The Relationship Between Hopelessness and Childhood Traumas in Men With Methamphetamine Use Disorder: The Mediating Role of Perceived Social Support

Meltem Hazel Şimşek; Ulaş Korkmaz; Fatma Gül Helvacı Çelik

doi:10.30773/pi.2025.0183

Psychiatry Investig > Volume 23(2); 2026 > Article

Şimşek, Korkmaz, and Çelik: The Relationship Between Hopelessness and Childhood Traumas in Men With Methamphetamine Use Disorder: The Mediating Role of Perceived Social Support

Original Article

Psychiatry Investigation 2026;23(2):278-288.

Published online: February 3, 2026

DOI: https://doi.org/10.30773/pi.2025.0183

The Relationship Between Hopelessness and Childhood Traumas in Men With Methamphetamine Use Disorder: The Mediating Role of Perceived Social Support

Meltem Hazel Şimşek

, Ulaş Korkmaz

, Fatma Gül Helvacı Çelik

Department of Psychiatry, Giresun University, Faculty of Medicine, Giresun, Türkiye

Correspondence: Meltem Hazel Şimşek, MD Mehmet İzmen St. Giresun Training and Research Hospital, Giresun 28100, Türkiye Tel: +90-5071991528, Fax: +90-4543102002 E-mail: hazel.simsek@giresun.edu.tr

Received May 31, 2025 Revised September 5, 2025 Accepted December 16, 2025

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

This study aims to investigate the effect of childhood trauma (CT) on the level of hopelessness in individuals diagnosed with methamphetamine use disorder (MUD) and the mediating role of perceived social support in this relationship.

Methods

The study included 43 patients diagnosed with MUD who attended a psychiatric outpatient clinic and 45 healthy controls with similar sociodemographic characteristics. Participants completed a sociodemographic data form, the Childhood Trauma Scale- Short Form, the Multidimensional Scale of Perceived Social Support, and the Beck Hopelessness Scale. Data were analyzed using SPSS 27 and the PROCESS Macro; correlation, group comparisons, and bootstrap-based mediation analysis were applied.

Results

In the group with MUD, CT, and hopelessness levels were significantly higher, while perceived social support levels were lower. Positive correlations were found between trauma and hopelessness, and negative correlations were found between social support and both variables. In the mediation analysis, the direct effect of CT on hopelessness was insignificant (b=0.037, p=0.115), while the indirect effect mediated by perceived social support was significant (b=0.062, 95% confidence interval: 0.028 to 0.101). These findings indicate that perceived social support is mediating in this relationship.

Conclusion

In conclusion, it appears that hopelessness levels in individuals diagnosed with MUD may be affected by CT and that this effect is shaped through social support. The findings emphasize the importance of strengthening social support systems in treatment.

Keywords: Methamphetamine, Methamphetamine-related disorders, Adverse childhood experiences, Social support, Hopelessness, Mental health

INTRODUCTION

The prevalence of methamphetamine use has risen, and it has emerged as a substantial public health concern. According to the 2023 World Drug Report, the use of amphetamine-like substances has reached 36 million individuals [1]. Methamphetamine has been demonstrated to exert a robust psychostimulant effect. Methamphetamine use carries a high potential for the development of dependence. The association between the condition and various mental disorders, particularly psychotic disorders, has been documented [2]. In individuals with methamphetamine use disorder (MUD), in addition to addictive behaviors, symptoms such as hopelessness, depression, anxiety, cognitive problems, and suicidal thoughts are commonly observed [3]. MUD causes cardiovascular and renal dysfunction, infectious diseases, cognitive decline, and impaired social functioning in addition to mental disorders [4]. When all these mental, physical, and social effects are considered together, methamphetamine use negatively impacts individuals’ life functioning and overall well-being in various ways.

Childhood traumatic experiences significantly contribute to methamphetamine use. These experiences, which may include physical neglect, emotional neglect, abuse, and sexual abuse, can weaken an individual’s ability to cope with stress. As a result, this vulnerability may lead to substance use and the development of other mental health disorders in the future [5].

Traumatic experiences in childhood can impact how we see ourselves, control our impulses, and build attachments with others. These factors are significant in the development of MUD and can influence the presence and severity of other mental health conditions [6]. Substances like methamphetamine heavily stimulate the brain’s reward systems and can provide temporary relief from negative emotions. This is particularly relevant for people who have experienced childhood trauma (CT), as they might turn to meth as a way to cope with their feelings [7]. Studies indicate that individuals with a history of CT are more likely to develop MUD compared to those without such a history [8]. Furthermore, CT can hinder the development of effective coping strategies and social support, increasing the risk of developing and relapsing in MUD [9]. Therefore, addressing CT is critical for preventing and treating MUD by supporting individuals in developing healthier coping strategies and gaining psychological resilience.

Social support is a crucial psychosocial factor that influences the development and recurrence of MUD. Recent studies highlight the significance of perceived social support in preventing MUD, mitigating its negative effects, and aiding in treatment processes [10]. This concept refers to how individuals view the emotional, cognitive, behavioral, and practical assistance they get from important people in their lives, such as family, friends, and partners [11]. For good mental health, it is very important for individuals to believe that they are valued and to have strong social support [12]. Individuals with strong social support are better able to cope with stress and challenging situations, leading to greater resilience and positive coping behaviors [13]. Conversely, feeling that one lacks sufficient social support can increase the likelihood of substance use, such as methamphetamine [14].

Individuals with a history of CT may have difficulty trusting others, forming close relationships, and experiencing intimacy. This can lead to social isolation and feelings of loneliness [15]. Perceived lack of social support can intensify the emotional distress caused by CT. This situation may increase the likelihood of turning to substances such as methamphetamine [9]. Studies show a negative relationship between perceived social support and MUD. Insufficient perceived social support is an important factor in both the development of MUD and the frequency of use [14,16,17]. A strong social support system can prevent the development of substance use disorders. It can also improve treatment adherence [18]. So, figuring out and dealing with perceived social support is an important part of full prevention and treatment plans for MUD and CT.

