse & Neglect. 2024;158: 107085. doi:10.1016/j.chiabu.2024.107085
Ramírez M, Ugedo A, Fañanás L, et al. Scoping review of biological and psychosocial pathways that lead from childhood adversity to early-onset substance use. Frontiers in Psychiatry. 2025;16: 1612494. doi:10.3389/fpsyt.2025.1612494
Miller GE, Chen E, Zhou ES. If it goes up, must it come down? Chronic stress and the corrosive nature of pro-inflammatory cytokines. Psychological Bulletin. 2007;133(1): 25-45. doi:10.1037/0033-2909.133.1.25
Kuhlman KR, Horn SR, Chiang JJ, et al. Early life adversity exposure and circulating markers of inflammation in children and adolescents: A systematic review and meta-analysis. Psychoneuroendocrinology. 2018;89: 31-35. doi:10.1016/j.psyneuen.2017.12.015
Koob GF. Drug addiction: Hyperkatifeia/negative reinforcement as a framework for medications development. Pharmacological Reviews. 2021;73(1): 163-201. doi:10.1124/pharmrev.120.000083
Koob GF, Volkow ND. Neurocircuitry of addiction. Neuropsychopharmacology. 2010;35(1): 217-238. doi:10.1038/npp.2009.110
Melhem NM, Keilp JG, Porta G, et al. Blunted HPA axis activity in suicide attempters compared to those at high risk for suicidal behavior. Neuropsychopharmacology. 2016;41(6): 1447-1456. doi:10.1038/npp.2015.309
Young ES, Doom JR, Farrell AK, et al. Life stress and cortisol reactivity: An exploratory analysis of the effects of stress exposure across life on HPA-axis functioning. Development and Psychopathology. 2020;33(3): 827-838. doi:10.1017/S095457942000002X
Liu SX, Harris AC, Gewirtz JC. How life events may confer vulnerability to addiction: the role of epigenetics. Frontiers in Molecular Neuroscience. 2024;17: 1462769. doi:10.3389/fnmol.2024.1462769
Funchal GA, Schuch JB, Zaparte A, et al. Cocaine-use disorder and childhood maltreatment are associated with the activation of neutrophils and increased inflammation. Acta Neuropsychiatrica. 2024;36(2): 97-108. doi:10.1017/neu.2023.11
Mikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change. 3rd ed. New York: Guilford Press; 2019.
Schindler A. Attachment and substance use disorders-theoretical models, empirical evidence, and implications for treatment. Frontiers in Psychiatry. 2019;10: 727. doi:10.3389/fpsyt.2019.00727
Pasteuning JM, Broeder C, Broeders TAA, et al. Mechanisms of childhood trauma: an integrative review of a multimodal, transdiagnostic pathway. Neurobiology of Stress. 2025;37: 100737. doi:10.1016/j.ynstr.2025.100737
Tull MT, Gratz KL, McDermott MJ, et al. The role of emotion regulation difficulties in the relation between PTSD symptoms and the learned association between trauma-related and cocaine cues. Substance Use & Misuse. 2016;51(10): 1318-1329. doi:10.3109/10826084.2016.1168445
Haider A, Yang T, Jia-Jing C, et al. The impact of childhood maltreatment experiences on emotion regulation in Chinese methamphetamine-dependent inpatients: A mediation model. Clinical Psychology & Psychotherapy. 2025;32(6): e70197. doi:10.1002/cpp.70197
Rizk MM, Herzog S, Dugad S, et al. Suicide risk and addiction: The impact of alcohol and opioid use disorders. Current Addiction Reports. 2021;8(2): 194-207. doi:10.1007/s40429-021-00361-z
Clark SL, Dodd CG, Taylor L, et al. Characterizing patterns of substance use in trauma exposed youth. Journal of Psychiatric Research. 2023;167: 1-9. doi:10.1016/j.jpsychires.2023.09.020
Proctor LJ, Lewis T, Roesch S, et al. Child maltreatment and age of alcohol and marijuana initiation in high-risk youth. Addictive Behaviors. 2017;75: 64-69. doi:10.1016/j.addbeh.2017.06.021
Martínez-Mota L, Jiménez-Rubio G, Hernández-Hernández OT, et al. Influence of the type of childhood violence on cannabis abuse and dependence among adolescents: A systematic review and meta-analysis. Adicciones. 2020;32(1): 63-76. doi:10.20882/adicciones.1050
De la Peña-Arteaga V, Nogueira SO, Lynskey M, et al. The relationship between childhood physical and sexual abuse and adolescent cannabis use: A systematic review. Frontiers in Psychiatry. 2021;12: 631245. doi:10.3389/fpsyt.2021.631245
Dube SR, Fairweather D, Pearson WS, et al. Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine. 2009;71(2): 243-250. doi: 10.1097/PSY.0b013e3181907888.
