Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses

A cross-lagged panel network analysis of loneliness, internet use, and depression among Chinese college students

BACKGROUND

Displacement theory proposes that internet use can lead to heightened feelings of loneliness and depression, whereas the stimulation theory posits the opposite pathway. However, most investigations on this topic have been cross-sectional, precluding causal inferences. Thus, we used cross-lagged network analyses to facilitate causal inferences in understanding the relations between Internet use, loneliness and depression.

METHODS

The participants (N = 25,249) who were recruited from 22 colleges in Guangdong province, China completed the survey in 2020 and 2021. This study examined the interactions between Internet use, loneliness and depressive symptoms (PHQ-9) among this participants. All analyses adjusted for demographics.

RESULTS

Contemporaneous networks revealed strong connections within the depression cluster and negligible associations between loneliness and internet use. Key bridging nodes were loneliness, guilt, anhedonia, and concentration problems, which linked constructs across the network. Temporal analyses did not support either the displacement or stimulation hypotheses, showing that higher loneliness predicted future depressive symptoms such as sad mood and anhedonia, as well as marginally higher internet use. Internet use exhibited mixed effects, weakly reducing suicide risk while marginally exacerbating depressive symptoms over time.

CONCLUSIONS

These findings underscore the importance of loneliness as a central driver and highlight the nuanced role of internet use.

Mapping vulnerability factors of chronic emotional and social loneliness: A network analysis

BACKGROUND

Chronic loneliness adversely impacts both mental and physical health. As current interventions are only moderately effective, examining vulnerability factors reflected in interpersonal behavior and their relationships with specific chronic loneliness subtypes may provide insights. The present study explored the associations between loneliness vulnerability factors and two subtypes of chronic loneliness: chronic emotional loneliness (a longing for intimate connections) and chronic social loneliness (dissatisfaction with the quantity and quality of one's social network).

METHODS

The sample consisted of 294 university students who had recently started at a new university. Participants completed surveys across three time points, separated by three-month intervals, including questionnaires on emotional and social loneliness, adult attachment styles, interpersonal behavioral styles, and features of emotional disorders. To explore relationships, we used network analysis by estimating a Mixed Graphical Model (MGM), in which chronic emotional loneliness and chronic social loneliness were dichotomized as binary variables (absence versus presence), while vulnerability factors were treated as continuous variables.

RESULTS

The network analysis demonstrated that chronic loneliness subtypes were differentially linked to vulnerability factors. Chronic emotional loneliness was predominantly linked to features of emotional disorders, whereas chronic social loneliness demonstrated a negative conditional association with secure attachment style.

LIMITATIONS

The assessment of chronic loneliness was based on three time points, which does not capture potential fluctuations between assessments.

CONCLUSIONS

These findings highlight the importance of differentiating between chronic loneliness subtypes when examining vulnerability factors. By distinguishing these subtypes, tailored interventions for loneliness can be developed to enhance prevention.

Metro/Nonmetro Migration as a Risk Factor for Opioid Use Disorder Among Older Medicare Beneficiaries: A Longitudinal Analysis of 2013-2018 Data

Opioid use disorder (OUD) among older adults (65+) has drawn researchers' attention. Nonetheless, whether migration between a metropolitan (metro) and nonmetropolitan (nonmetro) county shapes the risk of OUD remains underexplored. The drift hypothesis argues that individuals susceptible to a certain health condition tend to move, increasing the prevalence of the health condition in the destinations. By contrast, the environmental breeder hypothesis claims that migration alters the exposures to residential environment factors, which are associated with the occurrence of health conditions. Applying fixed-effects modeling to longitudinal data of older Medicare beneficiaries moving at least once between 2013 and 2018 (N = 6,227, person-year = 28,874), this study finds that older beneficiaries moving between metro and nonmetro counties demonstrated a higher risk of OUD than those who did not move. The positive association between migration and OUD risk is particularly strong for those moving from metro to nonmetro counties and the drift hypothesis receives stronger support.

Voluntary exercise is a moderately effective mitigator of chronic social isolation stress in two female rodent models

Depression is a common mood disorders, particularly among women, and often with social stress precursors. Exercise, in addition to the known physical benefits, can have psychological benefits, potentially alleviating certain symptoms of stressors. This study investigated the impact of chronic social isolation stress in two female rodent models - mice and prairie voles. To assess the mitigating impact of exercise, paired and isolated animals were either provided 24-hour access to running wheels in their cages or remained sedentary. In mice, only animals that remained paired and had access to exercise wheels retained adaptive levels of active behaviors in the forced-swim test. However, either remaining paired or having access to a running wheel prevented increased corticosterone levels in mice. By contrast, in voles, either being paired or having access to a running wheel promoted adaptive levels of active behaviors in the forced-swim test. Similar to mice, either being paired or having access to a running wheel also prevented increased corticosterone levels in prairie voles. Body weight and adrenal:body mass ratios were not affected by either isolation or exercise in either species. Together these findings highlight the important differences between female rodents of different species in responses to chronic social stress. They also allude to differences between female and male rodent models. Lastly, these results indicate that for female rodents, exercise can provide certain mitigating effects against chronic social stress consequences.

Child characteristics and parents' risk of depression in old age: The impact of number, sex and educational attainment

INTRODUCTION

Knowledge about the impact of having adult children on the risk of depression in old age is limited. This study aims to examine the association of having children and their characteristics (number, sex, and education) on their parents' risk of depression in old age.

METHODS

A main study population of all older adults (N = 1,064,652) born 1935-1953 and living in Denmark at the age of 65, were followed for up to 10 years for incident depression diagnosis or incident use of antidepressant medication in nationwide registers. Associations were estimated using adjusted Cox Proportional Hazards models.

RESULTS

During the mean follow-up time of 6.7 years, the incidence rate of depression in the main study population was 196 per 10,000 person-years (IR:196, 95 % CI: [195;197]). Compared to having children, not having children was associated with 8 % (HR: 0.92, 95%CI: [0.90;0.94]) lower HR of depression among older adults. For specific characteristics of adult children, having one child was associated with 3 % (HR: 1.03, 95%CI: [1.02;1.05]) higher HR of depression compared to having 2-3 children. 4+ children and sex of children were not associated with depression. Having adult children with a short or medium education, respectively, as the longest educational attainment were associated with 22 % (HR: 1.22, 95%CI: [1.19;1.25]) and 10 % (HR:1.10, 95%CI: [1.08;1.11]) higher HR of depression compared to having adult children with a long education.

CONCLUSION

Availability and characteristics, especially educational attainment, of adult children were identified to be associated with their parent's probability of being with depression in old age.

'Nowhere to go:' older African immigrants' experience of loneliness while living with adult children in the United States

OBJECTIVES

Loneliness emerged in previous studies as a challenge that negatively impacts older immigrants' physical and mental health. Despite the rapid growth of this population in the United States, there is limited knowledge about the loneliness experiences of older African immigrants. This study explored the loneliness experiences of older African immigrants living with their adult children in the United States.

METHODS

In‑depth interviews were conducted with nine participants aged 69‑84. The tape recordings of the interviews were transcribed verbatim for thematic analysis.

RESULTS

Findings show that loneliness is prevalent among older African immigrants, despite living with their adult children's family. Four major themes emerged from the study: 1) "Nowhere to go": Loneliness experience, 2) "It makes one sick if one is doing nothing": Consequences of loneliness, 3) "My grandkid makes me happy": Protective strategies, and 4) "If they ask older people to come. I will go there": Way forward in the community.

CONCLUSION

This study provides evidence that living with adult children may not prevent the experience of loneliness for older immigrant parents. Interventions that promote social interactions and embeddedness into the United States community are needed to ensure a good quality of life for older African immigrants.

Changes in prevalence of loneliness among home-dwelling older adults over three decades and associated factors

BACKGROUND

Studies examining loneliness trends over several decades among comparable cohorts of older people are rare.

OBJECTIVE

We evaluated how the prevalence of self-reported loneliness has changed over three decades among home-dwelling older people (75+ years), and factors associated with loneliness.

METHODS

We used data from four waves of the Helsinki Aging Study (1989-present), a repeated cross-sectional cohort study. The data had been collected using a postal questionnaire. The sample sizes were: 1989 (n = 660), 1999 (n = 2598), 2009 (n = 1637), 2019 (n = 1758). Based on responses to the question "Do you suffer from loneliness?", we categorized the respondents into lonely ('always or often', 'sometimes') and not lonely ('seldom or never'). The associations between various characteristics and loneliness were explored.

