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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO420

From childhood adversity to daily alcohol craving: sex-specific neural cue reactivity

FROM CHILDHOOD ADVERSITY TO DAILY CRAVING: SEX-SPECIFIC NEURAL CUE REACTIVITY

Prefrontal alcohol cue reactivity constitutes a sex-specific pathway linking adverse childhood experiences to daily alcohol craving, with this pathway particularly pronounced in women.

The study aimed to test whether adverse childhood experiences (ACEs) differentially shape neural alcohol cue reactivity in women and men with alcohol use disorder (AUD), and whether this mechanism links ACEs to craving and alcohol-related outcomes. Functional magnetic resonance imaging (fMRI) data were analyzed from 231 non-treatment-seeking individuals with predominantly mild to moderate AUD enrolled in a 12-month multicenter study (94 women, 137 men; mean age 39.11 ± 13.48; mean number of DSM-5 AUD criteria met 3.9). ACEs were measured using the total score on the Childhood Trauma Screener (CTS); participants completed an alcohol cue reactivity task during fMRI, followed by ecological momentary assessment (EMA) monitoring of daily craving and alcohol consumption. Analyses used sex-stratified linear regressions, general linear models, and mediation analyses with sex as a moderator. In the alcohol-versus-neutral cue contrast, activation in the left superior frontal gyrus/anterior cingulate cortex (SFG/ACC) was positively associated with CTS scores in women (n=94, B=0.288, confidence interval [0.007; 0.041], p=0.009) and negatively associated in men (n=137, B=-0.288, confidence interval [-0.058; -0.010], p=0.012). This activation was associated with mean daily craving during EMA follow-up in women (n=86, B=0.624, confidence interval [0.006; 1.264], p=0.048), whereas no association was observed in men (n=130, B=0.193, confidence interval [-0.227; 0.686], p=0.387). In the sex-moderated mediation analyses, indirect effects were in opposite directions for the two sexes (men: ab=-0.013, confidence interval [-0.034; -0.002]; women: ab=0.008, confidence interval [0.001; 0.022]), and these effects persisted after sensitivity adjustments for age, AUD severity, baseline alcohol consumption, tobacco use, psychological distress, and the progesterone-to-estradiol ratio. The authors suggest that sex-specific prefrontal cue reactivity may represent a distinct neural pathway linking ACEs to vulnerability to craving in early-stage AUD, and that the findings support sex-sensitive, trauma-informed intervention strategies.

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