Skip to main content
SpringerLink
Log in

Childhood abuse and craving in methamphetamine-dependent individuals: the mediating role of alexithymia

  • Original Paper
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Individuals with a history of childhood abuse (CA, including neglect and abuse by caregivers before the age of 18 years) have more severe substance dependence problems than those without a history of childhood abuse. However, whether a history of CA exacerbates craving and the mechanism of this effect remain largely unknown. The aim of this study was to explore the role of alexithymia in the effects of CA on craving in a large sample of methamphetamine-dependent individuals based on latent vulnerability theory. A total of 324 methamphetamine-dependent individuals who met DSM-5 criteria for substance use disorder were recruited. CA, alexithymia, and craving data were collected from the Childhood Trauma Questionnaire, the Toronto Alexithymia Scale-20, and the Obsessive Compulsive Drug Use Scale, respectively. t tests and ANCOVA were conducted to compare variables between the CA and non-CA groups, while partial correlation and mediation analyses were conducted to examine the potential mediating role of alexithymia in the relationship between CA and craving. Abused methamphetamine-dependent individuals reported higher levels of craving and higher levels of alexithymia than those of non-abused methamphetamine-dependent individuals. Alexithymia partially mediated the link between CA and craving, especially the effect of CA on craving frequency was fully mediated by alexithymia. Our findings reveal that a history of childhood abuse has a lasting effect on craving in stimulant-dependent individuals, and alexithymia contributes to some extent to the severity of substance abuse problems in abused methamphetamine-dependent individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Data available on request from the authors.

References

  1. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Washington, DC

    Book  Google Scholar 

  2. Anton RF (2000) Obsessive-compulsive aspects of craving: Development of the obsessive compulsive drinking scale. Addiction 95(Suppl 2):S211-217

    Article  PubMed  Google Scholar 

  3. Asensio S, Romero MJ, Palau C, Sanchez A, Senabre I, Morales JL, Carcelen R, Romero FJ (2010) Altered neural response of the appetitive emotional system in cocaine addiction: An fmri study. Addict Biol 15:504–516

    Article  PubMed  Google Scholar 

  4. Aslan M, Sala M, Gueorguieva R, Garrison KA (2023) A network analysis of cigarette craving. Nicotine Tob Res 25:1155–1163

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bagby RM, Parker JD, Taylor GJ (1994) The twenty-item toronto alexithymia scale—i. Item selection and cross-validation of the factor structure. J Psychosom Res 38:23–32

    Article  CAS  PubMed  Google Scholar 

  6. Banducci AN, Hoffman EM, Lejuez CW, Koenen KC (2014) The impact of childhood abuse on inpatient substance users: Specific links with risky sex, aggression, and emotion dysregulation. Child Abuse Negl 38:928–938

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bankier B, Aigner M, Bach M (2001) Alexithymia in dsm-iv disorder: Comparative evaluation of somatoform disorder, panic disorder, obsessive-compulsive disorder, and depression. Psychosomatics 42:235–240

    Article  CAS  PubMed  Google Scholar 

  8. Bauer DJ, Preacher KJ, Gil KM (2006) Conceptualizing and testing random indirect effects and moderated mediation in multilevel models: New procedures and recommendations. Psychol Methods 11:142–163

    Article  PubMed  Google Scholar 

  9. Beck AT, Beck RW (1972) Screening depressed patients in family practice. A rapid technic. Postgrad Med 52:81–85

    Article  CAS  PubMed  Google Scholar 

  10. Bernstein D, Fink L, Bernstein D (1998) Childhood trauma questionnaire: A retrospective self-report manual.

  11. Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, Stokes J, Handelsman L, Medrano M, Desmond D, Zule W (2003) Development and validation of a brief screening version of the childhood trauma questionnaire. Child Abuse Negl 27:169–190

    Article  PubMed  Google Scholar 

  12. Buckland NJ, Swinnerton LF, Ng K, Price M, Wilkinson LL, Myers A, Dalton M (2021) Susceptibility to increased high energy dense sweet and savoury food intake in response to the covid-19 lockdown: The role of craving control and acceptance coping strategies. Appetite 158:105017

    Article  PubMed  Google Scholar 

  13. Capusan AJ, Gustafsson PA, Kuja-Halkola R, Igelström K, Mayo LM, Heilig M (2021) Re-examining the link between childhood maltreatment and substance use disorder: A prospective, genetically informative study. Mol Psychiatry 26:3201–3209