RESULTS

The prevalence of loneliness among older people decreased slightly between 1989 and 2019, from 34 % to 30 %. Loneliness decreased among both sexes. In the multivariable forward stepwise regression model, factors associated with loneliness were widowhood (OR 2.18, 95 % CI 1.91-2.49), needing help daily (OR 1.83, 95 % CI 1.56-2.16), feeling depressed (OR 5.26, 95 % CI 3.56-7.77), comorbidities (OR 1.07, 95 % CI 1.03-1.11), feeling useful (OR 0.36, 95 % CI 0.31-0.41), meeting friends (OR 0.65, 95 % CI 0.57-0.74), and male sex (OR 0.69, 95 % CI 0.59-0.80).

CONCLUSIONS

Loneliness among both older men and women has decreased over the past three decades. Several factors were found to be associated with loneliness. Given the detrimental impact of loneliness on health of individuals, policies and health strategies aimed at alleviating loneliness among older people should be a top priority.

Information and Communication Technology Use Among Social Ties of Varying Strength: Who Benefits and How?

BACKGROUND AND OBJECTIVES

Information and communication technology (ICT) use has been associated with well-being among older adults. This link is often attributed to the fact that ICT use facilitates connecting with others. The purpose of this study is to assess how contact frequency and social tie strength impact the relationship between ICT use and depressive symptoms among older adults.

RESEARCH DESIGN AND METHODS

Using data from the Detroit-based Social Relations Study collected in 2015, we use Bayesian analyses to examine the extent to which contact frequency with social network members moderates and the strength of these social tie (strong, moderate, and weak) mediate the link between ICT use and depressive symptoms among adults age 60 + (n = 483).

RESULTS

ICT use was found to be associated with fewer depressive symptoms. Furthermore, ICT use was associated with more moderate and weak ties which were, in turn, associated with fewer depressive symptoms. Finally, a moderating effect was also found as ICT use was associated with fewer depressive symptoms only among those with lower contact frequency.

DISCUSSION AND IMPLICATIONS

Our findings suggest that for older adults who communicate with others less frequently, ICT use can prove beneficial to mental health (i.e., fewer depressive symptoms). Furthermore ICT use may be especially meaningful to connect with weaker social ties. These findings may be due in part to ICTs capabilities which enable older adults to maintain connection to a diverse array of social ties and bridge social and physical distance.

Experiences of Loneliness Among Gay Men: A Systematic Review and Meta-Synthesis

Loneliness is a significant social and public health issue, particularly among gay men who often face unique challenges shaped by their social identities and minority status. These challenges often exacerbate feelings of isolation and exclusion, yet the specific ways in which gay men experience loneliness remain underexplored. This study aimed to offer insights for health professionals and policymakers via a systematic review and meta-synthesis. A comprehensive literature search was conducted in May 2024 across five major databases and gray literature to identify appropriate qualitative studies (i.e. if they focused on the experiences of loneliness among gay men, were qualitatively designed, and included participants over the age of 18). 72 studies, encompassing approximately 1335 participants were analyzed. Guided by Intersectionality Theory and the Minority Stress Model, data analysis generated three categories that impacted gay men's experiences of loneliness. (1) external influences of discrimination (lack of support systems, cultural standards, geographic location), (2) internal conflicts (internalized homophobia, concealment, fear of rejection), and (3) coping mechanisms (sex, substance use, social life and connections, embracing solitude). The findings highlight the complex interplay between external pressures and internal struggles, as well as how intersecting identities shape the diverse experience of loneliness among gay men.

The longitudinal association between adverse childhood experiences (ACEs) with transient and chronic loneliness among older adults

OBJECTIVES

Determine whether exposure to adverse childhood experiences (ACEs) confer a greater vulnerability to chronic and/or transient loneliness in older age, and whether specific types of ACEs are more strongly associated with chronic and/or transient loneliness.

METHOD

Participants (N = 1532) were drawn from the English Longitudinal Study of Ageing, a nationally representative sample of UK adults aged 50 years and over. Multinomial logistic regressions adjusted for sociodemographic and health-related covariates were used to determine how ACEs related to chronic and transient loneliness and which subtypes of ACEs (dysfunction, threat, or loss-based) are most associated with chronic and/or transient loneliness.

RESULTS

Experiencing 1 ACE (adjusted odds ratio [AOR] 1.43 [95% confidence interval [CI] 1.01-2.02]) or 2 or more ACEs (AOR 1.63 [95% CI 1.09-2.42]) was associated with a greater likelihood of experiencing chronic loneliness when compared to people who never experienced ACEs. There was no association between number of ACEs with transient loneliness. Dysfunction-based ACEs had a fully adjusted association with chronic loneliness (AOR 1.57 [95% CI 1.12-2.20]) and transient loneliness (AOR 1.58 [95% CI 1.12-2.23]).

CONCLUSION

This research suggests that ACEs are associated with a greater likelihood of experiencing chronic loneliness in older age. More specifically, dysfunction-based ACEs (linked to parental conflict, separation, mental illness, or substance use) were particularly associated with loneliness in older age. These findings suggest that it is important to consider the role of early life adversity when developing interventions to tackle loneliness in older age.

Effects of reminiscence therapy for loneliness in older adults: a systematic review and meta-analysis

BACKGROUND

Loneliness has detrimental effects on the mental well-being of senior citizens. Reminiscence therapies have emerged as a potential intervention to alleviate loneliness. This study aimed to systematically review and quantitatively analyse the effects of reminiscence therapy on loneliness among older adults.

METHODS

A comprehensive search was performed across 11 electronic databases, meta-analyses were used to explore the effectiveness of reminiscence therapy on loneliness among older adults, while multiple subgroup analyses were conducted to explore differences in the effectiveness of different types of reminiscence therapy. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

RESULTS

Twenty-two studies were included in the systematic review meta-analysis. The meta-analysis indicated that reminiscence therapy significantly reduced loneliness in older adults (standard mean difference = -1.52, 95% CI [-2.11, -0.93], P < .01). Subgroup analyses showed significant effects for both simple reminiscence and life review therapy. Group reminiscence therapy was more effective than individual reminiscence therapy, and that reminiscence therapy conducted by professional facilitators was more effective than that led by non-professionals.

CONCLUSIONS

Reminiscence therapy is an effective intervention for reducing loneliness among older adults, highlighting its importance in clinical practice. Future research should explore the best practices for different types of reminiscence therapies, tailored to the personal needs and backgrounds of older adults.

A perceived community typology in older Korean Americans: implications for mental health

OBJECTIVES

The aims of this study were to identify a community typology in older Korean Americans and to examine how the typology is associated with feelings of loneliness and mental distress. We hypothesized that distinct community groups would be identified and that they would be differentially associated with mental health and background characteristics.

METHOD

Data were drawn from a survey with older Korean Americans aged 60 and older, collected during 2017-2018 in diverse locations (n = 2138). To identify a community typology, a series of latent profile analyses (LPA) were conducted using 15 community-related variables in three domains (neighbourhood characteristics, social cohesion, ethnic attachment).

RESULTS

Based on model evaluation criteria, an LPA model with five community groups was identified as the best fit. The five groups were identified as "safe/integrated" (10%), "safe/distant" (10%), "moderate integration" (38%), "marginal" (31%), and "vulnerable" (11%). After examining descriptive characteristics of the identified groups, regression models of loneliness and mental distress were estimated. Using the safe/integrated group as reference, the marginal and vulnerable groups were consistently associated with elevated feelings of loneliness and mental distress.

CONCLUSIONS

The results suggest the need to understand community profiles and their relationships with health/well-being among older immigrants.

Participation in diverse social activities predicts fewer depressive symptoms

OBJECTIVES

Engagement in a greater number and more diverse activities is associated with higher levels of well‑being. One reason may be that these activities provide opportunities for a variety of social interactions. To examine the importance of the social nature of daily activity, the current study examines the unique association between social activity variety and later depressive symptoms, after adjusting for non‑social activity variety.

METHOD

Using data from the Health and Retirement Study (HRS), we included 5,160 adults in a cross‑sectional analysis from 2008 and 3,081 adults in a longitudinal analysis spanning 2008 to 2012, all of whom completed questionnaires on social activity participation and depressive symptoms.

