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Few studies have examined whether psychological distress mediates the relationship between child maltreatment and alcohol use. We examined the role of psychological distress in linking child maltreatment subtypes (ie, emotional abuse, physical abuse, sexual abuse, neglect) to four patterns of alcohol use, including frequency of alcohol use, binge drinking, alcohol\u2010related problems, and alcohol dependence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used a community sample of young adults (<jats:italic>N<\/jats:italic>\u2009=\u2009337), who completed an interview assessing exposure to childhood maltreatment, current psychological distress, and drinking behaviors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Emotional abuse was associated with psychological distress, whereas psychological distress was related to more pathological drinking behaviors such as alcohol\u2010related problems and alcohol dependence. Subsequent analyses indicated significant mediated effects between emotional abuse and alcohol\u2010related problems and alcohol dependence via psychological distress, even after controlling for demographic factors, other maltreatment subtypes, parental alcoholism, and peer alcohol use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Scientific Significance<\/jats:title><jats:p>Findings suggest that among four types of childhood maltreatment, emotional abuse might be the major driver of pathological drinking among child maltreatment victims. Interventions aimed at negative emotionality may be useful in preventing and treating problematic drinking among the victims of childhood emotional abuse. 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