    Article  PubMed  Google Scholar 

  14. Cheng SK-W, Wong C-W, Wong K-C, Chong GS-C, Wong MT-P, Chang SS-Y, Wong S-Y, Chan CK-Y, Wu K-O (2002) A study of psychometric properties, normative scores, and factor structure of the beck anxiety inventory–the chinese version. Chin J Clin Psychol 10:4–6

    Google Scholar 

  15. Colman I, Kingsbury M, Garad Y, Zeng Y, Naicker K, Patten S, Jones PB, Wild TC, Thompson AH (2016) Consistency in adult reporting of adverse childhood experiences. Psychol Med 46:543–549

    Article  CAS  PubMed  Google Scholar 

  16. Contreras-Rodríguez O, Martín-Pérez C, Vilar-López R, Verdejo-Garcia A (2017) Ventral and dorsal striatum networks in obesity: Link to food craving and weight gain. Biol Psychiat 81:789–796

    Article  PubMed  Google Scholar 

  17. Craparo G, Gori A, Dell’Aera S, Costanzo G, Fasciano S, Tomasello A, Vicario CM (2016) Impaired emotion recognition is linked to alexithymia in heroin addicts. PeerJ 4:e1864

    Article  PubMed  PubMed Central  Google Scholar 

  18. Cui S, Cheng F, Yuan Q, Zhang L, Wang L, Zhang K, Zhou X (2021) Association between alexithymia, social support, and duration of methamphetamine use among male methamphetamine-dependent patients. Front Psych 12:713210

    Article  Google Scholar 

  19. Curran PG (2016) Methods for the detection of carelessly invalid responses in survey data. J Exp Soc Psychol 66:4–19

    Article  Google Scholar 

  20. Ditzer J, Wong EY, Modi RN, Behnke M, Gross JJ, Talmon A (2023) Child maltreatment and alexithymia: A meta-analytic review. Psychol Bull 149:311–329

    Article  PubMed  Google Scholar 

  21. Dvir Y, Ford JD, Hill M, Frazier JA (2014) Childhood maltreatment, emotional dysregulation, and psychiatric comorbidities. Harv Rev Psychiatry 22:149

    Article  PubMed  PubMed Central  Google Scholar 

  22. Elton A, Smitherman S, Young J, Kilts CD (2015) Effects of childhood maltreatment on the neural correlates of stress- and drug cue-induced cocaine craving. Addict Biol 20:820–831

    Article  CAS  PubMed  Google Scholar 

  23. Emery MA, Akil H (2020) Endogenous opioids at the intersection of opioid addiction, pain, and depression: The search for a precision medicine approach. Annu Rev Neurosci 43:355–374

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Erdfelder E, Faul F, Buchner A (1996) Gpower: A general power analysis program. Behav Res Methods Instrum Comput 28:1–11

    Article  Google Scholar 

  25. Evren C, Evren B, Dalbudak E, Ozcelik B, Oncu F (2009) Childhood abuse and neglect as a risk factor for alexithymia in adult male substance dependent inpatients. J Psychoactive Drugs 41:85–92

    Article  PubMed  Google Scholar 

  26. Franken IH, Hendriks VM, van den Brink W (2002) Initial validation of two opiate craving questionnaires: The obsessive compulsive drug use scale and the desires for drug questionnaire. Addict Behav 27:675–685

    Article  PubMed  Google Scholar 

  27. Frewen PA, Dozois DJ, Neufeld RW, Lanius RA (2008) Meta-analysis of alexithymia in posttraumatic stress disorder. J Traum Stress 21:243–246

    Article  Google Scholar 

  28. Fydrich T, Dowdall D, Chambless DL (1992) Reliability and validity of the beck anxiety inventory. J Anxiety Disord 6:55–61

    Article  Google Scholar 

  29. George O, Koob GF (2013) Control of craving by the prefrontal cortex. Proc Natl Acad Sci 110:4165–4166

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Ghorbani F, Khosravani V, Mohammadzadeh A, Shadnia S (2019) The role of emotion dysregulation in the relation of childhood trauma to heroin craving in individuals with heroin dependence. Drug Alcohol Depend 195:132–139

    Article  PubMed  Google Scholar 

  31. Gong H, Zhang Y, Ren Q, Zhou Z, Zhou H, Sun X, Zhang C, Voon V, Zhao M, Yu S (2020) The chinese version of obsessive compulsive drug use scale: Validation in outpatient methadone maintenance treatment program. BMC Psychiatry 20:1–7