RESULTS

Cross‑sectional findings indicated that social activity variety was related to lower severity of depressive symptoms, but not likelihood of having any depressive symptoms, after adjusting for health, sociodemographic covariates, and non‑social activity. Longitudinal results showed that participants with consistently high levels of social activity variety over four years experienced fewer depressive symptoms at follow‑up compared to those with low levels, even after adjusting for baseline depressive symptoms.

CONCLUSION

Findings suggest that participation in a greater variety of social activities can be a protective factor against the severity of depressive symptoms.

The role of loneliness in mediating the relationship between financial strain and mental health: Exploring gender differences in a UK longitudinal study

OBJECTIVES

This study explores the association between financial strain and loneliness over time, investigates loneliness as a mediator in the relationship between financial strain and mental health, and examines the influence of gender.

STUDY DESIGN

Longitudinal study.

METHODS

Using data from six waves (2017-2023) of the UK Household Longitudinal Study (UKHLS), which includes 34,535 participants (154,316 person-years), this study employs fixed-effects regression models.

RESULTS

Financial strain is significantly associated with increased loneliness over time (b = .155, p < .001). Loneliness partially mediates the relationship between financial strain and mental health, accounting for approximately 15 % of the effect. Notably, the relationship between loneliness and mental health is moderated by gender (b = .120, p < .001), with women experiencing more severe negative effects.

CONCLUSIONS

These findings suggest that alleviating financial strain could reduce loneliness and its detrimental effects on mental health. Addressing financial and social stressors is essential for public health strategies. Implementing gender-sensitive approaches is critical for addressing specific vulnerabilities, particularly among women.

Diversity of Group Memberships Predicts Well-Being: Cross-Sectional and Longitudinal Evidence

Groups have their health and well-being impacted by satisfying their members' needs and providing resources to help cope with threats. Multiple group memberships serve to accumulate these benefits and also provide resilience to the effects of group loss. However, the additional well-being benefits of belonging to multiple different types of group remain to be determined. In a preregistered cross-sectional survey in Nottingham, England (Study 1, N = 328), we found that group-type diversity predicted well-being and that this effect was fully serially mediated by increased creative self-efficacy, then reduced loneliness. To confirm our hypothesis in a more robust sample we conducted longitudinal analyses on the English Longitudinal Study of Aging (ELSA) dataset (Study 2, N = 5,838) finding that group-type diversity at time one (T1) predicted well-being at T2 (4 years later), even when accounting for wellbeing and loneliness at T1. We discuss the implications for enhancing group-based health interventions.

Cross-cultural adaptation and validation of a French version of the Measure of Stroke Environment (MOSE) in stroke survivors in Sub-Saharan Africa

PURPOSE

To investigate the psychometric properties of the MOSE-Benin, a French-language version of the Measure of Stroke Environment (MOSE) for Sub-Saharan Africa.

MATERIALS AND METHODS

The original English version of the MOSE has been translated into French following the guidelines for cross-cultural adaptation. The resulting questionnaire (MOSE-Benin) was administered to a convenience sample of participants recruited in Benin, a French-speaking country.

RESULTS

Eighty-two stroke survivors (41 females; mean ± SD: 54.94 ± 11.6 years old) participated in the study. Internal consistency of each domain of the MOSE-Benin and the overall questionnaire was high (Cronbach's α: 0.78 to 0.92). Test-retest reliability was excellent (n = 31; ICC: 0.977 to 0.998). Overall, the standard error of measurement (SEM) and the minimum detectable change (MDC) showed very low values (SEM = 0.85; MDC = 2.35). Convergent validity demonstrated moderate correlations for the three domains in separate comparison respectively with the ACTIVLIM-Stroke questionnaire, the Participation Measurement Scale, and the communication domain of the Stroke Impact Scale (r or ρ: 0.42 to 0.54; p < 0.0001).

CONCLUSION

MOSE-Benin has good evidence regarding psychometric properties (i.e., content validity, convergent validity, internal consistency, and test-retest reliability) that can support its use for the assessment of perceived environmental barriers after stroke in a French-speaking Sub-Saharan African country, such as Benin.

[A panel model of the relationships between loneliness and depression in older adults]

ANTECEDENTS AND OBJECTIVE

The declining birth rate and increasing life expectancy have led to an aging population, causing challenges at the economic, social and healthcare levels. Ensuring and maintaining high levels of well-being and mental health in older adults is crucial for successful aging. Given that previous literature indicates that perceived loneliness and depressive symptoms constitute significant obstacles to their quality of life, the aim of this study is to examine how perceived loneliness and depression intertwined in community-dwelling older adults over time.

METHODOLOGY

For this purpose, we conducted a longitudinal research study with a total of 46,317 European older adults (57.40% women), using the SHARE database (Survey of Health, Ageing and Retirement in Europe), at waves 6, 7, and 8, spanning a recent four-year period from 2016 to 2020. Several cross-lagged panel models were estimated using the structural equation modeling package Mplus.

RESULTS

The results show that loneliness and depression are bidirectionally related, which is difficult to combat because of their feedback and stability over time.

CONCLUSIONS

We discuss the practical implications of these findings concerning the potential double-edged sword of these reciprocal relationships on treatment and preventive interventions, as well as the study's limitations and future research directions.

The impact of unmet community service demand on the loneliness of older adults: based on CLHLS (2008-2018)

PURPOSE

To explore the impact of unmet community service demands on loneliness among older adults.

METHODS

Based on the longitudinal tracking data of CLHLS (2008-2018), latent growth curve model (LGCM) was used to describe the trajectory of loneliness among older adults. Panel regression was used to analyze the impact of unmet community service demands on loneliness, and latent classification analysis (LCA) was used to classify the older adults and analyze the differences in loneliness among different types of older adults.

RESULTS

A total of 1445 older people participated in all four surveys, and 22.4% of them reported feeling lonely. From 2008 to 2018, there was a significant non-linear increase in loneliness, with average values of 1.77, 1.81, 1.83, and 1.96, respectively. The level of community service supply (1.31) was far from meeting the demand level (5.11). Unmet community service demands were associated with a higher prevalence of loneliness (β = 0.012, P = 0.003, 95% CI = [0.004, 0.020]). In addition, according to the demand difference for community services, older adults were classified into the comprehensive demand type (Type I) and the medical demand type (Type II). The loneliness of Type I older adults was significantly higher than that of Type II (P < 0.05).

CONCLUSIONS

With the passage of time, loneliness of older adults is showing an accelerating upward trend. Unmet community services can lead to enhanced loneliness among older adults, and the higher the demand for community services, the stronger the loneliness. The government should increase the supply of community services to meet the basic and socio-emotional needs of the older adults to reduce loneliness.

Experience of Loneliness Among Middle-Aged Hemodialysis Patients: Qualitative Study

Aim: To phenomenologically explore the subjective experience of loneliness among middle-aged hemodialysis patients. Background: In South Korea, the number of middle-aged hemodialysis patients is steadily increasing, and qualitative research on the loneliness they experience is needed to understand them and develop nursing management strategies. Methods: A qualitative study using the phenomenological research method of Giorgi was employed. Participants were 11 patients aged 40-64, receiving regular hemodialysis for over 3 months at a hemodialysis treatment facility in Seoul, South Korea. Data were collected from June 2021 to February, 2022, and they were in-depth interviewed until data saturation. Results: The seven components derived from the study results were "The loneliness felt in a life tied to dialysis like shackles," "The sorrow and loneliness of my irretrievable life," "Helplessness in death and isolation at the edge of life," "Living everyday wrapped in solitude," "Complex emotions and alienation within the family," "Lonely life in the shadow of illness and societal prejudice," and "Struggling to break free from the abyss of loneliness." Also, 20 subcomponents were derived. Implications for Nursing Management: Despite facing the negative aspects of loneliness associated with illness and treatment, middle-aged hemodialysis patients accept loneliness as a meaningful adaptive experience. This repetitive phenomenon throughout the life cycle of lifelong dialysis patients suggests a continuous process. In nursing management, nurses or nursing managers need to pay attention to the results of this study for deep understanding of middle-aged hemodialysis patients and qualitative nursing management. Based on the results of this study, nursing management strategies for them can be developed.