Hopelessness, characterized by widespread negative expectations about the future and a negative belief that one’s situation will not improve, is an important predictor of mental health problems [19]. Hopelessness is one of the fundamental building blocks of depression and is considered a decisive variable in predicting suicidal behavior [20]. Recent studies have shown that individuals diagnosed with MUD have high levels of hopelessness. This condition is associated with both addiction and cognitive impairment, as well as treatment non-compliance and suicide risk [3,21]. CT can play a significant role in making people feel hopeless. Repeated experiences of abuse, neglect, or violence can lead a person to believe that the world is dangerous and that they cannot change their situation [22]. Low perceived social support can also make people feel more hopeless because they lack the emotional and practical resources to cope with their problems [23]. Feeling that one lacks sufficient social support increases the likelihood of developing CT and feelings of hopelessness, increasing the likelihood of developing MUD [24].

Most studies have examined CT, hopelessness, and perceived social support levels separately in individuals with MUD. However, very few studies have examined how these variables interact over time. To the best of our knowledge, no previous studies have examined the mediating role of perceived social support in the relationship between CT and hopelessness among individuals diagnosed with MUD. Accordingly, our study provides an original contribution to the existing literature.

Understanding the connections between MUD, CT, perceived social support, and hopelessness is essential for developing effective prevention and treatment approaches for MUD. Therefore, the primary objective of our study is to explore the possible mediating role of perceived social support in the relationship between CT and hopelessness. Secondarily, the levels of these three variables were compared between individuals diagnosed with MUD and a healthy control group. Additionally, correlations between CT, hopelessness, and perceived social support were examined, and a mediation model was developed based on the significant relationships between these variables.

The following testable hypotheses are proposed in this study:

1. There is a positive and significant relationship between CT and hopelessness.

2. There is a negative and significant relationship between perceived social support and hopelessness.

3. There is a negative and significant relationship between perceived social support and CT.

4. Perceived social support mediates the relationship between CT and hopelessness.

5. Compared to healthy controls, individuals diagnosed with MUD report higher levels of CT and hopelessness, and lower levels of perceived social support.

METHODS

Study design and data source

This study was conducted using a cross-sectional case-control design, and the sample size was calculated using the G Power 3.1.9.7 program (Heinrich Heine University Düsseldorf). Since no study in the literature determined the effect size d, it was accepted as d=0.8, and the power level was set at 0.85. Based on these data, the study group and healthy control groups were determined to include 30 participants each, totaling 60 participants.

Participants were selected on a voluntary basis from individuals who visited the psychiatry outpatient clinics of a tertiary care hospital between September 2024 and May 2025. The diagnosis of MUD was made by a specialist psychiatrist using the Structured Clinical Interview for DSM-5 (SCID-5) according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnostic criteria. The healthy control group was selected from hospital staff, patients’ relatives, and volunteers from the community. Participants declared that they had no history of psychiatric disorders or substance use, and this was verified by a specialist psychiatrist using the nonpatient version of the SCID-5. The participation of hospital staff and patients’ relatives in the control group was entirely voluntary. For relatives of patients, data collection was conducted after the completion of treatment processes to prevent any perception of pressure or obligation. Participants were clearly informed, both in writing and verbally, that their nonparticipation in the study would have no impact on their employment, duties, or the medical care they or their relatives received. All necessary measures were taken to ensure that neither hospital staff nor patients’ relatives were subjected to any hierarchical pressure; the informed consent process was conducted independently. These methods and protective ethical practices were evaluated and approved by the institution’s Ethics Committee within the scope of the study protocol.

There were 43 people with MUD and 45 healthy people who agreed to take part in the study. The inclusion criteria required participants to be between 18 and 65 years of age, have the mental capacity to understand and respond to instructions, be willing to participate voluntarily, and provide written consent.

Exclusion criteria included the presence of neurological or psychiatric disorders that impair cognitive capacity—such as intellectual disability of any severity, major neurocognitive disorders (e.g., dementia), acute psychotic disorders or psychotic episodes, substance-induced delirium or confusion states, severe manic or mixed episodes that markedly impair judgment, and any other condition that prevents the participant from providing informed consent or completing the scales reliably-along with unresolved serious physical illnesses and being under the influence of alcohol or drugs during the assessment. Patients experiencing difficulty with reality testing due to acute intoxication were excluded from the study until they became clinically stable.

Of the 60 MUD patients initially planned for inclusion, 17 did not participate. Eleven declined to volunteer, three were excluded because they were acutely intoxicated during the assessment, and three were excluded due to comorbid neurological or psychiatric disorders impairing cognitive capacity. Consequently, 43 MUD patients met the eligibility criteria and were included in the study.

Both groups completed a sociodemographic data form, the Childhood Trauma Questionnaire-Short Form (CTQ-28), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Beck Hopelessness Scale (BHS). This was conducted in a quiet environment under the supervision of a psychiatrist.

Written and verbal consents were obtained from both the patients and the control group. Ethical approval was granted by our institution’s Non-Interventional Scientific Research Ethics Committee on September 18, 2024, with reference number 18.09.2024/01.

Clinical assessment

Socio-demographic data form

This form, created by the researchers, includes gender, age, place of residence, marital status, presence of children, educational status, employment status, income status, and living arrangements, as well as substance use variables such as alcohol and tobacco use, age of onset of methamphetamine use, duration and quantity of methamphetamine use, method of methamphetamine use, current medical conditions and medications used, history of psychiatric disorders, and medications used.

CTQ-28

The CTQ-28 was used to assess participants’ traumatic experiences during childhood. This scale was developed by Bernstein et al. [25] (1994), and its Turkish validity and reliability study was conducted by Şar et al. [26]. The CTQ-28 consists of a total of 28 items and includes five subscales: emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect. Each item is answered using a 5-point Likert-type scale (1=not at all true, 5=completely true). There are also three additional items to assess the consistency of responses. High scores indicate more traumatic experiences in the relevant subdimension. In the Turkish adaptation of the scale, Cronbach’s alpha values for the sub-scales ranged from 0.63 to 0.83, while the total scale had a value of 0.93.