    Article  Google Scholar 

  32. Gratz KL, Roemer L (2004) Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess 26:41–54

    Article  Google Scholar 

  33. Halpern SC, Schuch FB, Scherer JN, Sordi AO, Pachado M, Dalbosco C, Fara L, Pechansky F, Kessler F, Von Diemen L (2018) Child maltreatment and illicit substance abuse: A systematic review and meta-analysis of longitudinal studies. Child Abuse Rev 27:344–360

    Article  Google Scholar 

  34. Hayes AF (2012) Process: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling. University of Kansas, Kansas

    Google Scholar 

  35. Herbert BM, Herbert C, Pollatos O (2011) On the relationship between interoceptive awareness and alexithymia: Is interoceptive awareness related to emotional awareness? J Pers 79:1149–1175

    Article  PubMed  Google Scholar 

  36. Huang C, Yuan Q, Shi S, Ge M, Sheng X, Yang M, Zhang L, Wang L, Zhang K, Zhou X (2022) Associations between alexithymia, parental rearing styles, and frequency of drug use in male methamphetamine dependence patients. BMC Psychiatry 22:1–9

    Article  CAS  Google Scholar 

  37. Jaffee SR (2017) Child maltreatment and risk for psychopathology in childhood and adulthood. Annu Rev Clin Psychol 13:525–551

    Article  PubMed  Google Scholar 

  38. Jiang WJ, Zhong BL, Liu LZ, Zhou YJ, Hu XH, Li Y (2018) Reliability and validity of the chinese version of the childhood trauma questionnaire-short form for inpatients with schizophrenia. PLoS ONE 13:e0208779

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Kahl J, Holl J, Grundmann J, Lotzin A, Hiller P, Schroeder K, Schulte B, Barnow S, Schäfer I (2020) Emotion regulation as a mediator between childhood abuse and neglect and posttraumatic stress disorder in women with substance use disorders. Subst Use Misuse 55:2184–2193

    Article  PubMed  Google Scholar 

  40. Khosravani V, Samimi Ardestani SM, Sharifi Bastan F, Mohammadzadeh A, Amirinezhad A (2019) Childhood maltreatment, cognitive emotion regulation strategies, and alcohol craving and dependence in alcohol-dependent males: Direct and indirect pathways. Child Abuse Negl 98:104197

    Article  PubMed  Google Scholar 

  41. Kim JH, Martins SS, Shmulewitz D, Santaella J, Wall MM, Keyes KM, Eaton NR, Krueger R, Grant BF, Hasin DS (2014) Childhood maltreatment, stressful life events, and alcohol craving in adult drinkers. Alcohol Clin Exp Res 38:2048–2055

    Article  PubMed  PubMed Central  Google Scholar 

  42. Kokkonen P, Karvonen JT, Veijola J, Läksy K, Jokelainen J, Järvelin M-R, Joukamaa M (2001) Prevalence and sociodemographic correlates of alexithymia in a population sample of young adults. Compr Psychiatry 42:471–476

    Article  CAS  PubMed  Google Scholar 

  43. Kooiman C, Spinhoven P, Trijsburg R (2002) The assessment of alexithymia: A critical review of the literature and a psychometric study of the toronto alexithymia scale-20. J Psychosom Res 53:1083–1090

    Article  CAS  PubMed  Google Scholar 

  44. Kopera M, Zaorska J, Trucco EM, Suszek H, Kobyliński P, Zucker RA, Nowakowska M, Wojnar M, Jakubczyk A (2020) Childhood trauma, alexithymia, and mental states recognition among individuals with alcohol use disorder and healthy controls. Drug Alcohol Depend 217:108301

    Article  PubMed  PubMed Central  Google Scholar 

  45. Le Berre A-P (2019) Emotional processing and social cognition in alcohol use disorder. Neuropsychology 33:808

    Article  PubMed  PubMed Central  Google Scholar 

  46. McClure SM, Bickel WK (2014) A dual-systems perspective on addiction: Contributions from neuroimaging and cognitive training. Ann N Y Acad Sci 1327:62–78

