Overall, the current study suggests that alcohol or nicotine dependent individuals who have suffered abuse or physical neglect during childhood are more likely to have persistent disorders. Associations remained strong despite control for other childhood adversities, suggesting specific effects of a history of direct maltreatment rather than a generally difficult childhood. Future research should address the mechanisms of this effect, including psychiatric, psychological, social, and/or neurological mediators. The findings suggest the need for assessment of childhood maltreatment history during intake for alcohol or nicotine dependence treatment, as maltreatment experiences suggest a more difficult path to recovery, and may indicate the need for more intensive treatment. This study adds important and novel findings to the literature on factors predicting course of dependence, and suggests directions for future research on how childhood maltreatment impacts persistence.