MSPSS

The MSPSS was used to measure perceived social support. The scale was developed by Zimet et al. [27] (1988) and adapted into Turkish by Eker et al. [28] (1995). The MSPSS consists of a total of 12 items and includes three subscales: family, friends, and significant other. Participants respond to each item on a 7-point Likert-type scale (1=strongly disagree, 7=strongly agree). High scores on the scale indicate a higher level of perceived social support. In the Turkish adaptation study, the internal consistency coefficient (Cronbach’s alpha) of the scale was 0.89 for the total scale and between 0.85 and 0.91 for the subscales.

BHS

The BHS was used to assess levels of hopelessness. The scale was developed by Beck et al. [29] (1974), and its validity and reliability in Turkish were established by Seber et al. [30] (1993). The BHS consists of a total of 20 items, each of which is answered as “true/false.” The total score on the scale ranges from 0 to 20, with higher scores indicating higher levels of hopelessness. Although the original study defined three subscales (emotional, cognitive, and motivational), most studies use the total score. In the Turkish adaptation study, the internal consistency coefficient (Cronbach’s alpha) of the scale was found to be 0.86 [31].

In the section on measurement instruments, the original developers, Turkish adaptation studies, structure and scoring properties, and Cronbach’s alpha values were rewritten in a consistent format.

Procedure

All scales used in the study were self-report based and completed by participants according to their own statements. Instructions were explained to participants by a specialist psychiatrist, and questions were answered when necessary. Data collection was conducted in a quiet room in the outpatient clinic setting, in a single session, and under supervision. Each assessment took approximately 20 minutes. Patients diagnosed with MUD were assessed during their outpatient visits when they were clinically stable and not under the acute influence of substances. Healthy controls were also assessed under the same conditions. Blinding was not applied; the evaluators knew the participants’ group status (MUD or control).

Statistical analysis

Statistical analyses were conducted using IBM SPSS Statistics 27 (IBM Corp.) and the PROCESS Macro. Normality was assessed by examining skewness and kurtosis values, with values between -1.5 and +1.5 considered acceptable [32]. For comparisons between two groups, chi-square (χ²), Student’s t, or Mann-Whitney U tests were applied depending on the data type. Sample size (n), percentages, means, standard deviations, medians, interquartile ranges, and χ², t, and Z values were reported. Correlation analyses were performed using Pearson’s correlation for normally distributed variables and Spearman’s correlation for non-normally distributed variables. Mediation analysis was performed using regression methods with bootstrap procedures and 5,000 resamples. CT was entered as the independent variable, hopelessness as the dependent variable, and perceived social support as the mediating variable. The mediation analysis was conducted with PROCESS Macro Model 4, which corresponds to a simple mediation model with a single mediator [33]. Two regression models were tested: first, the prediction of perceived social support by CT, and second, the prediction of hopelessness by both CT and perceived social support. Regression coefficients and their significance levels were examined for each model. Total, direct, and indirect effects were reported. The level of statistical significance was set at p<0.05 for all tests. No adjustments were made for multiple comparisons; since the analyses were based on prespecified hypotheses, the results were interpreted as exploratory in nature.

RESULTS

An examination of sociodemographic characteristics revealed no statistically significant differences between the methamphetamine group and the control group regarding age, place of residence, marital status, number of children, lifestyle, educational attainment, presence of medical conditions, use of medications, loss of parents during childhood, family history of psychiatric disorders, or presence of additional psychiatric disorders. However, the methamphetamine group exhibited lower employment rates and monthly incomes, as well as higher rates of smoking, trauma history, hospital admissions, and psychiatric treatment compared to the control group. A detailed comparison of sociodemographic characteristics between the two groups is presented in Table 1.

Table 2 presents the results of the comparison between the two groups in terms of hopelessness level, perceived social support, CT, and its subdimensions. The methamphetamine group scored significantly higher than the control group in hopelessness, CT, and all areas of CT. The scores for perceived social support and its subdimensions were found to be significantly lower in the methamphetamine group.

The results of the correlation analysis are shown in Table 3. Moderate to high correlations were observed between perceived social support, hopelessness, and CT. Notably, the correlation between perceived social support—along with its subdimensions— and other variables was negative. Table 4 presents the correlations between clinical variables, including the age of first methamphetamine use and the frequency of methamphetamine use in the past year. The findings indicate a negative relationship between the level of hopelessness and the age at which individuals first used methamphetamine. Furthermore, negative correlations were found between perceived social support and the frequency of methamphetamine use, while positive correlations were identified between the level of hopelessness and CT and the frequency of methamphetamine use.

The model designed to illustrate the mediating effect of perceived social support on the relationship between CT and levels of hopelessness is presented in Figure 1. This model is statistically significant (p<0.001) and accounts for approximately 56% of the variance in functionality (R²=0.558).

The total effect of CT on hopelessness levels was found to be significant (b=0.099, 95% confidence interval [CI]=0.059 to 0.138). However, its direct effect (b=0.037, 95% CI=-0.009 to 0.083) was not statistically significant. In contrast, the indirect effect of CT on hopelessness through perceived social support was statistically significant (b=0.062, 95% CI=0.028 to 0.101).

These findings indicate that perceived social support serves as a mediator in the relationship between CT and hopelessness. Specifically, CT influences perceived social support, which in turn contributes to the experience of hopelessness.

DISCUSSION

This study investigated the role of perceived social support in the relationship between CT and hopelessness in individuals diagnosed with MUD. The findings indicate that the MUD group had higher levels of CT and hopelessness compared to healthy controls but lower levels of perceived social support. Correlation analyses revealed positive correlations between CT and hopelessness and negative correlations between perceived social support and both variables. Additionally, perceived social support was found to play a mediating role in this relationship.