Measuring Whether Gratitude and Loneliness Mediate the Link Between Non-organizational Religiosity and Suicidal Ideation: Evidence From Black Adults During COVID-19

OBJECTIVES

Suicides among Black adults in the United States increased nationally during the COVID-19 pandemic, although limited empirical evidence documents the pathways that explain how suicide risk may develop in this population. We examined experiences of non-organizational religious involvement, gratitude, and loneliness and their relation to suicidal ideation among Black adults in the United States.

METHODS

We analyzed data from a probability-based sample of 995 Black adults in the United States who completed online surveys from April through June 2022. We recruited participants from the AmeriSpeak panel at the National Opinion Research Center. We applied structural equation modeling techniques to measure direct and indirect associations among religiosity, positive psychology, and mental health variables. We tested whether non-organizational religiosity was indirectly associated with suicidal ideation via feelings of gratitude and COVID-19-specific forms of loneliness during the pandemic.

RESULTS

The measurement model demonstrated a good fit to the data. Structural model results indicated that non-organizational religious involvement was positively related to gratitude (β = 0.51; P < .001); in turn, feelings of gratitude were associated with reduced suicidal ideation (β = -0.12; P = .02). Moreover, COVID-19-specific forms of loneliness were positively associated with past-year suicidal ideation (β = 0.11; P = .01). Non-organizational religious involvement, however, was not directly associated with feelings of COVID-19-related loneliness or suicidal ideation.

CONCLUSIONS

Public health officials should account for feelings of gratitude and loneliness as mechanisms that can be leveraged to inform the development of evidence-based suicide prevention interventions for Black adults during public health emergencies such as the COVID-19 pandemic and beyond.

Loneliness in Advanced Life-Threatening Illness: An Integrative Review

CONTEXT

To inform supportive interventions, experiences of loneliness must be understood specifically from the perspective of those with advanced life-threatening illness and their caregivers.

OBJECTIVES

To identify the causes, experiences, and impacts of loneliness among adults with advanced life-threatening illnesses and caregivers, and which modifiable factors might mitigate loneliness.

METHODS

Systematic searching of six databases (CINHAL, Web of science, Cochrane central, Medline, HMIC and Proquest) was supplemented by backward citation searching from Jan 2014-Jan2024. This was followed by screening and selection based on the PRISMA extension for scoping reviews (PRISMA-ScR) guidelines. Studies were imported into NVivo version 1.6 for data management. An inductive approach was used to facilitate the synthesis. Quality assessment with diverse studies (QuADS) was used. The review protocol was registered with Prospero, ID: CRD42023493999.

RESULTS

Ninteen observational studies and 6 intervention studies were included in this review. Evidence confirms that the causes, impacts and outcomes of loneliness are multifaceted and interact dynamically. Risk factors on a micro level include psychological and existential factors such as emotional distress and fear of death; potentially modifiable factors include efforts to enhance communication and befriending programs. On meso level physical and social factors are risk factors such as symptom burden and social withdrawal, potentially modifiable factors include utilizing technology to make home an accessible place to maintain social connections. On a macro level environmental and societal risk factors include mobility restrictions and stigma; potentially modifiable factors include increasing societal engagement through community programs CONCLUSION: This integrative review will help healthcare providers, policymakers and the public understand the causes, experiences and impact of loneliness in adults with advanced life-threatening illnesses and their caregivers. The evidence suggests that an integrated approach that combines personal, social, and systemic efforts is needed which includes enhanced communication, targeted interventions, robust support systems, and community engagement. Rigorous research studies are required which include patient and public involvement from inception to completion to ensure that the study designs and methodologies are purposeful for those they intend to serve.

The impact of intergenerational support on the mental health of older adults: a discussion of three dimensions of support

Introduction

This paper examines the effects of intergenerational support on the mental health of older adults and elucidates the mechanisms underlying these effects.

Methods

Utilizing data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), We examine the effects of different dimensions of intergenerational support on the positive and negative emotions of older adults based on the main effect model and the buffer model. Then we employ instrumental variable methods to address key endogeneity concerns. The indirect effect mechanism through which children's economic support influences the mental health of the older adults was examined using a mediation model. In addition, robustness tests and heterogeneity analyses were conducted.

Results

The intergenerational support from children has a significant impact on the mental health of older adults. All three types of support contribute to the positive emotions of older adults. In terms of the impact on negative emotions, the regression coefficients for financial support and emotional support are significantly negative, while the direction of the effect of caregiving support is positive. Additionally, financial support promotes the mental health of the older adults by influencing their social participation. Heterogeneity analysis further indicates that the impact of intergenerational support varies across different subpopulations, with rural older adults particularly benefiting from emotional support.

Discussion

Our findings reveal that financial support from adult children enhances older adults' mental health by improving positive emotions and reducing negative emotions, and emotional support from children has a similar effect. However, while caregiving by adult children significantly boosts positive emotions among older adults, long-term caregiving also engenders feelings of guilt, which in turn exacerbates negative emotions and diminishes overall mental health. Our study emphasizes the need to consider Filial Piety Culture, social care support and social participation in order to improve older adults' mental health.

Prevalence and network structure of depression and its association with quality of life among older stroke survivors: findings from a national survey in China

Background

Post-stroke depression (PSD) is a common neuropsychiatric problem associated with a high disease burden and reduced quality of life (QoL). To date, few studies have examined the network structure of depressive symptoms and their relationships with QoL in stroke survivors.

Aims

This study aimed to explore the network structure of depressive symptoms in PSD and investigate the interrelationships between specific depressive symptoms and QoL among older stroke survivors.

Methods

This study was based on the 2017-2018 collection of data from a large national survey in China. Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale (CESD), while QoL was measured with the World Health Organization Quality of Life-brief version. Network analysis was employed to explore the structure of PSD, using expected influence (EI) to identify the most central symptoms and the flow function to investigate the association between depressive symptoms and QoL.

Results

A total of 1123 stroke survivors were included, with an overall prevalence of depression of 34.3% (n=385; 95% confidence interval 31.5% to 37.2%). A higher risk of PSD was significantly associated with limited activities of daily living (odds ratio (OR)=1.340; p=0.048), presence of heart diseases (OR=1.589; p=0.002) and more severe anxiety symptoms (OR=1.472; p<0.001). In the network model of depression, the most central symptoms were CESD3 ('feeling blue/depressed', EI: 1.180), CESD6 ('feeling nervous/fearful', EI: 0.864) and CESD8 ('loneliness', EI: 0.843). In addition, CESD5 ('hopelessness', EI: -0.195), CESD10 ('sleep disturbances', EI: -0.169) and CESD4 ('everything was an effort', EI: -0.150) had strong negative associations with QoL.

Conclusion

This study found that PSD was common among older Chinese stroke survivors. Given its negative impact on QoL, appropriate interventions targeting central symptoms and those associated with QoL should be developed and implemented for stroke survivors with PSD.

Understanding the relationship between education-based hypergamy and women's social interaction in China: mediating roles of career aspirations and social distrust

Background

Education-based hypergamy (EBH) is a key factor influencing the social interaction (SI) of women in China. Women in education-based hypergamous marriages, where they have lower education levels than their spouses, often face unique challenges that may impact their social lives. The dynamics of traditional gender norms and opportunity costs of balancing career and household duties present barriers to SI for these women. Thus, understanding the mechanisms that mediate and moderate this relationship is crucial for addressing social inequalities and improving public health outcomes.

Methods

Data for this study were obtained from the 2021 Chinese General Social Survey (CGSS), which sampled 1,442 women. We employed a mediation effect testing model to examine the relationships among EBH, career aspirations (CA), social distrust (SD), and SI. The model also tested the moderating role of household income in mitigating the effects of EBH on SI.

Results

This study first highlights that EBH is negatively associated with women's SI. Notably, household income moderated this relationship, with higher income levels alleviating the negative impact of EBH on SI. Additionally, CA and SD were found to mediate the relationship between EBH and SI, demonstrating that these factors contribute to the reduction in SI among women in education-based hypergamous marriages.

Discussion/conclusion

These findings partially align with prior research on gender norms and social interaction, offering theoretical insights into the negative effects of EBH on women's SI. From a public health perspective, the results underscore the need for policies that enhance household income and provide flexible work arrangements. Such policies could reduce the constraints imposed by EBH, thereby promoting better social interaction, mental well-being, and overall health for women.