Kiburi SK, Molebatsi K, Obondo A, et al. Adverse childhood experiences among patients with substance use disorders at a referral psychiatric hospital in Kenya. BMC Psychiatry. 2018;18(1): 197. doi:10.1186/s12888-018-1780-1
Fernandes GS, Spiers A, Vaidya N, et al. Adverse childhood experiences and substance misuse in young people in India: results from the multisite cVEDA cohort. BMC Public Health. 2021;21(1): 1920. doi:10.1186/s12889-021-11892-5
Rakovski C, Lalli M, Gu J, et al. Childhood maltreatment as a predictor of substance use/misuse among youth: A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews. 2024;166: 105873. doi:10.1016/j.neubiorev.2024.105873
Turner S, Mota N, Bolton J, et al. Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and Anxiety. 2018;35(9): 851-860. doi:10.1002/da.22771
McHugh RK, Votaw VR, Sugarman DE, et al. Sex and gender differences in substance use disorders. Clinical Psychology Review. 2018;66: 12-23. doi:10.1016/j.cpr.2017.10.012
Peltier MR, Verplaetse TL, Mineur YS, et al. Sex differences in stress-related alcohol use. Neurobiology of Stress. 2019;10: 100149. doi:10.1016/j.ynstr.2019.100149
Armoon B, SoleimanvandiAzar N. Prevalence and risk factors of suicide attempt among people with substance use disorders: A systematic review and meta-analysis. Journal of Addictive Diseases. 2021;39(4): 516-527. doi:10.1080/10550887.2021.1912572
Bumaguin DB, Narváez JCM, Schuch JB, et al. Parental pattern, childhood trauma, and impulsivity contribute to the severity of crack cocaine addiction: a cluster analysis. Revista Brasileira de Psiquiatria. 2025;47: e20243645. doi:10.47626/1516-4446-2024-3645
Leza L, López-Goñi JJ, Arteaga A, et al. Prevalence and differential profiles of people with adverse childhood experiences in treatment for substance use disorder. The Spanish Journal of Psychology. 2025;28: e7. doi:10.1017/SJP.2025.6
Sinha R. Chronic stress, drug use, and vulnerability to addiction. Annals of the New York Academy of Sciences. 2008;1141: 105-130. doi:10.1196/annals.1441.030
Volkow ND, Jones EB, Einstein EB, et al. Prevention and treatment of opioid misuse and addiction: A review. JAMA Psychiatry. 2019;76(2): 208-216. doi:10.1001/jamapsychiatry.2018.312
Zhang S, Lin X, Liu J, et al. Prevalence of childhood trauma measured by the short form of the Childhood Trauma Questionnaire in people with substance use disorder: A meta-analysis. Psychiatry Research. 2020;294: 113524. doi:10.1016/j.psychres.2020.113524
Gürbüzer N, Güler MC, Tör IBH. Methamphetamine use disorder and inflammation: A case-control study. Psychiatry Investigation. 2024;21(5): 513-520. doi:10.30773/pi.2023.0199
Alameda L, Rodriguez V, Carr E, et al. A systematic review on mediators between adversity and psychosis: potential targets for treatment. Psychological Medicine. 2020;50(12): 1966-1976. doi:10.1017/S0033291720002421
Catone G, Marwaha S, Kuipers E, et al. Bullying victimisation and risk of psychotic phenomena: Analyses of British national survey data. The Lancet Psychiatry. 2015;2(7): 618-624. doi:10.1016/S2215-0366(15)00055-3
Baekkerud SH, Sømhovd MJ, Martinussen LM. Violence - suicide and suicidal ideation as sequelae of trauma in substance use disorder inpatients. Scandinavian Journal of Psychology. 2023;64(3): 288-293. doi:10.1111/sjop.12891
Pompili M, Erbuto D, Innamorati M, et al. The relationship between mental pain, suicide risk, and childhood traumatic experiences: Results from a multicenter study. The Journal of Clinical Psychiatry. 2022;83(4): 21m14176. doi:10.4088/JCP.21m14176
Govender T, Vidal-Ribas P, Yu J, et al. Adverse childhood experiences and risk of suicide and substance-related mortality through middle adulthood. Journal of Affective Disorders. 2025;369: 1201-1208. doi:10.1016/j.jad.2024.10.085
Hughes K, Bellis MA, Sethi D, et al. Adverse childhood experiences, childhood relationships and associated substance use and mental health in young Europeans. European Journal of Public Health. 2019;29(4): 741-747. doi:10.1093/eurpub/ckz037
Mortier P, Yang X, Altwaijri YA, et al. The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors - Results from the World Mental Health International College Student Initiative. Psychiatry Research. 2025;350: 116555. doi:10.1016/j.psychres.2025.116555
Icick R, Karsinti E, Brousse G, et al. Childhood trauma and the severity of past suicide attempts in outpatients with cocaine use disorders. Substance Abuse. 2022;43(1): 623-632. doi:10.1080/08897077.2021.1975875
Bahji A. Navigating the Complex intersection of substance use and psychiatric disorders: A comprehensive review. Journal of Clinical Medicine. 2024;13(4): 999. doi:10.3390/jcm13040999
Hinckley JD, Adams ZW, Dellucci TV, et al. Co-occurring trauma- and stressor-related and substance-related disorders in youth: A narrative review. Medical Research Archives. 2024;12(8). doi:10.18103/mra.v12i8.5688
Fan J, Liu W, Xia J, et al. Childhood trauma is associated with elevated anhedonia and altered core reward circuitry in major depression patients and controls. Human Brain Mapping. 2021;42(2): 286-297. doi:10.1002/hbm.25222
Wolitzky-Taylor K (ed.). Treating comorbid substance use and emotional disorders: CBT: Science into practice. Switzerland: Springer Nature Switzerland; 2022.
