Childhood Trauma, Personality, and Substance Use Disorder: The Development of a Neuropsychoanalytic Addiction Model

Abstract

Background: While traditional psychoanalysis has been criticized as insufficient for the treatment of substance use disorder (SUD), recent progress in the field of neuropsychoanalysis has generated new and promising hypotheses regarding its etiology. However, empirical research applying this framework has been sparse. Aim and Scope: The present overview aims at developing and empirically validating a neuroscientifically informed psychodynamic framework regarding the etiology of SUD. For this purpose, this review provides a concise overview of the most relevant historical and contemporary psychoanalytic theories on SUD etiology. Furthermore, the original research summarized in this paper consists of three studies investigating connections between childhood trauma, primary emotions, personality structure and attachment, as well as their relation to SUD development and treatment. Conclusions: The results highlight the empirical validity of the neuropsychoanalytic approach towards SUD etiology. In particular, the findings underscore the conceptualization of SUD as a disorder related to dysfunctional attachment and affect regulation abilities especially linked to increased SADNESS and ANGER dispositions, which mediated the relationship between SUD and traumatic childhood relationships. Based on these findings, a refined model of SUD etiology is proposed, which should be tested in future studies.

Adverse childhood experiences: Pathways to internalising and externalising problems in young adulthood

“…In this regard, drug use is an extreme strategy usually linked to extreme adversities, such as sexual abuse, which is also more prevalent in women (Pereda et al, 2014; Villanueva & Gomis‐Pomares, 2021), and at the same time, closely linked to internalising problems (Muniz et al, 2019). According to previous studies (Fuchshuber & Unterrainer, 2020), feelings of anxiety and pain associated with early childhood trauma are often managed by the child ignoring his or her own feelings and self‐esteem. In adulthood, this internalised coping strategy may predispose them to risky behaviours such as drug use.…”

Is there an affective neuroscience of spirituality? The development and validation of the OCEANic feelings scale

“…Based on his studies on mammalian brains, Jaak Panksepp identified areas in the subcortical-limbic circuits of the brain to be the seat of seven primal emotion systems (Panksepp, 2004;Fuchshuber et al, 2019Fuchshuber et al, , 2022, which he derived from electrical stimulation of specific neuronal networks, namely SEEKING/foraging, PLAY/joy, CARE/nurturance, LUST/sexuality; PANIC/separation, RAGE/anger, and FEAR/anxiety. Within contemporary psychoanalytic discourse these affective systems are currently discussed regarding reconceptualization of classical drive theory (Fuchshuber and Unterrainer, 2020;Solms, 2021;Kernberg, 2022).…”

Influence of anxious attachment on the relationship between primary emotions and substance-related addictive behaviors

“…Most recently, Fuchshuber et al ( 12 ) developed The German Version of the Brief Affective Neuroscience Personality Scales including a LUST scale (BANPS–GL). Regarding the impact of primary emotions on the pathogenesis of SUDs recent studies emphasize dysregulations especially within the SEEKING, the SADNESS and the ANGER systems ( 13 , 14 ).…”