Childhood Maltreatment and Drug Craving in Patients With Methamphetamine Use Disorder: The Independent and Serial Mediating Roles of Emotional Dysregulation and Impulsivity

Growing evidence suggests that childhood maltreatment (CM) is associated with adverse emotional and behavioural outcomes in individuals with methamphetamine use disorder (MUD). However, the psychological mechanisms underlying the association between CM and drug craving remain insufficiently understood. This study examined whether emotional dysregulation (ED) and impulsivity independently and serially mediated the association between CM and drug craving in patients with MUD. A total of 407 male inpatients with MUD were recruited from a drug rehabilitation centre in China. CM, ED, impulsivity and drug craving were assessed using the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Difficulties in Emotion Regulation Scale (DERS), the Barratt Impulsiveness Scale (BIS-11) and the Obsessive-Compulsive Drug Use Scale (OCDUS), respectively. Of the total sample, 229 (56.2%) patients had experienced at least one form of CM. Patients with a history of CM exhibited significantly higher levels of ED, impulsivity and drug craving than those without CM (all p < 0.01). Significant associations were observed among CM, ED, impulsivity and drug craving (all p < 0.05). Furthermore, ED and impulsivity independently (β = 0.041, 95% CI [0.023, 0.062]; β = 0.024, 95% CI [0.009, 0.042]) and serially (β = 0.011, 95% CI [0.003, 0.021]) mediated the association between CM and drug craving. These findings suggest that the association between CM and drug craving may be partly explained by emotion regulation difficulties and impulsivity, highlighting the potential value of interventions targeting emotion regulation skills and impulse control in patients with MUD.