    Article  PubMed  PubMed Central  Google Scholar 

  47. Miller GA, Chapman JP (2001) Misunderstanding analysis of covariance. J Abnorm Psychol 110:40–48

    Article  CAS  PubMed  Google Scholar 

  48. Morie KP, Yip SW, Nich C, Hunkele K, Carroll KM, Potenza MN (2016) Alexithymia and addiction: A review and preliminary data suggesting neurobiological links to reward/loss processing. Curr Addict Rep 3:239–248

    Article  PubMed  PubMed Central  Google Scholar 

  49. Müller J, Bühner M, Ellgring H (2003) Is there a reliable factorial structure in the 20-item toronto alexithymia scale?: A comparison of factor models in clinical and normal adult samples. J Psychosom Res 55:561–568

    Article  PubMed  Google Scholar 

  50. Noël X, Brevers D, Bechara A (2013) A triadic neurocognitive approach to addiction for clinical interventions. Front Psych 4:179

    Google Scholar 

  51. Ogren M, Johnson SP (2021) Primary caregiver emotional expressiveness relates to toddler emotion understanding. Infant Behav Dev 62:101508

    Article  PubMed  Google Scholar 

  52. Palma-Álvarez RF, Ros-Cucurull E, Daigre C, Perea-Ortueta M, Martinez-Luna N, Serrano-Perez P, Sorribes-Puertas M, Ramos-Quiroga JA, Grau-Lopez L, Roncero C (2021) Is alexithymia related to retention and relapses in patients with substance use disorders?: A one year follow-up study. Addict Behav 113:106681

    Article  PubMed  Google Scholar 

  53. Pepe M, Di Nicola M, Panaccione I, Franza R, De Berardis D, Cibin M, Janiri L, Sani G (2023) Impulsivity and alexithymia predict early versus subsequent relapse in patients with alcohol use disorder: A 1-year longitudinal study. Drug Alcohol Rev 42:367–372

    Article  PubMed  Google Scholar 

  54. Preece D, Becerra R, Robinson K, Dandy J (2018) Assessing alexithymia: Psychometric properties and factorial invariance of the 20-item toronto alexithymia scale in nonclinical and psychiatric samples. J Psychopathol Behav Assess 40:276–287

    Article  Google Scholar 

  55. Puetz VB, McCrory E (2015) Exploring the relationship between childhood maltreatment and addiction: A review of the neurocognitive evidence. Curr Addict Rep 2:318–325

    Article  PubMed  PubMed Central  Google Scholar 

  56. Rosenkranz SE, Muller RT, Henderson JL (2014) The role of complex ptsd in mediating childhood maltreatment and substance abuse severity among youth seeking substance abuse treatment. Psychol Trauma Theory Res Pract Policy 6:25–33

    Article  Google Scholar 

  57. Saladin ME, Santa Ana EJ, LaRowe SD, Simpson AN, Tolliver BK, Price KL, McRae-Clark AL, Brady KT (2012) Does alexithymia explain variation in cue-elicited craving reported by methamphetamine-dependent individuals? Am J Addict 21:130–135

    Article  PubMed  PubMed Central  Google Scholar 

  58. Salminen J, Saarijärvi S, Toikka T, Kauhanen J, Äärelä E (2006) Alexithymia behaves as a personality trait over a 5-year period in finnish general population. J Psychosom Res 61:275–278

    Article  CAS  PubMed  Google Scholar 

  59. Sayette MA (2016) The role of craving in substance use disorders: Theoretical and methodological issues. Annu Rev Clin Psychol 12:407–433

    Article  PubMed  Google Scholar 

  60. Schoemann AM, Boulton AJ, Short SD (2017) Determining power and sample size for simple and complex mediation models. Social Psychol Person Sc 8:379–386

    Article  Google Scholar 

  61. Serre F, Fatseas M, Swendsen J, Auriacombe M (2015) Ecological momentary assessment in the investigation of craving and substance use in daily life: A systematic review. Drug Alcohol Depend 148:1–20

    Article  PubMed  Google Scholar 

  62. Shrive FM, Stuart H, Quan H, Ghali WA (2006) Dealing with missing data in a multi-question depression scale: A comparison of imputation methods. BMC Med Res Methodol 6:57

    Article  PubMed  PubMed Central  Google Scholar 

  63. Sifneos PE (1973) The prevalence of “alexithymic” characteristics in psychosomatic patients. Psychother Psychosom 22:255–262

    Article  CAS  PubMed  Google Scholar 

  64. Sutherland BD, Fallah-Sohy N, Kopera M, Jakubczyk A, Sutherland MT, Trucco EM (2022) Alexithymia mediates the association between childhood trauma and adolescent e-cigarette use. Drug Alcohol Depend 236:109500