Our study found that individuals diagnosed with MUD have lower income levels, lower employment rates, and higher rates of cigarette use. These findings are consistent with risk factors associated with MUD in the literature, such as low socioeconomic status, housing instability, and inadequate health insurance [34,35]. The elevated smoking rates corresponded with prior studies, indicating that smoking may serve as a coping strategy for stress, anxiety, and other negative emotions [4,36].

Our study demonstrated that the rates of psychiatric comorbidity were significantly higher in the MUD group compared to the control group. This finding is consistent with the existing literature indicating that MUD frequently co-occurs with psychiatric disorders [2,37]. Psychiatric comorbidities are important factors influencing the development and maintenance of MUD.

Our research indicates that individuals with MUD exhibit significantly higher overall CTQ scores, as well as elevated scores on each subscale. Previous literature supports these findings. For instance, one study found that 56.2% of people with MUD had experienced at least one type of CT, with 44.6% reporting a history of moderate to severe trauma [9,38]. Additionally, a meta-analysis examining various substance use disorders, including methamphetamine, revealed that 38% of cases involved emotional neglect, 36% involved physical neglect, and 31% involved sexual abuse [39]. These statistics suggest that CT is a systematic risk factor for the development of MUD, rather than a random occurrence. Multiple factors may contribute to this relationship, including environmental factors (such as low socioeconomic status, family abuse, and social isolation), psychological factors (including impulsivity, depressive symptoms, and intense substance cravings), and neurobiological factors (e.g., dysregulation of the hypothalamic-pituitary-adrenal axis and prefrontal cortex dysfunction) [40,41].

Unlike other studies, ours found no significant correlation between CT and the age at which methamphetamine use began. Nonetheless, prior research has demonstrated that the presence of CT is linked to an earlier onset of methamphetamine use [5,42]. This disparity might result from variations in the sample size and the group’s sociodemographic or clinical features.

One of the important findings in our study is that a history of CT in individuals diagnosed with MUD increases the frequency of methamphetamine use. This finding is similar to other studies. CT causes increased impulsivity by impairing neuropsychological development. The oxytocin system is disrupted, and intense substance cravings may develop. This can increase the frequency of methamphetamine use and lead to the development of substance use disorder [43]. Studies examining the relationship between methamphetamine use frequency and CT are limited. Our study is one of the few investigations examining the effect of CT on methamphetamine use behavior.

Our study found that perceived social support and all subgroups, including family support, were significantly low in individuals diagnosed with MUD. Similar results have been found in other studies. In a study involving 100 individuals diagnosed with MUD, low perceived social support was demonstrated. In particular, family support has been reported to have the most significant impact [44]. Perceived social support increases psychological resilience and coping skills in individuals. This mechanism may reduce the risk of MUD development [45]. In another study, it was demonstrated that low perceived social support in 67 individuals with MUD may negatively impact treatment adherence and treatment response [10].

In our study, we found that a decrease in perceived social support was associated with an increase in the frequency of methamphetamine use. This finding is consistent with the literature. In a study involving 158 individuals with MUD, a relationship was found between low perceived social support and an increase in the frequency of methamphetamine use in the past 30 days [14].

In our study, it was observed that individuals diagnosed with MUD had significantly higher levels of hopelessness. Hopelessness can play an important role in both the onset and continuation of substance use. This emotion can affect both the emotional and cognitive processes of the individual, leading to negative thought patterns and unhealthy coping mechanisms. Individuals who experience intense hopelessness are more likely to turn to substance use in search of escape or short-term relief [46,47]. Indeed, the existing literature also describes emotional difficulties associated with MUD in similar terms [48]. Hopelessness is closely linked to depression, treatment non-adherence, impaired functioning, and an increased risk of suicide among individuals with substance use disorders [49,50]. Furthermore, our study revealed that hopelessness levels increased as the age of onset for methamphetamine use decreased. This relationship may be bidirectional: early substance use can elevate levels of hopelessness, while enduring feelings of hopelessness during childhood may also contribute to early substance use [51,52]. While limited studies have directly examined this relationship, our findings also showed a significant link between hopelessness levels and the frequency of methamphetamine use. However, because of our correlational design, we cannot determine the direction of this relationship. While hopelessness may increase vulnerability to substance use [53], frequent and uncontrolled substance use may also reinforce feelings of hopelessness. These findings suggest that hopelessness can function both as a cause and a consequence of addictive behaviors. Nonetheless, systematic studies exploring this bidirectional relationship—especially among methamphetamine users—are still quite limited.

One of the important findings of our study is that an increase in perceived social support significantly reduces hopelessness. Similarly, previous studies have also shown that perceived social support in individuals diagnosed with MUD has a protective effect, particularly on hopelessness and depressive symptoms [9,54]. In our study, we found that individuals with higher perceived family support had lower levels of hopelessness. Family support is an important protective factor that reduces loneliness, improves treatment adherence, and enhances recovery motivation [55].

CT is believed to play a significant role in the development of hopelessness in individuals diagnosed with MUD. These traumas can lead to the formation of negative thought patterns, which may result in bleak expectations about the future [24]. In our study, consistent with existing literature, we found a strong and significant correlation between CT and hopelessness. Notably, individuals with a history of emotional abuse and neglect reported significantly higher levels of hopelessness. While previous studies have mainly focused on the connection between childhood emotional trauma and depression [38], our findings indicate that such traumas may also lead to feelings of hopelessness regarding the future.

Our study has shown that there is a significant relationship between high CTQ scores and perceived lack of social support. In particular, it has been found that emotional neglect and abuse may lead to a perceived lack of social support in the future. Studies have shown that CT may be associated with low perceived social support in individuals diagnosed with MUD. Insufficient perceived social support may exacerbate methamphetamine use problems in these individuals [56]. In a study involving 528 individuals diagnosed with MUD, perceived social support was found to be significantly lower in those with a history of trauma [9].

