Emotional abuse during childhood is linked to alcohol-related problems in later life through increased insomnia

A recent study suggests that children who suffer emotional abuse go on to experience increased insomnia, and in turn, more alcohol-related problems during adulthood. The researchers behind the study suggest that addressing childhood trauma may be one avenue of treatment for dysregulated drinking. The findings were published in the journal Addictive Behaviors Reports.

People who suffer from trauma often experience sleep disturbances. The Hyperarousal Theory says this is because trauma activates the body’s fight-or-flight response, which triggers the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system and interferes with sleep quality.

In turn, there appears to be a connection between insomnia and alcohol-related problems. For example, there is some evidence that insomnia makes people more susceptible to the negative repercussions of alcohol. Study authors Julie Patock-Peckham and her colleagues wondered whether insomnia brought on by childhood trauma might contribute to problematic drinking in later life.

“The Social Addictions Impulse Lab has a general interest in how environment and personality traits affect alcohol use and alcohol-related problems,” explained Patock-Peckham, an assistant research professor at Arizona State University. “Several of my students wished to move away from examining parenting styles and bonds and instead have us start looking at faces of childhood maltreatment and trauma and the role that may play in alcohol-related problems. Poor sleep quality impacts so many aspects of life and the choices one makes that we thought a study on insomnia might be a good place to understand the etiology of alcohol use disorders.”

The researchers conducted a study to investigate whether insomnia mediates the link between childhood trauma and drinking outcomes. First, they recruited 941 university students to answer a series of questionnaires. These surveys included an assessment of childhood trauma that measured physical, sexual, and emotional abuse, and physical neglect. The survey also assessed the presence of emotionally supportive family members, insomnia, and problems with alcohol.

The researchers then analyzed the data and found that students with experiences of emotional abuse during childhood had higher scores for insomnia and impaired control over one’s alcohol intake. In turn, they drank more alcohol as adults and experienced more alcohol-related problems. Patock-Peckham and team said this suggests that impaired control might be one process tying insomnia to problems regulating alcohol intake.

“People underestimate the power of words and emotional abuse on people,” Patock-Peckham told PsyPost. “While it is considered to be one of the milder forms of abuse, it is the most common and words can stick with people for a long time. It is possible that those hurtful words just make it harder to fall asleep for some individuals.”

Neither physical abuse nor physical neglect was significantly associated with insomnia, although physical neglect was linked to impairment control over alcohol use. This suggests a specific connection between emotional abuse and insomnia. “The more directed nature of emotional abuse may induce a stress response that results in hyperarousal,” the researchers wrote. “Conceivably, emotionally abused individuals might ruminate over their untoward conversations more while trying to settle down and sleep.”

The authors said that piling insomnia on top of childhood maltreatment produces a “perfect storm of risk factors” that paves the way to alcohol abuse. Addressing emotional abuse in therapy may be one way to target alcohol abuse.

“We would like people to understand that emotional abuse is the most common form of childhood maltreatment,” Patock-Peckham told PsyPost. “Emotional abuse directly reduces the quality of one’s sleep due to insomnia. Not sleeping well can make it more likely that one may increase impaired control over drinking alcohol (ie drinking to excessive levels or heavy-episodic-drinking with beyond legal limits for reached).

“Physical neglect also directly predicts poor self-control over drinking (ie impaired control over drinking). The idea here is that if you grow up without having access to proper food or access to medical care when needed, that you might be much more likely to grab reinforcing substances such as alcohol more than is wise to drink in a particular time frame.”

While the findings extend the current literature on trauma and insomnia, the study was not without limitations. The researchers said that future research should include measures of biomarkers — like HPA axis activation or hormone concentrations — to help determine whether hyperarousal is driving the link between childhood trauma and insomnia. The sample was also confined to college students, a population that tends to have lower levels of physical abuse compared to the general population.

“We need to study these ideas longitudinally in a large sample of people,” Patock-Peckham said. “It would also be good to study trauma histories, sleep quality, and alcohol use with alcohol self-administration work (ad libitum drinking studies allowing for people to drink freely in a bar setting) to establish causal links with experiments over time.”

The study, “Does insomnia mediate the link between childhood trauma and impaired control over drinking, alcohol use, and related problems?”, was authored by Sean N. Noudali, Julie A. Patock-Peckham, Sophia L. Berberian, Daniel A. Belton, Lyndsay E. Campbell, and Frank J. Infurna.

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