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The analysis employed two approaches: first, examining symptom presentation and progression over time in alcohol\u2010dependent individuals using cumulative adversity as a moderating variable; second, comparing symptom patterns between alcohol\u2010dependent participants with high versus low lifetime adversity against 38 control participants at each timepoint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Abstinence symptoms resolved by the third week of inpatient treatment across all participants. However, alcohol\u2010dependent individuals with greater lifetime adversity exhibited significantly more severe symptom patterns compared to alcohol\u2010dependent individuals with fewer adverse experiences. These differences persisted even when controlling for recent alcohol and tobacco use severity over the preceding 3\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Understanding the profile and progression of early abstinence symptoms, along with stress\u2010related moderating factors, could inform more personalized care planning. Cumulative lifetime adversity may serve as a readily measurable correlate of early abstinence severity and may be valuable for predicting alcohol treatment outcomes. Addressing the effects of cumulative lifetime adversity may serve as a target for early intervention in patients with alcohol use disorder.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.70137","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T15:00:26Z","timestamp":1759158026000},"page":"2225-2238","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Early alcohol abstinence symptoms and the role of cumulative adversity"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3607-439X","authenticated-orcid":false,"given":"Helen C.","family":"Fox","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Yale School of Medicine Yale Stress Center  New Haven Connecticut USA"},{"name":"Department of Psychiatry, Indiana School of Medicine Indiana University  Indianapolis Indiana 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