Brief Mindfulness-Based Intervention for Seniors-An Exploratory Semi-Randomized Examination of Decentering Effects on Cognitive Functions and Psychological Distress

The need for psychological treatment in the community, specifically in times of crisis and for those in isolation, calls for finding suitable interventions, especially for older adults. The present study examined the effect of a short mindfulness-based intervention emphasizing a 'decentering' component and an equivalent guided-imagery intervention on cognitive and emotional measures in seniors living in the community. Thirty community seniors (Mage = 74.7) performed either 'decentering' or matched guided-imagery intervention, or care as usual as a control. The 8-week interventions included weekly 20 min sessions and daily 10 min home practice. Participants underwent a cognitive and emotional assessment before and after the interventions, which included filling out questionnaires and performing the cognitive Simon task. The results showed improvements only for intervention groups: cognitively, reduced response time and improved accuracy rate were found in the Simon task. Emotionally, reported depression levels were decreased and an increase in reported positive relationships was found. Our study, hence, introduces two intervention protocols, with promising positive effects on psychological and cognitive status. This contributes evidence-based treatments, easy to deliver in nursing homes or retirement communities, for improving the life quality of older adults.

Transitioning to college during COVID-19: A brief report on incoming students' self-reports of mental health from 2020 to 2022

Objective: Depression and anxiety have been identified as growing concerns for many populations in the United States, including young adults. We investigated how internalizing symptoms may have changed throughout the COVID-19 pandemic among students transitioning to college.Participants: Participants were incoming undergraduates in Fall 2020, 2021, and 2022 at Northeastern Universities (N = 263).Methods: Participants completed self-reports of mood, repetitive thinking, and social satisfaction within two weeks of beginning their first college semester.Results: Depression and anxiety symptoms appear to differ by year, such that both have increased over time. These results seem to be co-occurring with an increase in repetitive negative thinking - a known predictor of depression and anxiety.Conclusions: These preliminary results suggest that mental health concerns in young adults may be worsening despite the resumption of in-person activities post-initial pandemic onset. This highlights the need to monitor and intervene on mental health in students transitioning to college.

A Meta-Synthesis Exploring Daily Experiences of Adults With Coeliac Disease in Adhering to a Gluten-Free Diet

BACKGROUND

Coeliac disease (CD) is an autoimmune disease affecting 1.4% of the population worldwide. The only treatment for this condition is a strict, lifelong gluten-free diet (GFD). Although the complexity of this condition is recognised, the definitive follow-up strategy and long-term management have still not been developed in the United Kingdom (UK) and Australia. This meta-synthesis aimed to explore the experiences of patients living with CD who follow the GFD in the UK and Australia.

METHODS

A systematic search for primary qualitative literature related to experiences of patients with CD on a GFD and a meta-synthesis of the results were conducted. Healthcare-relevant online databases were screened: Academic Search Complete, CINAHL, MEDLINE, and Scopus, followed by reference list searching. A defined inclusion criteria were used to identify relevant studies. The data synthesis from the literature followed the thematic synthesis approach. A clear description of the methodology and peer review were applied to ensure transparency.

RESULTS

A total of 286 studies were screened for eligibility. Of those, six studies met the inclusion criteria. The experiences of 198 patients living with CD were analysed and reported. Five analytical themes emerged through the thematic synthesis process: acceptance and adaptation, dietary burden, cost burden, socialising, and importance of support. All themes were found to impact patients' quality of life (QoL). The overall quality of the reviewed studies was described as good.

CONCLUSION

This meta-synthesis revealed insights into the daily experiences of patients with CD in adhering to a GFD in the UK and Australia, being the first secondary qualitative study to explore this phenomenon. It highlighted the need for the development of defined strategies for patient follow-up to provide holistic care, considering the complexities of this condition and its impact on both physical and psychological domains.

Material, Health, and Social Vulnerability and Loneliness Among Older Adults: From the Welfare Regime Perspective

Loneliness in later life is a significant global public health issue that negatively impacts well-being, life satisfaction, and mental health. This study investigates how material, health, and social vulnerabilities contribute to loneliness among older adults using a welfare regime framework. It examines the link between vulnerability and loneliness in the United States, Korea, Sweden, Spain, and Germany using the Health and Retirement Study (HRS) alongside its international sister studies, encompassing both Western and East Asian welfare states. Findings indicate that older adults in less generous welfare regimes experience higher levels of loneliness and material vulnerability. A multidimensional approach reveals that the most urgently vulnerable population is the multiply vulnerable group. Vulnerable groups are more likely to experience loneliness, with divergent associations emerging across countries. Cross-national variations demonstrate how institutional arrangements can either mitigate or exacerbate the relationship between vulnerability and loneliness.

Network analysis of loneliness, mental, and physical health in Czech adolescents

BACKGROUND

The increasing urgency to address rising loneliness among adolescents has become a critical issue, underscoring the need for further studies on its association with mental and physical health. The objective was to examine the changes in loneliness and its relation to mental and physical health issues in three adolescent age groups.

METHODS

A total sample of 14,588 Czech pupils (50.7% boys, mean age 13.6 ± 1.7 years) in grades 5, 7 and 9 was used from a representative dataset of the Health Behaviour in School-aged Children (HBSC) study. The network analysis based on undirected graphical models was used as an exploratory technique to assess and test the structure of the data.

RESULTS

The association between loneliness and health decreased with age. There was a significant positive association between loneliness, feeling low, and irritability. No significant direct association between loneliness and physical health complaints was found.

CONCLUSION

Further studies, preferably of longitudinal character, are needed to confirm the changes in associations between loneliness and mental and physical health outcomes.

Loneliness Among Adults Aging With Intellectual and Developmental Disabilities: The Importance of Living Situation

BACKGROUND AND OBJECTIVES

Loneliness is a serious public health concern among the aging population. Not only is loneliness an unpleasant emotional experience but it is also associated with worse health, well-being, and even mortality. This is a particularly important issue among the population aging with intellectual and developmental disabilities, who are more likely to experience loneliness across the life course, and who-particularly if living in an intermediate care facility (ICF) or nursing facility-may lack social connections.

RESEARCH DESIGN AND METHODS

We analyzed data from the 2012-2013 to 2021-2022 waves of the National Core Indicators-Intellectual and Developmental Disabilities In-Person Survey (NCI-IPS; 8 waves total), a national survey of adults with intellectual and developmental disabilities receiving state services (N = 101,374 observations drawn from 49 states). Multilevel logistic regression models examined whether loneliness varied according to living situation.

RESULTS

Indicated that (a) adults aging with intellectual and developmental disabilities in ICF and nursing facilities reported significantly greater loneliness than those living in the community, (b) having friends was associated with reduced loneliness overall, yet (c) having friends was associated with reduced loneliness among those living in the community, but not for those living in ICF or nursing facilities.

DISCUSSION AND IMPLICATIONS

These results indicate not only that adults with intellectual and developmental disabilities living in institutionalized settings are at higher risk of experiencing loneliness and its detrimental effects but also that specialized interventions are required to meet their unique needs and reduce their loneliness in mid and later life.

Gender difference in prevalence and network structure of subclinical Hikikomori and depression among college students

BACKGROUND

Subclinical Hikikomori and depression are common among college students, yet gender differences in their prevalence and interrelationships are under-explored. This study evaluated gender differences in prevalence and symptom networks of these disturbances.

METHODS

A large-scale, multi-center study was conducted across Xinjiang, Qinghai, and Guangdong provinces, China between September and December 2023. Subclinical Hikikomori and depression were assessed with the 1-month 25-item Hikikomori Questionnaire (HQ-25M) and the Patient Health Questionnaire-9 (PHQ-9), respectively. Gender differences in prevalence were tested with univariate analyses, while network analyses assessed symptom structures within each gender. Expected Influence (EI) identified the most central symptoms, with higher EI indicating greater impact. Bridge EI identified specific symptoms that linked Hikikomori and depression symptom communities.

