Childhood neglects: intimate partner violence in PTSD-SUD comorbid patients treated with narrative exposure therapy

Background: Childhood emotional neglect is a prevalent form of maltreatment, with long-term consequences on emotional regulation and relational patterns. Existing literature indicates associations between emotional neglect, substance use disorder (SUD), post-traumatic stress disorder (PTSD), and intimate partner violence (IPV).Objective: This study investigates how experiences of parental emotional neglect in childhood reflect on behaviours related to the perpetration of IPV in adulthood, with a particular focus on the interaction with PTSD and SUD.Method: A qualitative thematic content analysis was conducted on N = 28 narratives collected from individuals who underwent Narrative Exposure Therapy (NET) within a long-term inpatient substance use treatment facility in the west of Norway. Of the 28 participants 67% were male, and the participants' age ranged from 23 to 58 years (M = 37.5, SD = 8.8). The age of onset of substance use ranged from 11 to 33 years (M = 18.0, SD = 6.8). All fit the criteria for PTSD, and all had been subjected to three or more types of potentially traumatic events. Data was collected between May 2021 and May 2024 from a larger clinical project integrating NET and Dialectical Behaviour Therapy (DBT) for individuals with SUD and PTSD.Results: Four interconnected themes emerged: (1) Enduring impact of childhood experiences on adult life; (2) Interplay between emotional neglect and the search for validation; (3) PTSD Symptoms and Substance Use as Intermediary Factors Connected to Violence; (4) Continuity between early family dynamics and adult intimate relationships.Conclusion: The findings indicate that childhood emotional neglect contributes to adult IPV perpetration through specific PTSD and SUD pathways. The study identified concrete mechanisms linking early emotional wounds to adult violent behaviour, with gender-specific patterns and inferences related to intergenerational transmission.