One of the original contributions of our study to the literature is that perceived social support mediates the relationship between CT and hopelessness in individuals diagnosed with MUD. According to the results of our study, insufficient perceived social support plays a decisive role in CT causing hopelessness. Perceived social support plays an important role in coping with stress. The literature indicates that social support may be a key factor in preventing and reducing the severity of mental disorders such as depression and anxiety that may develop after trauma [57,58]. According to Abramson’s theory of hopelessness, emotional neglect and abuse experienced in childhood lead to the development of pessimistic schemas about the future [56]. In this context, high perceived social support reduces negative cognitions triggered by trauma. Thus, it can prevent feelings of hopelessness [59,60]. It has been reported that social support has a partial mediating effect on post-traumatic depressive symptoms [61] and that the absence of social support increases the risk of depression in methamphetamine users who were exposed to childhood abuse [9]. The mediating effect identified in our study revealed that this relationship is valid not only in terms of depression but also in terms of hopelessness. Social support plays a critical role in the mental health of individuals diagnosed with MUD. According to the model results, CT negatively affects CT individuals’ perception of social support. Thus, it increases feelings of loneliness and helplessness and deepens hopelessness. Traumatic childhood experiences can lead to the development of insecurity and worthlessness schemas in individuals. This situation can cause inadequate social support perception and reinforce hopelessness. On the other hand, high levels of perceived social support can act as a buffer that reduces the effects of trauma and function as a protective factor that breaks the cycle of hopelessness. For this reason, family-based psychosocial interventions are particularly important. Family support strengthens the perception of social support and reduces hopelessness. This, in turn, increases motivation to recover and has a positive effect [62,63]. According to the mediation analysis conducted in this study, approximately 62% of the total effect of CT on hopelessness is explained through perceived social support. This finding indicates that perceived social support plays a significant and strong mediating role in the relationship between CT and hopelessness. In other words, a substantial part of the impact of CT on hopelessness emerges through the weakening of individuals’ perceived social support. This suggests that psychosocial interventions aimed at strengthening perceived social support may represent an important target in the prevention and treatment of trauma-related psychopathologies.

Our results demonstrate the importance of a biopsychosocial approach in the treatment of addiction. They show that social support-boosting interventions can enhance treatment outcomes and foster long-term well-being. In particular, family-based psychosocial interventions are expected to successfully reduce feelings of isolation and despair by enhancing perceived social support.

Limitations

This study has some limitations. First, due to its cross-sectional design, causal relationships between variables cannot be determined; only correlational interpretations can be made. Therefore, the findings should be interpreted at the correlational level rather than as causal inferences.

Second, the sample was single-centered and relatively small (n=88), and consisted solely of man participants, representing a homogeneous sample. This limits the generalizability of the findings to women and individuals from different sociocultural backgrounds, thereby reducing external validity.

Third, the data were collected using self-report measures. This may have introduced potential biases such as recall bias or social desirability bias. Thus, the findings should be interpreted with these possible limitations in mind.

Finally, psychiatric comorbidities were not completely excluded. Although common diagnoses such as anxiety and depression were statistically controlled for, their residual effects cannot be ruled out, which may have partially influenced the observed relationships.

Conclusion

This study adds to the body of knowledge by looking at CT, perceived social support, and hopelessness in people with MUD. The results show that these people have high levels of CT and hopelessness and low levels of perceived social support. Also, there was a strong link between high levels of hopelessness and starting to use methamphetamine at a young age and using it often.

One of the most interesting things is that the relationship between CT and hopelessness is affected by how much social support people think they have. This result suggests that social support may be critical in post-traumatic hopelessness. Our results show how important it is to look at both biological and psychosocial factors when treating addiction. Strengthening protective environmental factors like social support may be very important to stop and treat MUD. We need multicenter, longitudinal studies to understand the cause-and-effect nature of these relationships better.

Notes

Availability of Data and Material

The datasets generated or analyzed during the study are available from the corresponding author on reasonable request.

Conflicts of Interest

The authors have no potential conflicts of interest to disclose.

Author Contributions

Conceptualization: Meltem Hazel Şimşek. Data curation: Meltem Hazel Şimşek. Formal analysis: Ulaş Korkmaz. Investigation: Meltem Hazel Şimşek. Methodology: Meltem Hazel Şimşek, Ulaş Korkmaz. Supervision: Meltem Hazel Şimşek, Fatma Gül Helvacı Çelik. Writing—original draft: Meltem Hazel Şimşek. Writing—review & editing: Fatma Gül Helvacı Çelik.

Funding Statement

None

Acknowledgments

None

Figure 1.

Mediation model: relationship between CT, perceived social support, and hopelessness. Direct effect: b: 0.037, p: 0.115. Indirect effect: b: 0.062, 95% confidence interval: 0.028 to 0.101. b, unstandardized beta coefficient; CT, childhood trauma.

Table 1.

Comparison of sociodemographic characteristics

	Methamphetamine (N=43)	Control (N=45)	Statistics (t/χ²)	p
Age (yr)	28.70±6.84	29.96±6.10	-0.911	0.365
Place of residence			0.375	0.540
Urban	30 (69.8)	35 (77.8)
Rural	13 (30.2)	10 (22.2)
Marital status			0.002	0.960
Married	16 (37.2)	18 (40.0)
Single	27 (62.8)	27 (60.0)
Having children			1.117	0.291
Yes	17 (39.5)	12 (26.7)
No	26 (60.5)	33 (73.3)
Living arrangement			0.027	0.869
Living with others	26 (60.5)	29 (64.4)
Living alone	17 (39.5)	16 (35.6)
Level of education			4.580	0.101
Primary-secondary school	9 (20.9)	3 (6.7)
High school	28 (65.1)	31 (68.9)
University	6 (14.0)	11 (24.4)
Employment status			34.079	<0.001
Employed	12 (27.9)	41 (91.1)
Unemployed	31 (72.1)	4 (8.9)
Monthly income			13.557	0.001
Low	20 (46.5)	5 (11.1)
Moderate	17 (39.5)	30 (66.7)
High	6 (14.0)	10 (22.2)
Smoking status			17.783	<0.001
Smoker	43 (100)	28 (62.2)
Non-smoker	0	17 (37.8)
Presence of medical illness			0.007	0.932
Yes	6 (14.0)	6 (13.3)
No	37 (86.0)	39 (86.7)
Medication use			0.006	0.939
Yes	5 (11.6)	5 (11.1)
No	38 (88.4)	40 (88.9)
Parental loss during childhood			2.404	0.121
No	33 (76.7)	41 (91.1)
Yes	10 (23.3)	4 (8.9)
History of trauma			10.887	<0.001
No	30 (69.8)	44 (97.8)
Yes	13 (30.2)	1 (2.2)
Family history of psychiatric disorder			1.598	0.206
No	23 (53.5)	31 (68.9)
Yes	20 (46.5)	14 (31.1)
Comorbid psychiatric disorder			1.834	0.176
No	29 (67.4)	37 (82.2)
Yes	14 (32.6)	8 (17.8)
Psychiatric hospitalization history			13.652	<0.001
No	30 (69.8)	45 (100)
Yes	13 (30.2)	0
History of psychiatric treatment			5.594	0.018
No	31 (72.1)	42 (93.3)
Yes	12 (27.9)	3 (6.7)

