Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB R3T 2N2, Canada.
Department of Psychology, University of Winnipeg, 515 Portage Ave, Winnipeg, MB R3B 2E9, Canada.
Addict Behav. 2018 Jul;82:94-100. doi: 10.1016/j.addbeh.2018.02.023. Epub 2018 Feb 19.
Alcohol and gambling problems are common in young adults. Self-medication theory states that young adults with depression drink and/or gamble to escape negative emotions. Research shows that depression is a risk factor for drinking/gambling problems, but more work is needed to examine mediators underlying these associations. One potential mediator is shame. Shame is a self-directed emotion that follows a negative life event and is characterized by intense feelings of inferiority, worthlessness, and embarrassment. Depressed individuals are especially susceptible to shame (and associated emotions). Shame has also been implicated in risk for addiction. Accordingly, we predicted that elevated shame would explain why depression is associated with both alcohol and gambling problems.
A longitudinal design was used to examine this hypothesis. Undergraduates (N = 210) completed self-reports of depression at baseline (Time 1) and then completed self-reports of shame, alcohol misuse, gambling problems one month later (Time 2).
Results showed that individuals with elevated depression at Time 1 endorsed high levels of shame at Time 2, which in turn predicted more gambling (β = .038, 95% CI [.010, .087]) and alcohol problems (β = .249, 95% CI [.123, .435]) at Time 2. We found that increased levels of shame explained the effects of depression on problem drinking and gambling.
Study findings improve our understanding of the depressive pathway to addiction by providing evidence for shame as a potential mechanism of this pathway.
Reducing shame can be a target of clinical interventions for young adults with depression and alcohol/gambling problems.
酗酒和赌博问题在年轻人中很常见。自我药物治疗理论表明，患有抑郁症的年轻人会通过饮酒和/或赌博来逃避负面情绪。研究表明，抑郁是导致饮酒/赌博问题的一个风险因素，但需要更多的工作来研究这些关联的潜在中介因素。一个潜在的中介因素是羞耻感。羞耻感是一种自我导向的情绪，源于负面的生活事件，其特点是强烈的自卑、无价值感和尴尬感。抑郁的个体尤其容易受到羞耻感（和相关情绪）的影响。羞耻感也与成瘾风险有关。因此，我们预测，羞耻感的升高可以解释为什么抑郁与酒精和赌博问题都有关。
采用纵向设计检验这一假设。大学生（N=210）在基线（时间 1）时完成抑郁自评，一个月后（时间 2）完成羞耻感、酒精使用不当和赌博问题的自评。
结果表明，在时间 1时抑郁程度较高的个体在时间 2时表现出较高的羞耻感，而这种羞耻感反过来又预示着更多的赌博（β=0.038，95%CI [0.010，0.087]）和酒精问题（β=0.249，95%CI [0.123，0.435]）。我们发现，羞耻感水平的升高解释了抑郁对问题饮酒和赌博的影响。
研究结果通过提供羞耻感作为这一途径的潜在机制的证据，增进了我们对抑郁导致成瘾的途径的理解。
减少羞耻感可以成为针对患有抑郁和酒精/赌博问题的年轻人的临床干预的目标。