RESULTS

Among 6,222 college students, no significant gender differences were found in the prevalence of subclinical Hikikomori (males: 11.4% and females: 13.3%) or depression (males: 19.1% and females: 18.3%). Network analysis revealed 'I avoid talking with other people' (HQ18) as the most central symptom for both males (EI = 1.60) and females (EI = 1.73), followed by 'It is hard for me to join in groups' (HQ13, EI = 1.442) and 'I have little contact with other people' (HQ19, EI = 1.437) in males, and followed by 'Loss of energy' (PHQ4, EI = 1.17) and 'I have little contact with other people' (HQ19, EI = 1.09) in females. The key bridge symptoms were identified as 'Guilt feelings' (PHQ6) for males (Bridge EI = 0.14) and 'Suicidal ideation' (PHQ9) for females (Bridge EI = 0.13). Significant overall gender differences in networks were observed (M = 0.12, p = .01).

CONCLUSION

Depression and subclinical Hikikomori are common among Chinese college students although we observed no significant gender differences in its prevalence. The most influential central and bridge symptoms from network models are viable targets for intervention for both genders.

Epistemic Trust, Mistrust and Credulity Questionnaire (ETMCQ) validation in French language: Exploring links to loneliness

The concept of epistemic trust is gaining traction in the mental health field. Epistemic trust is thought to play a foundational role as a resilience factor against the development and maintenance of psychopathology by fostering social learning. The primary aim of this study was to validate the French-language version of the Epistemic Trust, Mistrust and Credulity Questionnaire (ETMCQ). We further sought to replicate previously reported associations with key developmental and psychological factors (childhood trauma, mentalizing and attachment) and test for epistemic trust's potential mediating roles between childhood traumatic experiences and psychopathology, and between loneliness and psychopathology. A total of 302 participants were recruited via the online survey platform Prolific. Confirmatory factor analysis and generalized linear models of mediation were conducted. Our findings suggest that the ETMCQ is a valid instrument to assess epistemic trust in the French language. Satisfactory psychometric properties were found to replicate the original three-factor solution in a Francophone population with a 12-item version of the questionnaire, with criterion-related validity similar to that previously published in validations of the ETMCQ in other languages. We also replicate previous findings reporting differential associations between epistemic stances (trust, mistrust and credulity) and attachment dimensions and styles, while also replicating mediation analyses showing the role of epistemic stances in the relationship between childhood traumatic experiences and psychopathology. Finally, we report preliminary evidence suggesting that epistemic trust mediates the well-described association between loneliness and psychopathology. Future research should investigate the ETMCQ in clinical populations in which psychopathological expressions are severe, enduring and co-occurring, where identifying potential mediators could help target and personalize psychosocial interventions.

The effect of loneliness on depressive symptoms in the 65+ European population: a longitudinal observational study using SHARE data

Loneliness has consistently been found to be associated with an increased probability of depressive symptoms among older adults. Yet, the relationship is complex, and it remains unclear whether loneliness is a cause of depressive symptomatology. The aim of this study is to investigate the possible causal effect of loneliness on subsequent depressive symptoms among older adults (65+) in Europe. We analyzed two waves of observational data (2015-2017) from the Study of Health, Aging, and Retirement in Europe (SHARE) (n = 6808) and attempted to identify a causal effect of loneliness on depressive symptomatology by accounting for confounding by potential unmeasured factors using an endogenous treatment-effect model. The results showed a substantial positive association between loneliness in 2015 and depressive symptoms in 2017 in the sample. However, there was no support for the hypothesis that loneliness in 2015 was a cause of depressive symptoms in 2017. Additionally, there was no evidence of unmeasured factors confounding the relationship. Thus, loneliness may not be a cause of depressive symptoms among older adults in the short term. These findings suggest that there might be other reasons why lonely individuals are at an increased risk of depressive symptoms. Therefore, a shift in focus when aiming to reduce depressive symptoms among lonely older adults may be warranted.

Short-term social isolation acts on hypothalamic neurons to promote social behavior in a sex- and context-dependent manner

Social animals, including both humans and mice, are highly motivated to engage in social interactions. Short-term social isolation promotes social behavior, but the neural circuits through which it does so remain incompletely understood. Here, we sought to identify neurons that promote social behavior in single-housed female mice, which exhibit increased rates of social investigation, social ultrasonic vocalizations (USVs), and mounting during same-sex interactions that follow a period of short-term (3 days) isolation. We first used immunostaining for the immediate early gene Fos to identify a population of neurons in the preoptic hypothalamus (POA) that increase their activity in single-housed females following same-sex interactions (POAsocial neurons) but not in single-housed females that did not engage in social interactions. TRAP2-mediated chemogenetic silencing of POAsocial neurons in single-housed females significantly attenuates the effects of short-term isolation on social investigation, USV production, and mounting. In contrast, caspase-mediated ablation of POAsocial neurons in single-housed females robustly attenuates mounting but does not decrease social investigation or USV production. Optogenetic activation of POAsocial neurons in group-housed females promotes social investigation and USV production but does not recapitulate the effects of short-term isolation on mounting. To understand whether a similar population of POAsocial neurons promotes social behavior in single-housed males, we performed Fos immunostaining in single-housed males following either same-sex or opposite-sex social interactions. These experiments revealed a population of POA neurons that increase Fos expression in single-housed males following opposite-sex, but not same-sex, interactions. Chemogenetic silencing of POAsocial neurons in single-housed males during interactions with females reduces mounting but does not affect social investigation or USV production. These experiments identify a population of hypothalamic neurons that promote social behavior following short-term isolation in a sex- and social context-dependent manner.

Why friendship and loneliness affect our health

Humans, like all monkeys and apes, have an intense desire to be social. The human social world, however, is extraordinarily complex, depends on sophisticated cognitive and neural processing, and is easily destabilized, with dramatic consequences for our mental and physical health. To show why, I first summarize descriptive aspects of human friendships and what they do for us, then discuss the cognitive and neurobiological processes that underpin them. I then summarize the growing body of evidence suggesting that our mental as well as our physical health and wellbeing are best predicted by the number and quality of close friend/family relationships we have, with five being the optimal number. Finally, I review neurobiological evidence that both number of friends and loneliness itself are correlated with the volume of certain key brain regions associated with the default mode neural network and its associated gray-matter processing units.

Effects of voluntary or involuntary exercise in adolescent male rats exposed to chronic social isolation on cognition, behavior, and neurotrophic factors

This study investigated the effects of voluntary and involuntary/regular exercise on neurotrophic factors in the brain, cognitive functions, and anxiety in socially isolated adolescent male rats. In this study, 42 adolescent male Sprague-Dawley rats were divided into six groups: control (C), socially isolated (SI), voluntary exercise (VE), regular exercise (RE), socially isolated + voluntary exercise (SI-VE), and socially isolated + regular exercise (SI-RE). Socially isolated groups were kept in separate cages for 4 weeks. Treadmill and wheel running were used in the exercise groups. The following behavioral tests-elevated plus maze (EPM), open field, ultrasonic vocalization (USV), and Morris water maze (MWM)-rats were euthanized, and brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and vascular endothelial growth factor (VEGF) levels were measured in the prefrontal cortex (PFC) and hippocampus. Statistically, the differences between the groups were evaluated by one-way ANOVA and post hoc LSD tests using IBM SPSS software. In the EPM, locomotor activity was higher in the voluntary exercise groups. In the MWM, both regular exercise groups found the platform faster. In the USV, the SI-RE group produced more 50-kHz sounds. BDNF and NGF levels in the hippocampus were higher in the SI-RE and SI-VE groups; VEGF levels were higher in the SI-RE group. Neuron density in the PFC increased in the SI-RE and VE groups, while neuron density in the hippocampus increased in the SI-RE, SI-VE, and VE groups. According to the findings, we showed that voluntary exercise reduces social isolation-induced anxiety, and involuntary/regular exercise both reduces anxiety and has potential benefits on cognitive functions.

Quantifying Social Connectedness in Parkinson's Disease: Reliability and Validity of a Clinical Assessment Toolkit

BACKGROUND

Loneliness and isolation impact health detrimentally but are understudied in Parkinson's disease (PD). Outcome measurement properties for social connection remain unexplored in PD.

OBJECTIVE

To evaluate the measurement properties of six social connection outcomes in PD.

METHODS

We evaluated internal consistency, structural validity, and construct validity for measures of loneliness (brief UCLA Loneliness Scale [ULS3], short and long de Jong Gierveld Loneliness Scale [dJGLS], social isolation [Cohen Social Network Index-SNI total people, SNI high contact networks], and social support brief Perceived Social Support Scale [PSS]).

