Why do children of alcoholics develop addictions? The role of childhood trauma

For decades, emphasis has been placed on the family transmission of addictive disorders, such as alcoholism, without realizing that family transmission is not the same as hereditary transmission.

The association between traumatic experiences suffered by young people raised in a family where one of the parents had alcohol problems and the subsequent development of different psychiatric disorders, including alcoholism, has been the subject of various investigations.

Obviously, different factors come together in these young people that can explain the high risk of alcohol addiction. On the one hand, there are hereditary factors related to the response to alcohol. On the other hand, various mental disorders also appear in these young people that indirectly increase the risk of alcoholism, such as attention deficit hyperactivity disorder (ADHD) or depressive disorders.

Thirdly, due to their family history, this population group has between 2 and 13 times greater risk of having suffered traumatic experiences during childhood or adolescence (especially emotional abuse).

The findings on the role that early adverse experiences (EAT) play on the subsequent development of different disorders are very consistent in revealing a cause-effect relationship for depressive disorders, anxiety disorders, post-traumatic stress disorder, of eating behavior and addictive behaviors.

The limbic brain is where the brain structures responsible for emotional expression reside, such as the amygdala and the nucleus accumbens. Now, the limbic brain is subject to the influences of the rational brain, in this case the prefrontal cortex, which modulates it to adapt emotional expressions to the context.

This is how the brain changes with adverse experiences

There have been many studies that have shown the relationship between having been subjected to abuse during childhood and the risk of developing mental disorders. However, it has been mainly brain neuroimaging studies that have provided us with the keys to understanding the underlying neurobiological mechanisms.

In our opinion, the three mechanisms that attract the greatest consensus among researchers are those that link the traumatic experience with the maturational delay of the frontal cortex, with the dysfunction of the limbic system and with the alteration of the stress axis (hypothalamic-pituitary-pituitary-axis). adrenal or HPA axis).

Childhood trauma and maturation of the frontal cortex

Traumatic experiences experienced during childhood and adolescence cause changes in the structure and functioning of pathways and brain areas of the frontal cortex (specifically the so-called prefrontal cortex) that make it difficult to control behavior. This leads to an increase in disruptive behaviors, personality disorders, ADHD and addictive disorders.

The prefrontal cortex is a large brain area, with enormous importance in explaining behavioral control, personality and even cognitive abilities. Its maturation does not end until it reaches 25 years of age. The cognitive processes necessary to control and self-regulate one’s own behavior could not be carried out without their participation, so we are facing one of the most relevant areas when it comes to being able to adapt our behavior to situations and perform complex cognitive operations.

The prefrontal cortex has important connections with a large number of brain regions, both cortical and subcortical, such as the limbic system. That is why it influences and is influenced by a large amount of information coming from very different regions, making it essential for the correct management of behavior and our cognitive resources.

A slowdown in their maturation, caused by the stress associated with EAT, would cause significant difficulties in carrying out the inhibition of unacceptable behaviors (such as those that involve accepting limits) and the control of aggressiveness. But it would also hinder our ability to plan, solve problems, memorize, develop ideas, and have self-awareness.

This brain region is especially linked to the perception and expression of emotions, as well as the motivation capacity of the human being. Hence, this maturational slowdown prevents adequate emotional control, by not being able to exert correct inhibitory control over the limbic system.

Childhood trauma and limbic system dysfunction

EATs also induce changes in the limbic system, either directly on the system itself, or indirectly through the relationship between the frontal cortex and the limbic system.

This dysfunction of the limbic system (amygdala and nucleus accumbens) translates into a clear deficit in emotional control, especially negative emotions (sadness, anxiety, shame, anger or guilt). These alterations facilitate the appearance of depressive and personality disorders, as well as a greater risk for the development of addictive behaviors, in combination with the alterations derived from the involvement of the prefrontal cortex.

Furthermore, traumatic experiences encourage stimuli that have been conditioned with alcohol (such as bars, smells, flavors, beer cans, etc.) to capture the attention of the traumatized young person, making them more desirable for the subject. This influences the development of addictive behaviors.

Childhood trauma as a disturbing factor of the hypothalamic-pituitary-adrenal axis

Various studies have indicated that the alteration of this axis is associated with a greater stressful response to external stimuli related to the stressor, in such a way that the alert and alarm response is exacerbated through the activation of cortisol.

A state of alarm is what we find in stress disorders and post-traumatic stress disorder. In the latter case, the person reacts in a distressing way when some of the signs that were conditioned by the traumatic experience arise (the beating, the rape, or the insults and humiliations that are frequently repeated in cases of emotional abuse). ).

Experiencing these situations again, weeks or years later, causes avoidance behaviors to avoid the discomfort associated with it, with the consequent isolation. It is not uncommon for these people to experience depression or agoraphobia as a result of their high levels of stress and their significant isolation.

file 20231114 21 rkligq.png?ixlib=rb 1.1
Various conditions that act as risk factors for developing alcohol addiction in children of people with addiction to this substance.

In short, early adverse experiences cause, on the one hand, poor emotional control, and on the other, a greater emotional response to signals related to the stressor (reminiscent of the abuse experience). And that means that people are more attracted to stimuli associated with alcohol.

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