Childhood Maltreatment as a Prognostic and Prescriptive Predictor of Cognitive-Behavioral and Light Treatment Outcomes for Winter Depression

项目总结/摘要 儿童期虐待-一种被定义为情感或身体上的经历的创伤 虐待或忽视或性虐待16岁之前-是一个既定的风险因素， 萧条研究还表明，童年虐待与不利的 抑郁症的治疗结果，即缺乏反应和缓解。此外， 有证据表明，经历过童年虐待的人 增加抑郁症复发的风险。 尽管有大量的文学作品探讨了童年与 虐待和抑郁症，我们不知道任何已发表的研究调查， 儿童期虐待与冬季季节性情感障碍（SAD）之间的关系， 抑郁症的一种突出亚型，每年影响美国1600多万人 States. SAD涉及秋季/冬季的重度抑郁症复发和自发性抑郁症。 在春天缓解。SAD的有效治疗包括光疗法（LT）和SAD- 定制认知行为疗法（CBT-SAD）。更好地理解这种关系 儿童期虐待和SAD治疗结果之间的关系对于治疗至关重要 优化.这项研究产生了新的知识， 通过以下具体目标实现虐待和SAD治疗结果： 目的1：研究儿童期虐待对抑郁症复发、缓解和发展的影响。 在SAD治疗后的接下来的两个冬季期间的症状严重程度。 目的2：确定儿童期虐待是否预示着不同的急性治疗 通过症状严重程度和缓解状态测量的对CBT-SAD或光疗法的反应 后处理。 该项目将收集有关儿童虐待的各个领域（情感虐待、 虐待，身体虐待，情感忽视，身体忽视，性虐待） 童年创伤问卷，并将评估这些形式的童年的影响 治疗后以及第一个和第二个冬天的SAD治疗结果 治疗后。这项工作具有宝贵的公共卫生意义， 其中SAD治疗是最佳的个人谁赞同童年虐待是第一次 步骤，以帮助临床医生决策和促进精确医疗，从而改善两者 患者结果和医疗保健成本效益。

Project Summary/Abstract Childhood maltreatment – a form of trauma defined as the experience of emotional or physical abuse or neglect or sexual abuse before the age of 16 – is an established risk factor for depression. Research also suggests childhood maltreatment is associated with unfavorable depression treatment outcomes, namely a lack of response and remission. Further, there is evidence to suggest that individuals who have experienced childhood maltreatment are at increased risk of depression recurrence. Despite the substantial body of literature that explores the relationship between childhood maltreatment and depression, we are not aware of any published studies investigating the relationship between childhood maltreatment and winter seasonal affective disorder (SAD), a prominent subtype of depression that impacts over 16 million individuals yearly in the United States. SAD involves major depression recurrence in the fall/winter months and spontaneous remission in the springtime. Efficacious treatments for SAD include light therapy (LT) and SAD- tailored cognitive behavioral therapy (CBT-SAD). An improved understanding of the relationship between childhood maltreatment and SAD treatment outcomes is critical for treatment optimization. This study generates new knowledge about the relationship between childhood maltreatment and SAD treatment outcomes through the following specific aims: AIM 1: Examine the impact of childhood maltreatment on depression recurrence, remission, and symptom severity during the next two winter seasons following SAD treatment. AIM 2: Determine whether childhood maltreatment predicts a differential acute treatment response to CBT-SAD or light therapy as measured by symptom severity and remission status post-treatment. The project will collect information on the various domains of childhood maltreatment (emotional abuse, physical abuse, emotional neglect, physical neglect, sexual abuse) at baseline using the Childhood Trauma Questionnaire, and will assess the impact of these forms of childhood maltreatment on SAD treatment outcomes at post-treatment and at one and two winters following treatment. This work has valuable public health implications, as a better understanding of which SAD treatment is optimal for individuals who endorse childhood maltreatment is a first step to aid clinician decision-making and facilitate precision medicine, thereby improving both patient outcomes and healthcare cost effectiveness.