RESULTS

We administered measures to 178 PD participants (Mage = 67.9; 81.5% at Hoehn & Yahr stage 2). There was strong internal consistency, content validity across outcomes, and a 1-factor structure (PSS, ULS3) and a 2-factor structure (dJGLS) for two measures each.

CONCLUSIONS

We provide a toolbox for clinicians and researchers studying social connection in PD.

The Moderated Mediating Effects of Social Media Identity and Loneliness on the Relationship Between Problematic Internet Use and Mental Health in China: Nationwide Cross-Sectional Questionnaire Study

BACKGROUND

Mental health disorders are a major public health challenge, and problematic internet use (PIU) may play an important role in this issue. However, the underlying mechanisms of PIU and its effects on mental health have not yet been elucidated.

OBJECTIVE

This study examines the mediating effect of loneliness on the relationship between PIU and mental health, as well as the moderating effect of social media identity on the relationships among PIU, loneliness, and mental health.

METHODS

A cross-sectional questionnaire survey was conducted on 21,292 participants recruited using a multistage stratified sampling strategy from 31 provinces/regions in mainland China from June 20 to August 31, 2022. This study assesses PIU (PIU questionnaire-short form-6), depression (9-item Patient Health Questionnaire [PHQ-9]), anxiety (7-item Generalized Anxiety Disorder scale [GAD-7]), loneliness (3-item loneliness scale), and social media identity (identity bubble reinforcement scale). Additionally, we collected the sociodemographic characteristics of the participants. Participants whose total score of PHQ-9≥15 or total score of GAD-7≥10 were considered to have moderate or severe symptoms of depression or anxiety, respectively. A moderated mediation model was established to examine the mediating effect of loneliness on the association between PIU and mental health outcomes (depression and anxiety), moderated by social media identity.

RESULTS

Approximately 22.80% (4854/21,292) and 14.20% (3023/21,292) of the respondents reported moderate or severe symptoms of depression and anxiety, respectively. Loneliness significantly mediated the association between PIU and mental health outcomes, explaining 42.53% and 45.48% of the total effect of PIU on depression and anxiety, respectively. Social media identity significantly moderated the associations between PIU and depression (β=0.002, 95% CI 0.001-0.002), PIU and anxiety (β=0.001, 95% CI 0.000-0.002), loneliness and depression (β=0.010, 95% CI 0.007-0.013), and loneliness and anxiety (β=0.007, 95% CI 0.004-0.010), but not between PIU and loneliness (β=0.000, 95% CI -0.003 to 0.003). Higher levels of social media identity were significantly associated with lower levels of loneliness (β=-0.018, 95% CI -0.020 to -0.016).

CONCLUSIONS

Addressing loneliness may serve as a valuable approach to mitigate the impact of PIU on mental health outcomes. However, social media identity poses a significant challenge in addressing health issues linked to PIU.

Loneliness: A Scoping Review of Reviews From 2001 to 2023

The growing number of primary studies and reviews on loneliness, and the multidisciplinary efforts to comprehend this complex phenomenon from various perspectives, underscore the heightened recognition of its impact on individual and societal well-being and health. To comprehensively assess the size and scope of this research field, we conducted a scoping review of 35 English-language reviews of primary studies on loneliness, published between 2001 and 2023. Focusing specifically on psychological research, these reviews covered a total of N = 1,089 studies, which were conducted between 1986 and 2022. In addition to providing a broad overview of the structure of the field, the present scoping review aimed to explore the methodological landscape of loneliness research, including data collection, sample demographics, and measures, and to present key topics and evidence in the field. By deepening the understanding of loneliness and identifying data gaps and methodological challenges, our analyses provide critical insights for future research endeavors, thereby fostering advances in the field.

A Neighbourhood-oriented approach to foster healthy ageing in low socioeconomic older adults: development and protocol for evaluation through intervention mapping

The rapid ageing of our society poses significant challenges, including an increase in chronic diseases and loneliness among older adults, leading to higher demands for care and support. Addressing these needs requires an integral approach, especially among older adults with low socioeconomic status (SES). This article details the development of the Neighbourhood Active & Connected (NAC) intervention, using the Intervention Mapping framework to expand an evidence-based physical activity intervention into a neighbourhood-oriented, holistic and systemic strategy for healthy ageing. NAC focuses on enhancing physical activity, social connectedness, and digital literacy. It was developed through co-creation with local stakeholders and low-SES older adults, ensuring optimal alignment with their needs and capabilities. Performance and change objectives were established based on literature consultation and an extensive need assessment, with intervention materials refined through engagement with the target group. The results of a large-scale cluster randomised controlled trial will be utilised to evaluate NAC's impact on physical activity, loneliness, social cohesion, health-related quality of life, and digital literacy among low-SES community-dwelling older adults. This paper aims to provide a detailed roadmap for researchers and practitioners to adapt, implement and evaluate similar interventions, promoting healthy ageing in low socio-economic contexts.

A tale of two belongings: social and academic belonging differentially shape academic and psychological outcomes among university students

The benefits of belonging in academic settings are well established; however, past empirical research has for the most part conflated academic and social belonging. This study utilized latent class analysis (LCA) with a sample of undergraduates (N = 837) to determine whether distinct classes or profiles of belonging exist on a college campus and whether class membership predicts academic and psychological outcomes. Four distinct belonging classes emerged: High Social, High Academic belonging (35%), Low Social, High Academic belonging (15%), High Social, Low Academic belonging (38%), and Low Social, Low Academic belonging (12%). The results show that belonging classes play different roles. For academic outcomes (GPA), academic belonging was important, but not social belonging. For psychological outcomes (stress and self-esteem), both academic and social belonging mattered but academic belonging mattered more. These findings demonstrate that investigating the distinctive roles of academic and social belonging is a fruitful theoretical and applied endeavor.

The relationship between social support and interpersonal self-efficacy among higher vocational college students: parallel mediation effects of anxiety and loneliness

BACKGROUND

There is close cooperation between higher vocational colleges and enterprises. Thus, higher vocational college students attach great importance to the internship experience in enterprises during their study period. They need to have more interaction and communication with school teachers, classmates and enterprise staffs, etc. Their interpersonal self-efficacy is important for developing and maintaining their good interpersonal relationships.

METHOD

To explore the effect of social support on the interpersonal self-efficacy of higher vocational college students and the parallel mediating role of anxiety and loneliness in it, a questionnaire survey and empirical analysis was conducted on 4,270 Chinese higher vocational college students by using the Social Support Scale for Adolescents, Interpersonal Communication Self-efficacy Scale for College Student, Self-rating Anxiety Scale and UCLA Loneliness Scale.

RESULTS

(1) social support significantly and positively predicts interpersonal self-efficacy; (2) social support influences interpersonal self-efficacy through the mediating effect of anxiety; and (3) social support influences interpersonal self-efficacy through the mediating effect of loneliness.

CONCLUSIONS

This study contributes to the understanding of the underlying mechanisms of the relationship between social support and interpersonal self- efficacy, thus providing references for higher vocational institutions and other related sectors to improve the interpersonal self-efficacy of higher vocational college students.

Association between cumulative loneliness and risk of cardiovascular diseases in middle-aged and older adults: A longitudinal study

OBJECTIVE

Previous longitudinal studies have investigated the association between baseline loneliness and the risk of developing cardiovascular diseases (CVD). Nevertheless, the cumulative effect of loneliness on CVD remains uncertain. The objective of this study is to assess the relationship between the cumulative duration of loneliness and the risk of CVD in middle-aged and older adults.

STUDY DESIGN

Prospective cohort study.

METHODS

The study utilized data from a sample of 8353 adults aged 45 years and older who participated in the China Health and Retirement Longitudinal Study (CHARLS). Loneliness was assessed biennially between 2011 and 2015, and categorized into four groups: never, one time point, two time points, and three time points. The Cox Proportional Hazards Regression Model was employed to estimate hazard ratios (HRs) and corresponding 95 % confidence intervals (CIs).

RESULTS

Following a mean follow-up period of 4.7 years (standard deviation: 0.7 years), a total of 1314 cases of CVD were identified, including 913 cases of heart disease and 504 cases of stroke. After adjusting for potential confounding factors, individuals who experienced loneliness at one time point (HR, 1.21; 95 % CI: 1.06, 1.38), two time points (HR, 1.23; 95 % CI: 1.03, 1.45), and three time points (HR, 1.50; 95 % CI: 1.19, 1.89) had a significantly higher risk of developing CVD compared to those who never experienced loneliness.

