A recent study conducted by researchers at UCLA and published in the journal Neuropsychopharmacology has revealed that individuals with alcohol use disorder who experienced significant stress or trauma during childhood often face more intense emotional difficulties and elevated inflammation as adults.
Those with a history of early life stress showed higher levels of negative emotions and a marked increase in inflammatory markers compared to others with the same disorder but without early traumatic experiences. These findings suggest that childhood stress might lead to unique biological and emotional changes in people with alcohol use disorder, which could have implications for targeted treatment strategies.
Previous studies have shown that early life stress can increase the risk of various psychiatric conditions, including alcohol use disorder. However, little research has been conducted on whether people with alcohol use disorder who experienced early life stress have distinct emotional and biological profiles compared to those who did not.
“Early life stress—such as experiencing abuse and neglect or growing up in a difficult household environment—is highly prevalent and has been shown to be one of the most powerful predictors of adverse mental health outcomes, including alcohol use disorder,” said study author Dylan E. Kirsch, a postdoctoral fellow in the Department of Psychology at UCLA.
“Early life stress results in long-lasting changes in the brain and body, which increase the risk for these adverse mental health outcomes. People with a history of early life stress tend to face a more severe mental illness course and have a worse treatment response compared to those with the same diagnosis but no early life stress history. Research also shows that individuals with a history of early life stress show unique biological alterations that differentiate them from others with the same diagnosis but no early life stress history.”
“I was struck by this research, which converges to suggest that people with the same primary mental health diagnosis may differ in their clinical and biological profiles depending on their early life stress history. This research, however, has largely been conducted in individuals with mood disorders.”
“Therefore, I wanted to know whether these early life stress-related differences are also observed in individuals with alcohol use disorder,” Kirsch explained. “Specifically, I was interested in asking the question: Do individuals with alcohol use disorder and a history of early life stress differ in their clinical presentation and underlying biology from those with alcohol use disorder but no early life stress history?”
The study included 163 adults with alcohol use disorder who were seeking treatment. Each participant was evaluated for childhood trauma and stress using the Adverse Childhood Experiences questionnaire, a tool that measures different types of early life stress, including abuse, neglect, and family dysfunction. Based on their responses, participants were grouped into three categories: those with no history of early life stress, those with moderate levels of stress (one to three instances of adverse childhood experiences), and those with high levels of stress (four or more adverse experiences).
To understand the emotional and biological impacts, the researchers focused on two areas associated with addiction: negative emotionality and incentive salience. Negative emotionality reflects feelings of sadness, anxiety, and other negative emotions, while incentive salience relates to the desire or urge for alcohol. They used psychological assessments to measure these aspects, specifically examining how much participants thought about drinking and their feelings of guilt or sadness after drinking.
In addition, 98 of the participants provided blood samples, which were tested for a specific marker of inflammation known as C-reactive protein. Elevated levels of this protein can indicate increased inflammation, which has been associated with health issues like cardiovascular disease and is believed to be linked to long-term effects of early life stress.
The researchers found clear differences between individuals with high levels of early life stress and those with little or no such stress. Participants with a high history of early life stress reported higher levels of negative emotionality, including feelings of sadness, guilt, and anxiety, compared to the other two groups.
The findings also indicated a link between early life stress and inflammation. Those in the high-stress group showed significantly higher levels of C-reactive protein in their blood, indicating a higher level of inflammation. This was not observed in the moderate or no-stress groups, suggesting that more severe childhood stress might be required to trigger an inflammatory response later in life. The researchers observed that both age and body mass index played a role in inflammation levels but found that early life stress remained a key factor even when controlling for these variables.
“Individuals with an alcohol use disorder may exhibit unique clinical and biological characteristics based on their early life stress history,” Kirsch told PsyPost. “Specifically, our findings suggest that those with alcohol use disorder and a history of early life stress experience heightened negative emotionality and have higher levels of peripheral inflammation compared to those without early life stress.
“As the field of psychiatry moves towards precision medicine approaches, understanding these differences in alcohol use disorder presentation and their biological underpinnings is essential. This insight can guide the development of targeted treatment tailored to the unique presentation of individuals with a history of early life stress.”
Interestingly, early life stress did not appear to impact incentive salience, meaning that childhood trauma did not make individuals more inclined to think about or crave alcohol.
“We had hypothesized that early life stress would also be associated with greater incentive salience—or motivated ‘wanting’ of alcohol,” Kirsch told PsyPost. “Contrary to this prediction, early life stress was not associated with incentive salience in our sample, which suggests a dissociation of the effects of early life stress on alcohol use disorder clinical phenomenology.”
One limitation is that the study was cross-sectional, meaning it only provides a snapshot of participants’ experiences at one point in time. As a result, it cannot establish a causal relationship between early life stress and later inflammation or emotional challenges. Future research could address this by following individuals over time to understand how early life stress impacts the development of alcohol use disorder and related symptoms.
“Additionally, there is growing evidence that different forms of early life stress are associated with unique mental health outcomes,” Kirsch noted. “Our study did not have a large enough sample to investigate different types of early life stress. Therefore, we need to conduct large-scale longitudinal studies to further explore this topic.”
The study highlights the potential need for tailored treatment approaches for people with alcohol use disorder who have experienced early life stress. For instance, focusing on managing negative emotions and addressing inflammation could be particularly beneficial for these individuals. Additionally, anti-inflammatory treatments, which have shown promise in reducing symptoms in people with mood disorders and a history of early life stress, might be explored as an option for people with alcohol use disorder.
“I would love to extend this line of research in the following ways: (1) Understand how a history of early life stress influences in other biobehavioral processes in alcohol use disorder—such as brain structure and function, subjective response to alcohol, alcohol cue-reactivity, etc.; and (2) Understand how a history of early life stress influences treatment response in individuals with alcohol use disorder,” Kirsch said.
The researchers have also found evidence that biological sex may play a crucial role in moderating the inflammatory response associated with early life stress.
“While we did not examine this in the present study, existing research suggests that sex at birth may be an important variable moderating biological response to early life stress,” Kirsch explained. “We recently conducted another study to ask the question: Does biological sex moderate the effects of early life stress on peripheral inflammation in alcohol use disorder? (see: https://doi.org/10.1016/j.drugalcdep.2024.112474).”
“Our results suggest that biological sex moderates the effects of early life stress on peripheral inflammation in adults with alcohol use disorder. Specifically, findings suggest females with alcohol use disorder may be more vulnerable to the early life stress-related adaptations to the immune system, potentially resulting in a proinflammatory state in adulthood.”
The study, “Early life stress is associated with greater negative emotionality and peripheral inflammation in alcohol use disorder,” was authored by Dylan E. Kirsch, Erica N. Grodin, Steven J. Nieto, Annabel Kady, and Lara A. Ray.
