Aim of this paper was to investigate the responses to negative emotions in human lab, and the related HPA reactions to emotional arousal, among abstinent drug users, in relationship to their perception of childhood adverse experiences. Thirty male abstinent heroin dependent subjects were included in the study. Emotional response evaluation was assessed after 3 months of abstinence from heroin and any other drug and alcohol. Thirty healthy volunteers, matched for age and sex, were used as control. Emotional responses and childhood neglect perception were measured utilizing the State-trait Inventory Y-1 (STAI) and Child Experience of Care and Abuse Questionnaire (CECA-Q). Neutral and unpleasant set of pictures selected from the international effective picture system and the Self-Assessment Manikin procedure (SAM) have been used to determine rating s of pleasure and arousal. Blood samples were collected before and after the experimental session to determine ACTH and cortisol plasma levels. Basal anxiety scores, cortisol and ACTH levels were higher in abstinent heroin users than in controls and increased less significantly after the unpleasant task, in comparison to controls. Abstinent heroin users showed significantly higher levels of parents antipathy and childhood emotional neglect perception than controls for both father and mother scores. Abstinent heroin users showed higher increase in arousal score compare to controls after the vision of unpleasant slides, but without a similar increase in HPA axis hormones. Multiple regression correlation showed a significant relationship between childhood neglect, arousal reaction, impaired HPA axis response and addiction severity. Early adverse experiences seem to affect the entire interaction between hyper-arousal, reduced hormonal response to stress and addiction severity. Ours finding, although obtained in a small number of subjects, indicate a significant link between perception of parental style/ care/ support during childhood and the ability to cope with stressful emotional stimuli in adulthood and addiction severity.
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