A case series of study of childhood psychological trauma and alexithymia among persons with alcohol dependence syndrome attending inpatient de-addiction facility from Central Rural India

Abstract

Psychological trauma occurs when a person suffers from serious threat or loss to his/her life. Childhood psychological trauma can be of various forms such as physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect. Such adverse childhood experiences, if not effectively dealt or resolved, may lead to the development of drug dependence including alcohol dependence syndrome (ADS) in adult life. In many cases, development of ADS is preceded by the occurrence of childhood psychological trauma(s). Such a person with a history of childhood psychological traumas may consume alcohol to cope with his/her trauma-related distress. Alexithymia is a state characterized by a triad of difficulty in identifying one's own feelings, difficulty in differentiating between physical sensations and emotional arousal, and difficulty in explaining one's own feelings to others. Alexithymia has a role in the development of drug dependence including ADS. The number of childhood psychological trauma among persons with ADS was associated with alexithymia in adulthood. Childhood psychological traumas, mainly emotional abuse, might act as a predisposing factor for the development of alexithymia in persons suffering from ADS. This case series presented clinical picture of two individuals with ADS in which both childhood psychological trauma(s) and alexithymia were assessed by using standard and psychometrically valid psychological tools such as Childhood Trauma Questionnaire and Toronto Alexithymia Scale-20 item, respectively. This case series is unique because the assessment of childhood psychological trauma(s) and alexithymia is neglected area in Indian psychiatric research field and detailed ample of literature is not available at present in which the relationship between childhood psychological traumas, alexithymia, and ADS has been assessed. In the present case series, first individual with ADS had clinically significant alexithymia, severe emotional abuse, severe emotional neglect, moderate physical abuse, and moderate physical neglect, while second individual with ADS had no alexithymia but he had moderate-level emotional neglect and mild levels of emotional abuse, physical abuse, and physical neglect.