ABSTRACT
Objective: Drinking for emotion regulation may be a concern for college students who have experienced childhood maltreatment, due to high levels of shame and guilt. The present cross-sectional survey study tested how trait shame-proneness, trait guilt-proneness, and trauma-related guilt are differently related to drinking motives and how these pathways mediate the links between maltreatment severity and alcohol outcomes. Participants: Undergraduate student drinkers (n = 464; M age = 19.50, SD = 2.20) from a midsized midwestern University. Methods: Participants completed an online survey inquiring about demographics, childhood maltreatment, shame, guilt, drinking motives, alcohol use, and alcohol-related consequences. Results: There were several significant serial indirect effects of maltreatment on alcohol consumption and related consequences, through trauma-related guilt, shame-proneness, guilt-proneness, drinking-to-cope, and drinking for mood enhancement. Conclusions: On college campuses, to address problematic drinking among childhood maltreatment survivors, interventions may target maladaptive feelings of shame and guilt stemming from trauma exposure.
ABSTRACT
BACKGROUND: Bright light therapy (BLT) has not been well-studied in adolescents with major depressive disorder, particularly in outpatient settings. METHODS: We conducted an 8-week clinical trial of BLT in adolescents recruited from a primary care practice with moderate to severe major depression. Acceptability and feasibility were defined by daily use of the light box and integration into daily routines. To assess treatment effects, we utilized the Short Mood and Feelings Questionnaire (SMFQ) and actigraphic sleep variables. RESULTS: Of the nine enrolled adolescents, the rate of daily use of the light therapy box was 100% at week 2, 78% at week 4 (n = 7), and 67% at weeks 6 and 8 (n = 6). Participants were better able to integrate midday BLT compared to morning BLT into their day-to-day routines. Mean depression scores improved during the 2-week placebo lead-in (dim red light-DRL) and continued to show significant improvement through 6 weeks of BLT. Sleep efficiency increased significantly (p = 0.046), and sleep onset latency showed a trend toward a significant decrease (p = 0.075) in the BLT phase compared to the DRL phase. CONCLUSION: Bright light treatment that was self-administered at home was feasible, acceptable, and effective for adolescent outpatients with depression. Findings support the development of larger, well-powered, controlled clinical trials of BLT in coordination with primary care.
ABSTRACT
PURPOSE: Depressive disorders in adolescents are a major health concern associated with developmental, social, and educational impairment. Bright Light Therapy (BLT) is a feasible and effective treatment for depressive disorders in adults, but few controlled trials have been conducted with children or adolescents. This scoping review focuses on the current state of knowledge for BLT in the treatment of adolescent depression. We reviewed the literature for novel data and methodologic approaches using BLT and pediatric and young adult populations. RECENT FINDINGS: BLT is a tolerable treatment with few side effects. However, there is a marked lack of well-powered studies to support BLT as a treatment for depressive disorders in adolescent populations. Given evidence of tolerability and positive treatment effect on depression in the adult literature, research is needed to establish the efficacy, feasibility, and acceptability of BLT in adolescents.
