In conclusion, our results indicate that exposure to childhood trauma, in particular emotional and physical abuse, may be a particularly significant risk factor for the development of severe alcohol dependence. Our findings are based on a sample of treatment-seeking alcoholics, a population characterized by greater alcohol use, greater severity of dependence, greater psychiatric co-morbidity, and lower quality of life in general, compared to subjects identified as alcohol dependent in epidemiological samples (Fein and Landman, 2005; LoCastro et al., 2008). As such, our findings are particularly relevant for clinical populations of alcohol dependent patients, and point to the possibility that alcohol dependent patients with a history of childhood emotional abuse may represent a clinically distinct sub-group of alcoholics. Given that less than 1 in 4 alcoholics ever seek treatment (Hasin et al., 2007), and that relapse rates in alcoholics are very high, there is a clear need for individualized treatment approaches. Our data suggest that alcoholics with histories of childhood abuse may benefit from tailored treatment approaches that incorporate a focus on the long-term effects of childhood abuse and resulting psychiatric and psychosocial needs.
