Shame’s Associations with Depression and Problem Drinking: An Ecological Momentary Study

Abstract

Introduction

Depression and problem drinking are comorbid in emerging adulthood, yet the processes that link them are not well understood. Research has argued that shame has a unique influence on the experience of problematic drinking, but this has rarely been assessed at the state level. Using ecological momentary assessments (EMAs), we assessed whether shame, and not guilt, mediated the association between baseline depression and alcohol use and problems.

Methods

One hundred and eighty-four emerging adults (M_age= 19.27) completed a 12-day EMA study. Multilevel models were used to test hypotheses.

Results

In a model with alcohol use as the outcome, there were no significant associations between shame or guilt and alcohol use at the within- or between-subjects level. In a model with alcohol problems as the outcome, guilt was positively associated with alcohol problems but only at the daily level. At the between-subjects level and after controlling for guilt, there was a significant association between depression, shame, and alcohol problems; average levels of shame mediated the association between depression and alcohol problems. In post-hoc reverse directionality models, average alcohol problems mediated the relationship between depression and shame and guilt at the between-person level. No mediation was present for alcohol use.

Conclusion

After controlling for guilt, shame is an emotion that helps explain risk for alcohol problems among depressed emerging adults, which has implications for targeted interventions. Reciprocal associations between shame, guilt, and alcohol problems emerged highlighting the need for more fulsome assessments of shame and guilt in future EMA research.

Keywords:

• Depression
• shame
• guilt
• problem drinking
• alcohol problems
• EMA

Acknowledgments

We would like to thank Beatriz Aguiar, Patricia Aguiar, Van Bui, Ryan Clyde, Barbie Jain, Naama Kronstein, Emily Mesmer, Lily Pankratz, Stephanie Westra, and Abby Wilcoxson for their assistance with data collection.

Declaration of interest

All authors declare that they have no conflicts of interest.

The data underlying this article cannot be shared publicly due for the privacy of individuals that participated in the study.

No data from this study have been presented in other publications.

Additional information

Funding

This work was supported by a University of Manitoba startup grant and the Vanier Canada Graduate Scholarship from the Social Sciences and Humanities Research Council.