Values are presented as mean±standard deviation or N (%).

Table 2.

Comparison of groups in terms of hopelessness level, perceived social support, and childhood trauma

	Methamphetamine (N=43)	Control (N=45)	Statistics	p
Total perceived social support score	38.28±18.65	61.16±16.67	t=-6.073	<0.001
Support from family	14.93±6.63	22.11±5.61	t=-5.493	<0.001
Support from friends	11.56±7.04	20.07±6.79	t=-5.770	<0.001
Significant other support	11.79±6.90	18.98±7.96	t=-4.518	<0.001
Hopelessness	12 (8-14)	6 (4-7.5)	Z=-5.606	<0.001
CTQ total score	45 (37-70)	34 (30-39)	Z=-4.541	<0.001
Emotional abuse	9 (7-15)	6 (5-8)	Z=-4.157	<0.001
Physical abuse	7 (5-13)	5 (5-6)	Z=-3.911	<0.001
Emotional neglect	15.00±4.90	10.73±3.82	t=4.544	<0.001
Physical neglect	11.02±4.91	6.91±2.08	t=5.074	<0.001
Sexual abuse	5 (5-10)	5 (5-5)	Z=-3.122	0.002

Values are presented as mean±standard deviation or median (Q1-Q3). Q1, 25th percentile (first quartile); Q3, 75th percentile (third quartile); CTQ, Childhood Trauma Questionnaire.

Table 3.

Correlation coefficients between perceived social support, hopelessness, and childhood trauma

	Sexual abuse	Physical neglect	Emotional neglect	Physical abuse	Emotional abuse	CTQ total score	Hopelessness
MSPSS total score	-0.466^*	-0.715^**	-0.665^**	-0.546^**	-0.676^**	-0.672^**	-0.728^**
Support from family	-0.477^*	-0.748^**	-0.712^**	-0.565^**	-0.756^**	-0.712^**	-0.714^**
Support from friends	-0.317^*	-0.513^**	-0.468^*	-0.377^*	-0.437^*	-0.462^*	-0.576^**
Support from significant other	-0.546^**	-0.690^**	-0.635^**	-0.549^**	-0.655^**	-0.660^**	-0.694^**
Hopelessness	0.449^*	0.669^**	0.664^**	0.458^*	0.610^**	0.614^**	-

^* p<0.05;

^** p<0.001.

CTQ, Childhood Trauma Questionnaire; MSPSS, Multidimensional Scale of Perceived Social Support; -, not applicable.

Table 4.

Correlation coefficients between clinical variables and age at first methamphetamine use and frequency of methamphetamine use in the past year

	Age at first methamphetamine use	Frequency of methamphetamine use in the past year
MSPSS total score	0.216	-0.395^*
Support from family	0.258	-0.278
Support from friends	0.111	-0.397^*
Support from significant other	0.198	-0.355^*
Hopelessness	-0.344^*	0.465^*
Sexual abuse	-0.167	0.124
Physical neglect	-0.290	0.394^*
Emotional neglect	-0.220	0.337^*
Physical abuse	-0.143	0.445^*
Emotional abuse	-0.270	0.298
CTQ total score	-0.270	0.380^*

^* p<0.05.

MSPSS, Multidimensional Scale of Perceived Social Support; CTQ, Childhood Trauma Questionnaire.

REFERENCES

1. Brombacher D, Santos HF. The Amazon in the crossfire. Review of the special chapter of the UN World Drug Report 2023 on the Amazon Basin. J Illicit Econ Dev 2023;5:13-18.

2. Chiang M, Lombardi D, Du J, Makrum U, Sitthichai R, Harrington A, et al. Methamphetamine-associated psychosis: clinical presentation, biological basis, and treatment options. Hum Psychopharmacol 2019;34:e2710

3. Wang W, Sun G, Li C, Qiu C, Fan J, Jin Y. Exploring the mechanism of trait depression and cognitive impairment on the formation of among individuals with methamphetamine use disorder under varying degrees of social support. Front Public Health 2025;13:1435511

4. Jones CM, Compton WM, Mustaquim D. Patterns and characteristics of methamphetamine use among adults—United States, 2015-2018. MMWR Morb Mortal Wkly Rep 2020;69:317-323.

5. Svingen L, Dykstra RE, Simpson JL, Jaffe AE, Bevins RA, Carlo G, et al. Associations between family history of substance use, childhood trauma, and age of first drug use in persons with methamphetamine dependence. J Addict Med 2016;10:269-273.

6. Paulus MP, Stewart JL. Neurobiology, clinical presentation, and treatment of methamphetamine use disorder: a review. JAMA Psychiatry 2020;77:959-966.