CONCLUSIONS

Cumulative loneliness was associated with increased risk of CVD in middle-age and older adults. Additional research is warranted to delve into the underlying mechanisms, while it is advisable to contemplate social interventions aimed at addressing loneliness.

C57BL/6J and C57BL/6N mice show distinct aging-associated behavioral alterations

Aging affects emotional, cognitive, and social functions, increasing susceptibility to neuropsychiatric conditions. C57BL/6 mice are commonly used to study aging mechanisms, yet differences between C57BL/6J and C57BL/6N substrains remain underexplored. This study compared aging-related behavioral changes in these substrains. Aging reduced exploratory activity and heightened anxiety in C57BL/6J, but not C57BL/6N, mice. Conversely, aging reduced social novelty preference in C57BL/6N, but not C57BL/6J, mice. Male mice of both substrains exhibited increased female urine sniffing with age. These findings highlight substrain-specific aging effects, underscoring the importance of substrain selection in behavioral studies of aged mice for drug development.

Mental Health in Swiss Veterinary Medicine Students: Variables Associated with Depression Scores

Mental health and well-being in veterinary students has become an important area of study, given the high levels of mental distress compared to other professions. Although research has identified poor mental health of veterinary students, few studies have examined positive factors such as self-compassion, which can have a favorable effect on mental health. The aim of this study was to examine self-reported symptoms of depression and factors influencing this construct, such as loneliness, self-compassion, and various demographic aspects in Swiss veterinary students. A sample of 374 Swiss veterinary students completed online measures including a demographic questionnaire, the Center for Epidemiological Studies Depression Scale-Revised (CESD-R), a short form of the University of California Loneliness Scale (UCLA-9), and the short form of the Self-Compassion Scale (SCS-SF). Results showed that 54.3% of the students were above the CESD-R cut-off score for depression, indicating a higher likelihood to suffer from depression. Results from the backward selection linear regression showed loneliness to be a risk factor, while self-compassion and rural upbringing were protective of depression. Findings suggest that Swiss veterinary students are highly burdened and may benefit from interventions aimed at reducing loneliness and improving self-compassion.

Role Identity, Loneliness, and Bereavement During the Pandemic in Japan: A Cross-Sectional Study

Background and Aims

The COVID-19 pandemic significantly restricted social activities, prompting a re-examination of community dynamics. In Japan, where families are central, the absence of a spouse increases susceptibility to loneliness and isolation. The loss of a spouse, especially during the pandemic, has heightened these issues among middle-aged and older individuals. Limited quantitative studies on pandemic-related bereavement in Japan underscore the need to understand the associated risks of loneliness and social isolation. This study aimed to examine the relationships between role identity as a member of the local community, loneliness, and social support among middle-aged and older adults. This study also examined whether there were differences in the relationships between those who had experienced bereavement and those who had not.

Methods

An Internet survey was conducted with Japanese adults (aged 50-74 years), including those who experienced bereavement during the pandemic. The final sample included 322 participants (154 in the bereavement group and 168 in the cohabiting group). The variables, measured using psychological scales, included role identity as a local resident, social capital (trust, reciprocity, and membership), loneliness, and social support (family and friendship).

Results

The higher trust and role identity were related to lower loneliness. Membership in the cohabiting group was related to lower level of loneliness and higher level of social supports. However, membership in the bereavement group was not related to either. Furthermore, trust and reciprocity were related to loneliness and social support.

Conclusion

These results indicated that the role identity and perception of social capital related to preventing isolation and loneliness for bereaved people.

Loneliness is associated with adverse health behaviour and obesity: a Danish population-based study of 122,258 individuals

BACKGROUND

Loneliness is a public health concern associated with increased morbidity and mortality. Adverse health behaviours and a higher body mass index (BMI) have been proposed as key mechanisms influencing this association. The present study aims to examine the relationship between loneliness, adverse health behaviour and a higher BMI, including daily smoking, high alcohol consumption, physical inactivity, unhealthy dietary habits, and obesity in men and women and across different life stages.

METHODS

We conducted a cross-sectional study using data from the 2017 Danish National Health Survey (entitled "How are you?"). Loneliness was assessed using the Three-Item Loneliness Scale. Logistic regression models were employed to analyse the association between loneliness, health behaviour and obesity in a sample of 122,258 individuals (16 + years). The models were adjusted for sex, age, educational attainment, country of origin, and partnership status. Stratified analyses were conducted to investigate differences by sex and life stages.

RESULTS

Loneliness was associated with an increased risk of daily smoking (Adjusted odds ratio (AOR) = 1.30; 95% CI: 1.21-1.40), physical inactivity (AOR = 1.87; 95% CI: 1.75-1.99), unhealthy diet (AOR = 1.58; 95% CI: 1.47-1.70), and obesity (AOR = 1.60; 95% CI: 1.49-1.72). Conversely, loneliness was associated with a reduced risk of high alcohol consumption in men (AOR = 0.82; 95% CI: 0.74-0.0.91).

CONCLUSIONS

Our study provides evidence that loneliness is associated with adverse health behaviour and obesity in both men and women and across the lifespan. These findings suggest that health behaviours and obesity may influence the association between loneliness and poor health outcomes. Longitudinal studies are needed to clarify the causal relationships underlying these associations.

Functional connectivity induced by social cognition task predict individual differences in loneliness

Loneliness is intricately connected to social cognition, yet the precise brain mechanisms that underscore their relationship need further exploration. The present study employed a theory of mind processing task that engaged participants in assessing the trajectories of geometric shapes while undergoing fMRI scans. The comprehensive data pool encompassed loneliness assessments and brain imaging data from a cohort of 157 participants. Utilizing a machine learning approach, task-induced functional connectivity data was used to forecast individuals' loneliness scores. The findings unveil that specific patterns of task-induced alterations in brain functional connectivity hold a remarkable capability to anticipate loneliness scores. Further dissection of the data disclosed pivotal nodes, including the prefrontal cortex, temporoparietal junction, and amygdala, among other cerebral regions. Furthermore, functional connectivity among the social network, the default mode network, and somatomotor networks emerged as crucial factors in prediction. Brain regions contributed strongly in prediction are involved in a variety of social cognitive processes, including intention inference, empathy, and information integration. The results illuminate the association between brain functional connectivity induced by social cognition and loneliness, which enhance the comprehensive understanding of this complex emotional state and may have implications for its diagnosis and intervention.

Exploring the impact of aging on motor imagery abilities: a systematic review with meta-analysis

Objective

Explore motor imagery (MI) abilities in healthy older adults compared with healthy younger adults.

Methods

A systematic review with meta-analysis.

Results

Twenty-seven cross-sectional studies were included. Meta-analyses explored MI abilities between healthy older and younger adults for the ability to generate kinesthetic (60-70 years: g = -0.24, 95%CI = -1.61, 1.13; 70-80 years: g = -1.29, 95%CI = -2.75, 0.17), and visual modality (g = -0.08, 95%CI = -0.71, 0.86); vividness in kinesthetic (g = 0.14, 95%CI = -0.13, 0.41), IV (g = 0.11, 95%CI = -0.16, 0.38), and EV modalities (g = 0.05, 95%CI = -0.15, 0.24); mental chronometry in timed-up and go (seconds = 0.63, 95%CI = -0.02, 1.27), and linear walk (seconds = 0.75, 95%CI = -0.55, 2.06); and MI-execution time congruence (performance overestimation) in linear walk (g = -0.02, 95%CI = -0.73, 0.69). Mental chronometry in upper limb movements was analyzed visually in forest plot indicating tendencies of greater time in older adults. Hand recognition in hand laterality judgment task visual analysis revealed a poorer accuracy, greater response time and lower efficiency in older adults.

Conclusion

Vividness of MI in kinesthetic and visual modalities appears to be preserved in older adults. Tendencies for greater time in mental chronometry were observed in older adults in TUG, linear walk and upper limb tasks. Implicit MI assessed with hand laterality showed older adults have lower accuracy, longer response times and lower efficiency. The ability to generate MI in kinesthetic and visual modalities presented imprecise results, and no clear conclusions could be drawn on MI-execution temporal congruence due to imprecision. Further research is needed to potentially clarify these findings.

Systematic review registration

PROSPERO: CRD42023384916.