Recent research published in journals addictive behavior suggest that experiencing multiple traumatic events in childhood increases the risk of developing interrelated addictive behaviors later in life. This study provides evidence that people who endure cumulative childhood trauma experience more severe substance and behavioral addictions, which tend to reinforce each other. This pattern suggests a complex relationship between early psychological distress and the ways people try to cope in adulthood.
Scientists know that difficult childhood events can increase the likelihood of developing addiction. Historically, much research has focused on how a single type of trauma affects a specific addiction, such as alcoholism or gambling addiction. In reality, however, a single child often endures several different types of hardship due to the accumulation of negative childhood experiences.
At the same time, addiction rarely occurs in complete isolation. People often switch from one addictive behavior to another or engage in multiple addictive behaviors at the same time. This suggests that different addictions may share an underlying psychological basis.
“Our study was motivated by an important 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 has only been partially investigated, not only with respect to single addictive behaviors but also with respect to their interrelationships,” said study author Giorgio Veneziani, a postdoctoral researcher at the Sapienza University of Rome.
“Given that different addictive behaviors tend to co-occur and mutually reinforce each other, understanding how accumulated adverse childhood experiences influence their interactions could help identify mechanisms of vulnerability and inform clinical practice.” To this end, we adopted a network analysis approach to move beyond a single behavioral perspective to capture broader patterns linking multiple addictive behaviors in response to adverse childhood experiences.”
For the study, scientists recruited 802 adults from Italy’s general population. Participants were recruited using advertisements on social media platforms such as Facebook and Instagram. Participants completed an online survey asking about their personal background and history of psychological problems.
The study included a screening tool that measured 10 different addictive behaviors. Four of the cases involved substances, specifically alcohol, tobacco, cannabis and cocaine. The remaining six are behavioral addictions, which involve overwhelming urges to engage in activities such as gambling, shopping, video games, overeating, sex, and overwork.
Behavioral addiction is the inability to resist the urge to perform actions that ultimately harm one’s physical, mental, or social well-being. Researchers asked participants how often they felt like they had overdone these activities, lost control, or continued despite negative consequences.
The scientists also used a questionnaire to assess whether participants had been exposed to traumatic events before turning 17 years old. These events include the death of a close relative, serious parent-child relationship problems, physical violence, serious illness, and sexual abuse. Based on their answers, participants were divided into three specific categories.
The first category included 192 individuals who reported no adverse childhood experiences. The second category consisted of 226 people who experienced exactly one type of adverse event. The third category included 384 people who had experienced 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 technique that allows researchers to visualize how different variables are related to each other in a web-like structure. By looking at this web, researchers were able to see which addictions frequently co-occur and which act as central hubs connecting other behaviors.
The data provide evidence that groups with multiple adverse childhood experiences had significantly higher levels of certain addictions. Specifically, these people reported more severe problems with smoking, overeating, and compulsive sexual behavior compared to those without childhood trauma. Overeating was also more severe in this group than in the group with only one 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 relate to each other,” Veneziani told Cypost. “In individuals with multiple adverse experiences, addictive behaviors were more closely interrelated, highlighting underlying patterns of polysubstance use and stronger associations between behavioral and substance-related dependence.
“From a practical perspective, this suggests that when people experience multiple forms of early adversity, risks may emerge as clusters that reinforce addictive behaviors rather than isolated problems, highlighting the importance of prevention and trauma-informed approaches.”
Looking at network analysis, the researchers found that addiction was more interconnected among people who suffered multiple childhood traumas. In this group, different addictive behaviors showed more links to each other, forming a dense web. This elaborate structure suggests a pattern of mutual reinforcement, where one addictive behavior easily causes or influences another.
Within groups with multiple adverse experiences, substance-related dependence was strongly linked. Tobacco, alcohol, cannabis, and cocaine use often overlap, resulting in patterns of simultaneous use of multiple substances. Tobacco and alcohol served as the strongest central anchors in this particular network.
Binge eating also plays a unique role for people with multiple adverse experiences, showing strong associations with shopping, overwork, and drug use. In contrast, for people without childhood trauma, the association between binge eating and alcohol was weak and mostly associated with other behavioral addictions. Compulsive sex showed broad associations across all groups, but was particularly associated with shopping and overwork in the polytrauma group.
Associations with gambling also varied depending on a person’s childhood background. “One particularly notable finding was that gambling behavior differed between groups,” Veneziani said. “Gambling was strongly associated with drug-related addictive behaviors (alcohol and cocaine, respectively) in groups with single or multiple adverse childhood experiences.”
“In contrast, in the group without adverse childhood experiences, gambling was primarily associated with video games. These patterns raise broader questions about how gambling should be conceptualized, and whether it more closely aligns with behavioral addiction and substance-related profiles. Among those with cumulative adverse childhood experiences, gambling appeared to be more embedded in dysregulated, compulsive, and substance-related patterns.”
“Our findings suggest that clinicians and prevention programs need to address not only the management of single addictive behaviors, but also the co-occurring dynamics between them,” Veneziani explained. “Seen from this perspective, early screening for cumulative adversity and targeted prevention in educational and medical settings may be important strategies to reduce the development of interrelated patterns of addictive behaviors.”
Although this study provides a detailed look at how addictions overlap, it also has some limitations. This study relies on a cross-sectional design, which means capturing a snapshot of data at a specific moment in time. For this reason, researchers cannot definitively prove that childhood trauma is the direct cause of these interconnected addictions, only that a strong relationship exists.
Additionally, a social media recruitment strategy resulted in a sample that was primarily young, Italian, and female. This particular demographic means that the findings may not fully apply to older generations or people from different cultural backgrounds. Future research should aim to include a wider range of age groups and nationalities to see if these patterns hold globally. Scientists will also need to look at other factors in the future.
“One important next step is to extend this line of research to emerging technology-mediated addictions, including potential addiction patterns associated with the use of artificial intelligence,” Veneziani said. “As AI-based systems become increasingly integrated into daily life, it is important to understand the mechanisms of psychological vulnerability that may contribute to problematic or compulsive patterns of interaction with AI.”
“One of the broader implications of our findings is methodological. By applying network analysis to addictive behaviors associated with adverse childhood experiences, this study suggests the value of moving beyond diagnostic models to understanding addiction individually. Clinically, this supports integrated screening and prevention strategies that consider both the history of adverse experiences and the potential co-occurrence of multiple addictive behaviors.”
The study, “The role of cumulative adverse childhood experiences in the interrelationships between addictive behaviors: A network analysis study,” was authored by Giorgio Veneziani, Emanuele Girardi, Giulia Panagini, Giuseppe Marano, Giuseppe Manuel Festa, Marianna Mazza, and Carlo Rai.