7. Volkow ND, Michaelides M, Baler R. The neuroscience of drug reward and addiction. Physiol Rev 2019;99:2115-2140.

8. Chen J, Wang DM, Tian Y, Zhu R, Li Y, Jia L, et al. Childhood abuse and craving in methamphetamine-dependent individuals: the mediating role of alexithymia. Eur Arch Psychiatry Clin Neurosci 2025;275:209-217.

9. Qu M, Wang DM, Tian Y, Chen J, Zhu R, Li Y, et al. Association between child maltreatment and depressive symptoms in male methamphetamine-dependent patients: the mediating role of social support. Int J Ment Health Addiction 2025;23:1938-1950.

10. Arreola F, Vargas P, Domínguez M, Robles E. Perceived social support as predictor of treatment completion in methamphetamine dependent individuals. Rev Int Investig Adicciones 2019;5:21-29.

11. Wang J, Mann F, Lloyd-Evans B, Ma R, Johnson S. Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry 2018;18:156

12. Cobo-Rendón R, López-Angulo Y, Pérez-Villalobos MV, Díaz-Mujica A. Perceived social support and its effects on changes in the affective and eudaimonic well-being of Chilean university students. Front Psychol 2020;11:590513

13. Cao F, Li J, Xin W, Cai N. Impact of social support on the resilience of youth: mediating effects of coping styles. Front Public Health 2024;12:1331813

14. Rapier R, McKernan S, Stauffer CS. An inverse relationship between perceived social support and substance use frequency in socially stigmatized populations. Addict Behav Rep 2019;10:100188

15. Van Der Feltz-Cornelis CM, Allen S, Atkin K, Gilbody S. Is childhood trauma associated with loneliness, mental health symptoms and social exclusion in adulthood? A UK Biobank study. Eur Psychiatry 2023;66(S1):S533

16. Leach MJ, Ward B, Kippen R, Quinn B, Agius PA, Sutton K, et al. Level and correlates of social support in a community-based sample of Australians who primarily smoke methamphetamine. Health Soc Care Community 2022;30:e4950-e4960.

17. Cui S, Cheng F, Yuan Q, Zhang L, Wang L, Zhang K, et al. Association between alexithymia, social support, and duration of methamphetamine use among male methamphetamine-dependent patients. Front Psychiatry 2021;12:713210

18. Pei F, Wang Y, Wu Q, McCarthy KS, Wu S. The roles of neighborhood social cohesion, peer substance use, and adolescent depression in adolescent substance use. Child Youth Serv Rev 2020;112:104931

19. Keshoofy A, Pearl DL, Lisnyj K, Thaivalappil A, Papadopoulos A. Risk and protective factors associated with hopelessness among Canadian postsecondary students. Int J Ment Health Addiction 2024;22:3302-3317.

20. Sueki H. Relationship between Beck hopelessness scale and suicidal ideation: a short-term longitudinal study. Death Stud 2022;46:467-472.

21. Fang SC, Hung CC, Huang CY, Huang SM, Shao YHJ. Influence of baseline psychiatric disorders on mortality and suicide and their associations with gender and age in patients with methamphetamine use disorder. Int J Ment Health Addiction 2025;23:263-280.

22. Berardelli I, Sarubbi S, Rogante E, Erbuto D, Giuliani C, Lamis DA, et al. Association between childhood maltreatment and suicidal ideation: a path analysis study. J Clin Med 2022;11:2179

23. Zuo B, Yang K, Yao Y, Han S, Nie S, Wen F. The relationship of perceived social support to feelings of hopelessness under COVID-19 pandemic: the effects of epidemic risk and meaning in life. Pers Individ Differ 2021;183:111110

24. Ko CH, Lu YC, Lee CH, Liao YC. The influence of adverse childhood experiences and depression on addiction severity among methamphetamine users: exploring the role of perseveration. Front Psychiatry 2024;15:1382646

25. Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, et al. Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry 1994;151:1132-1136.

26. Şar V, Öztürk PE, İkikardeş E. [Validity and Reliability of the Turkish Version of Childhood Trauma Questionnaire]. Turkiye Klinikleri J Med Sci 2012;32:1054-1063. Turkish.

27. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The Multidimensional Scale of Perceived Social Support. J Pers Assess 1988;52:30-41.

28. Eker D, Arkar H, Yaldiz H. [Factorial structure, validity, and reliability of revised form of the Multidimensional Scale of Perceived Social Support]. Türk Psikiyatri Dergisi 2001;12:17-25. Turkish.

29. Beck AT, Weissman A, Lester D, Trexler L. The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol 1974;42:861-865.

30. Seber G, Dilbaz N, Kaptanoğlu C, Tekin D. [The Hopelessness Scale: validity and reliability]. Kriz Dergisi 1993;1:139-142. Turkish.

31. Durak A, Palabıyıkoğlu R. [Beck umutsuzluk ölçeği geçerlilik çalişmasi]. Kriz Dergisi 1994;2:311-319. Turkish.

32. Tabachnick BG, Fidell LS. Using multivariate statistics (6th ed). Boston: Pearson; 2013.

33. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: Guilford Press; 2017.

34. Rommel N, Rohleder NH, Wagenpfeil S, Haertel-Petri R, Kesting MR. Evaluation of methamphetamine-associated socioeconomic status and addictive behaviors, and their impact on oral health. Addict Behav 2015;50:182-187.

35. Han B, Compton WM, Jones CM, Einstein EB, Volkow ND. Methamphetamine use, methamphetamine use disorder, and associated overdose deaths among US adults. JAMA Psychiatry 2021;78:1329-1342.

36. Saloner B, Li W, Flores M, Progovac AM, Lê Cook B. A widening divide: cigarette smoking trends among people with substance use disorder and criminal legal involvement. Health Aff (Millwood) 2023;42:187-196.

37. Cumming C, Kinner SA, McKetin R, Li I, Preen D. Methamphetamine use, health and criminal justice system outcomes: a systematic review. Drug Alcohol Rev 2020;39:505-518.

38. Chen Y, Zhang J, Sun Y. The relationship between childhood abuse and depression in a sample of Chinese people who use methamphetamine. Int J Clin Health Psychol 2019;19:181-188.

