A recent study published in the journal Addictive Behaviors suggests that experiencing multiple traumatic events during childhood is linked to a higher risk of developing interconnected addictive behaviors later in life. The research provides evidence that people who endure cumulative childhood trauma tend to experience more severe substance and behavioral addictions that reinforce one another. This pattern hints at a complex relationship between early psychological pain and the ways people attempt to cope as adults.
Scientists know that difficult childhood events can increase the likelihood of someone developing an addiction. Historically, many studies have focused on how a single type of trauma affects a specific addiction, such as alcohol dependence or compulsive gambling. Yet, in reality, negative childhood experiences often pile up, with a single child enduring multiple different types of hardships.
At the same time, addictions rarely happen in total isolation. People often switch from one addictive behavior to another or engage in several at the same time. This suggests that different addictions might share an underlying psychological foundation.
“Our study was motivated by a key gap in the scientific literature. While the association between adverse childhood experiences and addictive behaviors has been extensively investigated, the role of cumulative adverse experiences remains only partially explored – not only in relation to single addictive behaviors, but also regarding their interrelationships,” said study author Giorgio Veneziani, a postdoctoral researcher at Sapienza University of Rome.
“Considering that different addictive behaviors tend to co-occur and reinforce each other, understanding how cumulative adverse childhood experiences influence their interaction could help identify vulnerability mechanisms and inform clinical practice. For this reason, we adopted a network analysis approach to move beyond a single-behavior perspective and capture the broader patterns linking multiple addictive behaviors according to adverse childhood experiences.”
For their study, the scientists recruited 802 adults from the general population in Italy. They gathered the participants using advertisements on social media platforms like Facebook and Instagram. The participants completed an online survey that asked about their personal backgrounds and their history of psychological challenges.
The survey included a screening tool to measure ten different types of addictive behaviors. Four of these were related to substances, specifically alcohol, tobacco, cannabis, and cocaine. The other six were behavioral addictions, which involve an overwhelming urge to engage in activities like gambling, shopping, playing video games, overeating, sex, and overworking.
A behavioral addiction is a condition where a person cannot resist the urge to perform an action that eventually harms their physical, mental, or social well-being. The researchers asked participants how often they felt they did these activities too much, lost control over them, or continued them despite negative consequences.
The scientists also used a questionnaire to assess the participants’ exposure to traumatic events before the age of seventeen. These events included the death of a close family member, severe parental relationship problems, physical violence, serious illness, or sexual abuse. Based on their answers, the participants were sorted into three specific categories.
The first category included 192 people who reported no adverse childhood experiences. The second category consisted of 226 people who had encountered exactly one type of adverse event. The third category included 384 individuals who had lived through two or more different types of childhood trauma.
To analyze the data, the scientists used a technique called network analysis. Network analysis is a statistical method that allows researchers to visualize how different variables relate to one another in a web-like structure. By looking at this web, the researchers could see which addictions frequently co-occurred and which ones served as central hubs connecting other behaviors.
The data provides evidence that the group with multiple adverse childhood experiences had noticeably higher levels of certain addictions. Specifically, these individuals reported more severe issues with tobacco use, overeating, and compulsive sexual behavior compared to the people with no childhood trauma. Overeating was also more severe in this group than in the group with only a single adverse experience.
“The main takeaway is that cumulative adverse childhood experiences appear to play an important role not only in the severity of individual addictive behaviors but also in how these behaviors become interconnected,” Veneziani told PsyPost. “In individuals with multiple adverse experiences, addictive behaviors were more tightly interrelated, highlighting a potential pattern of polysubstance use and stronger links between behavioral and substance-related addictions.
“From a practical standpoint, this suggests that when people experience multiple forms of early adversity, risk may manifest as clusters of reinforcing addictive behaviors, rather than isolated problems – underscoring the importance of prevention and trauma-informed approaches.”
When looking at the network analysis, the researchers found that addictions were much more interconnected for the people who endured multiple childhood traumas. In this group, the different addictive behaviors displayed a higher number of links to one another, creating a dense web. This dense structure suggests a pattern of mutual reinforcement, where one addictive behavior easily triggers or feeds into another.
Within the group with multiple adverse experiences, the substance-related addictions were strongly linked together. Tobacco, alcohol, cannabis, and cocaine use frequently overlapped, which tends to indicate a pattern of using multiple substances at the same time. Tobacco and alcohol acted as the strongest central anchors in this specific network.
Overeating also played a unique role for those with multiple adverse experiences, showing strong links to shopping, overworking, and substance use. In contrast, for people with no childhood trauma, overeating was only weakly associated with alcohol and was mostly tied to other behavioral addictions. Compulsive sex showed broad connections across all groups, but it linked to shopping and overworking specifically in the multiple trauma group.
Gambling associations also shifted depending on a person’s childhood background. “One particularly noteworthy finding was the way gambling behaved differently across groups,” Veneziani said. “In the single-and multiple-adverse childhood experiences groups, gambling was strongly associated with substance-related addictive behaviors (alcohol and cocaine, respectively).”
“In contrast, in the no-adverse childhood experiences group, gambling was mainly associated with videogaming. These patterns raise broader questions about how gambling should be conceptualized – whether it aligns more closely with behavioral addictions or substance-related profiles. In individuals with cumulative adverse childhood experiences, gambling appeared more embedded in a dysregulated, compulsive, substance-linked pattern.”
“Our findings suggest that clinicians and prevention programs should address not only the management of single addictive behaviors but also the co-occurring dynamics among them,” Veneziani explained. “In this perspective, early screening for cumulative adversity and targeted prevention in educational and healthcare settings may be key strategies to reduce the development of interrelated patterns of addictive behaviors.”
While the study offers a detailed look at how addictions overlap, it has some limitations. The research relied on a cross-sectional design, meaning it captured a snapshot of data at one specific moment in time. Because of this, the researchers cannot definitively prove that childhood trauma directly causes these interconnected addictions, only that a strong relationship exists.
Additionally, the social media recruitment strategy resulted in a sample that was primarily young, Italian, and female. This specific demographic makeup means the findings might not apply perfectly to older generations or people from different cultural backgrounds. Future research should aim to include a wider variety of age groups and nationalities to see if these patterns hold true globally. Scientists also need to look at other contributing factors in the future.
“One important next step is to extend this line of work to emerging and technologically mediated forms of addiction, including potential addictive patterns related to artificial intelligence use,” Veneziani said. “As AI-based systems become increasingly embedded in everyday life, it will be crucial to understand the psychological vulnerability mechanisms that may contribute to problematic or compulsive patterns of AI interaction.”
“One broader implication of our findings is methodological. By applying network analysis to addictive behaviors in relation to adverse childhood experiences, the study suggests the value of moving beyond diagnostic models toward an individual, personalized understanding of addiction. Clinically, this supports integrated screening and prevention strategies that consider both adverse experiences history and the potential co-occurrence of multiple addictive behaviors.”
The study, “The role of cumulative adverse childhood experiences in the interrelationships among addictive behaviors: A network analysis study,” was authored by Giorgio Veneziani, Emanuele Giraldi, Giulia Panagini, Giuseppe Marano, Giuseppe Manuel Festa, Marianna Mazza, and Carlo Lai.
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