Tang S, Ports KA, Zhang K, et al. Adverse childhood experiences, internalizing/externalizing symptoms, and associated prescription opioid misuse: A mediation analysis. Preventive Medicine. 2020;134: 106034. doi:10.1016/j.ypmed.2020.106034
Bernstein DP, Fink L, Handelsman L, et al. Initial reliability and validity of a new retrospective measure of child abuse and neglect. The American Journal of Psychiatry. 1998;155(8): 1083-1088.
Aslan SH, Alparslan ZN. Çocukluk örselenme yaşantıları ölçeğinin bir üniversite öğrencisi örnekleminde geçerlik, güvenirlik ve faktör yapısı. Türk Psikiyatri Dergisi. 1999;10(4): 275-285.
Şar V, Öztürk E, Hakan FA, et al. Çocukluk çağı travmaları ölçeği'nin (ççtö) Türkçede geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi. 2012;23(3): 177-184.
Gündüz A, Yaşar AB, Gündoğmuş İ, et al. Çocukluk çağı olumsuz yaşantılar ölçeği Türkçe formunun geçerlilik ve güvenilirlik çalışması. Anadolu Psikiyatri Dergisi. 2018;19(1): 68-75.
Hoeboer CM, Bodor N, Oprel DAC, et al. Validation of the childhood trauma questionnaire (ctq) in the context of trauma-focused Treatment. Child Maltreatment. 2026;31(1): 153-164. doi:10.1177/10775595251328611
Cloitre M, Courtois CA, Ford JD, et al. The ISTSS expert consensus treatment guidelines for complex PTSD in adults. Chicago: International Society for Traumatic Stress Studies; 2012.
Grummitt L, Kelly E, Barrett E, et al. Targets for intervention to prevent substance use in young people exposed to childhood adversity: A systematic review. PLoS One. 2021;16(6): e0252815. doi:10.1371/journal.pone.0252815
Herman JL. Trauma and recovery. NY: Basic Books; 2015.
Roberts NP, Lotzin A, Schäfer I. A systematic review and meta-analysis of psychological interventions for comorbid post-traumatic stress disorder and substance use disorder. European Journal of Psychotraumatology. 2022;13(1): 2041831. doi:10.1080/20008198.2022.2041831
Logsdon E, Cornelius-White JHD, Kanamori Y. The effectiveness of EMDR with individuals experiencing substance use disorder: A meta-analysis. Journal of EMDR Practice and Research. 2023;17(1): 21-32. doi:10.1891/EMDR-2022-0046
Martínez-Fernández DE, Fernández-Quezada D, Garzón-Partida AP, et al. The effect of eye movement desensitization and reprocessing (EMDR) therapy on reducing craving in populations with substance use disorder: A meta-analysis. Brain Sciences. 2024;14(11): 1110. doi:10.3390/brainsci14111110
Seok JW, Kim K, Kim JU. Therapeutic effects of eye movement desensitization and reprocessing for substance use disorders: A meta-analysis of addiction-related and emotional symptoms. Frontiers in Psychiatry. 2025;16: 1660046. doi:10.3389/fpsyt.2025.1660046
Najavits LM. Seeking Safety: A treatment manual for PTSD and substance abuse. NY: Guilford Press; 2015.
Kelly TM, Daley DC. Integrated treatment of substance use and psychiatric disorders. Social Work in Public Health. 2013;28(3-4): 388-406. doi:10.1080/19371918.2013.774673
Di Nicola M, Pepe M, Montanari S, et al. Childhood sexual abuse and suicide attempts in patients with substance use disorders: The mediating role of emotion dysregulation. Child Abuse & Neglect. 2024;151: 106731. doi:10.1016/j.chiabu.2024.106731
Mahon D. A systematic review of trauma informed care in substance use settings. Community Mental Health Journal. 2025;61(4): 734-753. doi:10.1007/s10597-024-01395-z