39. Zhang S, Lin X, Liu J, Pan Y, Zeng X, Chen F, et al. Prevalence of childhood trauma measured by the short form of the childhood trauma questionnaire in people with substance use disorder: a meta-analysis. Psychiatry Res 2020;294:113524

40. Lin CT, Wang TY, Tsai TY, Tseng HH, Chen KC, Lee IH, et al. The association between childhood trauma on executive functioning and treatment outcomes among individuals with methamphetamine use disorder. Clin Psychopharmacol Neurosci 2025;23:300-311.

41. Wei SY, Tsai TH, Tsai TY, Chen PS, Tseng HH, Yang YK, et al. The association between default-mode network functional connectivity and childhood trauma on the symptom load in male adults with methamphetamine use disorder. Clin Psychopharmacol Neurosci 2024;22:105-117.

42. Huang C, Yuan Q, Zhang L, Wang L, Cui S, Zhang K, et al. Associations between childhood trauma and the age of first-time drug use in methamphetamine-dependent patients. Front Psychiatry 2021;12:658205

43. Chang HM, Chen C, Lu ML, Jou S, Santos VHJ, Goh KK. The interplay of childhood trauma, oxytocin, and impulsivity in predicting the onset of methamphetamine use. Child Abuse Negl 2024;147:106579

44. Farnia V, Alikhani M, Jalali A, Golshani S, Salemi S, Hookari S, et al. The role of attachment styles and perceived social support in prediction of methamphetamine abuse. J Subst Use 2018;23:377-383.

45. Patel EU, Astemborski J, Feder KA, Rudolph JE, Winiker A, Sosnowski DW, et al. Temporal association of pre-pandemic perceived social support with psychological resilience and mental well-being during the COVID-19 pandemic among people with a history of injection drug use. Drug Alcohol Depend 2023;244:109802

46. Conrod PJ, Stewart SH, Comeau N, Maclean AM. Efficacy of cognitive-behavioral interventions targeting personality risk factors for youth alcohol misuse. J Clin Child Adolesc Psychol 2006;35:550-563.

47. Otis E, Yakovenko I, Sherry S, Smith M, Goldstein A, Ellery M, et al. Applicability of the four-factor personality vulnerability model for substance misuse in understanding gambling behaviour and gambling problems. Pers Individ Differ 2021;169:110400

48. Aghadinazu RE. Psychosocial variables as correlates of crystal methamphetamine (Mkpuru Mmiri) consumption among the youths in Awka Metropolis, Anambra State: counselling imperatives. J Educ Dev Areas 2023;31:321-334.

49. Martínez Martínez KI, Ojeda Aguilar YL, Hernández Villafuerte J, Contreras-Peréz ME. Depression and suicidal behavior comorbidity in patients admitted to substance-use residential treatment in Aguascalientes, Mexico. J Evid Based Soc Work (2019) 2023;20:508-519.

50. Kargin M, Ersöğütçü F, Aslanoğlu E. Medication adherence and hopelessness in male individuals with substance use disorder. J Subst Use 2001;26:218-223.

51. Assari S, Najand B, Sheikhattari P. Childhood depression, hopelessness, and suicidal attempt predict earlier tobacco and marijuana use initiation during adolescence. Open J Med Sci 2025;5:18-31.

52. Moreno-Mansilla S, Ricarte JJ, Hallford DJ. Cannabis use among early adolescents and transdiagnostic mental health risk factors. Clin Child Psychol Psychiatry 2021;26:531-543.

53. Afzali MH, Stewart SH, Séguin JR, Conrod P. The network constellation of personality and substance use: evolution from early to late adolescence. Eur J Pers 2020;34:1109-1119.

54. Wang S, Li J, Li Y, Xia Y, Gong Y, Mao F. The predictive role of impulsivity and perceived social support in psychiatric symptoms of women with methamphetamine use disorder. Front Psychiatry 2023;14:1116650

55. Gendera S, Treloar C, Reilly R, Conigrave KM, Butt J, Roe Y, et al. ‘Even though you hate everything that’s going on, you know they are safer at home’: the role of Aboriginal and Torres Strait Islander families in methamphetamine use harm reduction and their own support needs. Drug Alcohol Rev 2022;41:1428-1439.

56. Arabshahi A, Mohammad-Beigi A, Mohebi S, Gharlipour Z. Prediction of addiction relapse based on perceived social support and childhood trauma. Addict Health 2023;15:253-259.

57. Altaf K, Shahzadi K, Noor N, Ibrar E, Rehman DFU. Childhood trauma and dissociative experiences: moderating role of perceived social support among adults. Am J Psychol 2005;7:1-25.

58. Su YY, Li M, D’Arcy C, Caron J, O’Donnell K, Meng X. To what extent do social support and mastery mediate the association between childhood maltreatment and depression? A sequential causal mediation analysis. Epidemiol Psychiatr Sci 2022;31:e77

59. Lagdon S, Ross J, Robinson M, Contractor AA, Charak R, Armour C. Assessing the mediating role of social support in childhood maltreatment and psychopathology among college students in Northern Ireland. J Interpers Violence 2021;36:NP2112-2136NP.

60. Yao J, Zou Y, Luo Q, Luo Y, Chunghon T, Shang H. Social support and depression mediate the relationship between childhood trauma and nonsuicidal self-injury. Clin Psychol Psychother 2025;32:e70030

61. Lee JK, Lee J, Chung MK, Park JY, Shin T, Lee KJ, et al. Childhood adversity and late-life depression: moderated mediation model of stress and social support. Front Psychiatry 2023;14:1183884

62. Chen Z, Shen S, Dai Q. Long-term and short-term psycho-social predictors of early-adulthood depression: role of childhood trauma, neuroticism, social-support, resilience, and life-events. Curr Psychol 2023;423:3904-3916.

63. Quan L, Zhang K, Chen H. The relationship between childhood trauma and romantic relationship satisfaction: the role of attachment and social support. Front Psychiatry 2025;15:1519699