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.

Individuals who are exposed to comparable levels of stress routinely diverge in health, performance, and psychological outcomes, yet no existing theory integrates the regulatory processes that explain this divergence. We propose stress intelligence (SI) as a theoretical framework describing a signal-informed regulatory capacity that operates through three integrated processes: (1) detecting stress signals across physiological, psychological, and behavioural domains, (2) interpreting their meaning in terms of demands and resources, and (3) deploying adaptive responses matched to context and goals. We argue that these capacities produce consistent adaptive outcomes only when they operate as an integrated process, such that detection informs interpretation and interpretation guides response. We build on the concept of skin-deep resilience to describe a pattern in which individuals maintain outward functioning while accumulating hidden physiological costs, and argue that SI differentiates sustainable resilience from skin-deep resilience in ways that existing frameworks do not. We derive testable predictions, including the proposition that an individual’s stress quotient (SQ; i.e., measurable individual-difference operationalisation of SI) can prospectively differentiate sustainable from skin-deep resilience among individuals maintaining equivalent levels of outward functioning at the time of assessment. We outline a research agenda spanning measurement development, longitudinal panel data, and clinical trial designs of SI interventions.

Background: Stress resilience is a dynamic process shaped by the interaction between demands and adaptive resources. Existing measures assess stress and resilience as separate constructs, limiting their use in digital health and workplace interventions. An integrated measure capturing both domains is needed. Objective: We developed and validated the WONE Index, a multidimensional stress resilience tool designed to measure both current stress load and adaptive resources among full-time working adults. Methods: We developed the 32-item WONE Index through literature review, expert consultation, and iterative refinement to assess stress load and resilience resources across behavioral, cognitive, and social domains. Phase 1 (N=1005; United States– or United Kingdom–based full-time employees) evaluated the initial item pool using exploratory and confirmatory factor analyses to establish the preliminary factor structure and assess reliability and validity. Phase 2 (N=306; United States–based adults) expanded underperforming domains, refined items, and tested incremental validity, test-retest reliability, and measurement invariance. Data were collected online through CloudResearch (Connect) and Prolific (Prolific Academic Ltd) using secure survey platforms. Results: Phase 1 supported a 2-domain structure: a Stress Load factor (Work Stress, Personal Stress, and Burnout) and a Resilience Resources factor (Emotion Regulation and Coping, Social Connectedness, and Sleep). Model fit indices were excellent (comparative fit index, CFI=0.95; Tucker-Lewis index, TLI=0.94; and root mean square error of approximation, RMSEA=0.05). Phase 2 replicated and extended this structure, expanding Resilience Resources into 7 domains (adding Purpose and Prosociality, Physical Activity, Dietary Intake, and Perseverative Thinking). Confirmatory factor analyses supported a 2-domain structure, comprising a higher-order Stress Load factor with 3 subdomains (Work Stress, Personal Stress, and Burnout) and a higher-order Resilience Resources factor with 7 subdomains (Emotion Regulation and Coping, Social Connectedness, Purpose and Prosociality, Sleep, Physical Activity, Dietary Intake, and Perseverative Thinking). The Stress Load model demonstrated excellent fit ( χ ² ₃₃ =64.18; P =.01; CFI=0.99; TLI=0.98; RMSEA=0.06; and standardized root mean square residual=0.05), and the Resilience Resources model also fit well ( χ ² ₄₄₃ =745.20, P <.001; CFI=0.94; TLI=0.94; RMSEA=0.05; and standardized root mean square residual=0.06). All subscales showed strong internal consistency (composite reliability: mean 0.84, SD 0.10; range 0.74‐0.93) and excellent test-retest reliability over 3 weeks (intraclass correlation coefficients 0.77‐0.90, 95% CI 0.87-0.93). The index showed strong convergent validity ( r =0.73 with Connor-Davidson Resilience Scale and r =–0.66 with Perceived Stress Scale-4) and explained additional variance beyond established measures in predicting depression, anxiety, and well-being (Δ R ²=0.07‐0.11; P <.001). Conclusions: The WONE Index provides a psychometrically robust tool for assessing stress resilience capacity in working adults. Its integrated structure captures dynamic relationships between stress exposure and resilience resources, thereby supporting personalized intervention delivery in digital health platforms and organizational well-being programs.

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.

Childhood maltreatment has lasting adverse effects across multiple domains, contributing to cumulative disadvantage and accelerated aging. These outcomes may reflect not only individual vulnerability, but also ethnoracial-related differences in lived experience, highlighting how sociocultural contexts shape long-term risk. The effect of childhood maltreatment on cognitive functioning later in life varies, raising questions about the mechanisms that drive this association. Data were drawn from the Midlife in the United States (MIDUS) study. Participants were categorized into two racial groups for analysis; non-Hispanic white and ethnoracial minority. Physiological and psychosocial variables were pulled from wave II and cognitive variables were extracted from waves II and III. At wave II, the analytic sample included 692 adults (56% female, 19.5% ethnoracial minority, age: 53.43 ± 10.72 years). Serial mediation models evaluated whether depression and perceived stress linked childhood maltreatment to later cognitive decline, predicting wave III cognitive functioning while controlling for wave II cognitive decline, in the overall sample and by ethnoracial subsamples. In the full sample, the relationship between childhood maltreatment and cognitive decline was fully mediated via the indirect pathway from depression to perceived stress. Ethnoracial minority status significantly moderated the association between depression and perceived stress, yet, the subgroups estimates of the indirect pathway were not significantly different from each other. In the non-Hispanic white group, the total effect of childhood maltreatment on cognitive functioning was not significant (b = − 0.0014, p = 0.283), but a significant indirect pathway existed through depression to stress (b = − 0.0012, 95%CI [− 0.0023, − 0.0003]). However, in the ethnoracial minority group, the total and direct effects of childhood maltreatment on cognitive performance were significant (b = − 0.0079, p = 0.001, and b = − 0.0066, p = 0.013, respectively) with no significant indirect pathways. These findings highlight distinct psychosocial pathways that link childhood maltreatment to cognitive aging and underscore the importance of contextually relevant prevention and intervention strategies.