    Article  PubMed  PubMed Central  Google Scholar 

  65. Sutherland MT, Carroll AJ, Salmeron BJ, Ross TJ, Stein EA (2013) Insula’s functional connectivity with ventromedial prefrontal cortex mediates the impact of trait alexithymia on state tobacco craving. Psychopharmacology 228:143–155

    Article  CAS  PubMed  Google Scholar 

  66. Thorberg FA, Young RM, Hasking P, Lyvers M, Connor JP, London ED, Huang Y-L, Feeney GF (2019) Alexithymia and alcohol dependence: The roles of negative mood and alcohol craving. Subst Use Misuse 54:2380–2386

    Article  PubMed  Google Scholar 

  67. Van Dam NT, Rando K, Potenza MN, Tuit K, Sinha R (2014) Childhood maltreatment, altered limbic neurobiology, and substance use relapse severity via trauma-specific reductions in limbic gray matter volume. JAMA Psychiat 71:917–925

    Article  Google Scholar 

  68. van Strien T, Beijers R, Smeekens S, Winkens LHH, Konttinen H (2019) Parenting quality in infancy and emotional eating in adolescence: Mediation through emotion suppression and alexithymia. Appetite 141:104339

    Article  PubMed  Google Scholar 

  69. Veneziani G, Ciacchella C, Campedelli V, Lai C (2023) The mediation role of shame proneness in the association between perceived parenting and the severity of addictive behaviors: Risk or protective factor? Curr Psychol 42:26217–26226

    Article  Google Scholar 

  70. Verdejo-Garcia A, Clark L, Dunn BD (2012) The role of interoception in addiction: A critical review. Neurosci Biobehav Rev 36:1857–1869

    Article  PubMed  Google Scholar 

  71. Weiss NH, Bold KW, Contractor AA, Sullivan TP, Armeli S, Tennen H (2018) Trauma exposure and heavy drinking and drug use among college students: Identifying the roles of negative and positive affect lability in a daily diary study. Addict Behav 79:131–137

    Article  PubMed  Google Scholar 

  72. Xu P, Opmeer EM, van Tol M-J, Goerlich KS, Aleman A (2018) Structure of the alexithymic brain: A parametric coordinate-based meta-analysis. Neurosci Biobehav Rev 87:50–55

    Article  PubMed  Google Scholar 

  73. Zhao X-f, Zhang Y, Li L, Zhou Y-f (2005) Evaluation on reliability and validity of chinese version of childhood trauma questionnaire. Chin J Clin Rehab 9:209–211

    Google Scholar 

  74. Zhu X, Yi J, Yao S, Ryder AG, Taylor GJ, Bagby RM (2007) Cross-cultural validation of a chinese translation of the 20-item toronto alexithymia scale. Compr Psychiatry 48:489–496

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We sincerely thank the subjects whose participation made this study possible.

This study was funded by the Chinese National Programs for Brain Science and Brain-like Intelligence Technology (2021ZD0202102), the National Natural Science Foundation of China (31300848, 31800930), and CAS International Cooperation Research Program (153111KYSB20190004).

Author information

Authors and Affiliations

  1. CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China

    Jiajing Chen, Dong Mei Wang, Yang Tian, Rongrong Zhu, Yuqing Li, Li Wang & Xiang Yang Zhang

  2. Department of Psychology, University of Chinese Academy of Sciences, Beijing, China

    Jiajing Chen, Dong Mei Wang, Yang Tian, Rongrong Zhu, Yuqing Li, Li Wang & Xiang Yang Zhang

  3. Xin Hua Drug Rehabilitation Center, Sichuan, China

    Lianglun Jia, Fabing Fu, Shanshan Tang & Xiaotao Wang

Authors
  1. Jiajing Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dong Mei Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yang Tian
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rongrong Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yuqing Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lianglun Jia
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Fabing Fu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shanshan Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Xiaotao Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Li Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Xiang Yang Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xiang Yang Zhang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study. Additional informed consent was obtained from all patients for which identifying information is included in this article.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, J., Wang, D.M., Tian, Y. et al. Childhood abuse and craving in methamphetamine-dependent individuals: the mediating role of alexithymia. Eur Arch Psychiatry Clin Neurosci (2024). https://doi.org/10.1007/s00406-024-01775-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00406-024-01775-2

Keywords

Search

Navigation