Trajectories of loneliness during childhood and adolescence: predictors and health outcomes

Loneliness across the life span

Most people have experienced loneliness and have been able to overcome it to reconnect with other people. In the current review, we provide a life-span perspective on one component of the evolutionary theory of loneliness-a component we refer to as the reaffiliation motive (RAM). The RAM represents the motivation to reconnect with others that is triggered by perceived social isolation. Loneliness is often a transient experience because the RAM leads to reconnection, but sometimes this motivation can fail, leading to prolonged loneliness. We review evidence of how aspects of the RAM change across development and how these aspects can fail for different reasons across the life span. We conclude with a discussion of age-appropriate interventions that may help to alleviate prolonged loneliness.

Adolescent interpersonal relationships, social support and loneliness in high schools: Mediation effect and gender differences

The purpose of this study was to explore the associations between the qualities of different types of relationships in school, social support and loneliness in adolescence. Using a sample (N=1674) of adolescent students randomly selected from middle schools, we found boys' loneliness was influenced by the qualities of opposite-sex, teacher-student and same-sex relationships, whereas girls' loneliness was only influenced by same-sex relationships. Additionally, social support mediated the association between same-sex relationships and teacher-student relationships, and loneliness. Further, the quality of same-sex relationships showed stronger association with boys' loneliness than girls'. Finally, the quality of same-sex relationships showed the strongest association with boys' loneliness comparing with opposite-sex relationships and teacher-student relationships. These findings are discussed to illuminate the possible mechanisms by which interpersonal relationships could influence loneliness. In future research, causal relationships and other influencing factors on loneliness should be examined.

Daily cortisol activity, loneliness, and coping efficacy in late adolescence: A longitudinal study of the transition to college

Many late adolescents who transition to the college environment perceive changes in psychosocial stress. One such stressor, loneliness, has been associated with numerous health problems among adolescents and adults. The hypothalamic-pituitary-adrenal axis is one mechanism through which loneliness may affect health. Guided by a risk and resilience framework, the present study investigated the association between longitudinal changes in loneliness from high school to college and diurnal cortisol activity (waking levels, cortisol awakening response, diurnal slope) by sampling saliva intensively 5 times a day for 3 weekdays in a US sample of late adolescents in their first semester of college (N = 70; M_age = 18.49, SD = 0.38). The present study also explored how the link between loneliness and cortisol might depend on coping efficacy-one's belief in successfully coping with future stressors or novel situations. Results from hierarchical linear growth curve models demonstrated that an increase in loneliness across this contextual transition was associated with steeper cortisol slopes in college. Coping efficacy at baseline (in high school) significantly moderated the relation between changes in loneliness and diurnal slopes, such that late adolescents with low levels of coping efficacy who reported increased loneliness across the transition exhibited significantly flatter diurnal slopes in college. Higher levels of coping efficacy at baseline also significantly predicted lower waking cortisol levels during the first semester of college. These results suggest that coping efficacy may serve as a protective factor by contributing to regulation of daily physiological stress activity for late adolescents as they struggle with loneliness across the transition to college.

Peer Victimization and DRD4 Genotype Influence Problem Behaviors in Young Children

Decades of research supports the presence of significant genetic influences on children's internalizing (emotional), externalizing (acting out), and social difficulties, including victimization. Additionally, being victimized has been shown to relate to further behavioral problems. The current study assessed the nature of the gene-environment relationships between the DRD4 gene, peer victimization, and externalizing and internalizing difficulties in 6- to 10-year-old children. 174 children (56 % girls; 88.6 % Caucasian, 3.4 % African American, 8 % mixed race or Mayan) and their parents were administered victimization and problem behavior questionnaires, and DRD4 was genotyped for the children. An interaction between genes (DRD4) and environment (victimization) was significant and supported the differential susceptibility model for verbal victimization and child-reported externalizing behaviors. Children with the DRD4 7-repeat allele were differentially responsive to the verbal victimization environment, such that those experiencing little to no victimization reported significantly lower levels of externalizing behaviors, but if they experienced high amounts of victimization, they reported the highest levels of externalizing behaviors. Thus, consideration of how genes and environment affect children's experiences of victimization prior to adolescence is essential for understanding the trajectory of both externalizing and internalizing behaviors during adolescent development.

A Systematic Review of Loneliness and Smoking: Small Effects, Big Implications

BACKGROUND

Research supports an association between smoking and negative affect. Loneliness is a negative affective state experienced when a person perceives themselves as socially isolated and is associated with poor health behaviors and increased morbidity and early mortality.

OBJECTIVES

In this article, we systematically review the literature on loneliness and smoking and suggest potential theoretical and methodological implications.

METHODS

PubMed and PsycINFO were systematically searched for articles that assessed the statistical association between loneliness and smoking. Articles that met study inclusion criteria were reviewed.

RESULTS

Twenty-five studies met inclusion criteria. Ten studies were conducted with nationally representative samples. Twelve studies assessed loneliness using a version of the UCLA Loneliness Scale and nine used a one-item measure of loneliness. Seventeen studies assessed smoking with a binary smoking status variable. Fourteen of the studies were conducted with adults and 11 with adolescents. Half of the reviewed studies reported a statistically significant association between loneliness and smoking. Of the studies with significant results, all but one study found that higher loneliness scores were associated with being a smoker.

CONCLUSIONS/IMPORTANCE

Loneliness and smoking are likely associated, however, half of the studies reviewed did not report significant associations. Studies conducted with larger sample sizes, such as those that used nationally representative samples, were more likely to have statistically significant findings. Future studies should focus on using large, longitudinal cohorts, using measures that capture different aspects of loneliness and smoking, and exploring mediators and moderators of the association between loneliness and smoking.

Conceptualising loneliness in adolescents: development and validation of a self-report instrument

This paper reports the development and psychometric evaluations of a multidimensional model of loneliness in Australian adolescents. In the first study a new instrument was designed and administered to 1,074 adolescents (ages 10-18 years, M = 13.01). An exploratory factor analysis from data supplied by 694 of these participants yielded a 4-factor structure (friendship, isolation, negative attitude to solitude, and positive attitude to solitude). Competing measurement models were then evaluated using confirmatory factor analysis with data from the remaining 380 participants; strong support was demonstrated for the conceptual model. Significant main effects were evident for geographical location (rural remote/urban), age and sex. In a second study, involving 235 Australian adolescents (ages 10.0-16 years, M = 13.8) the superiority of the first-order model represented by four correlated factors was confirmed. The findings have clinical and practical implications for professional groups represented by child and adolescent psychiatry, pediatric and clinical psychology services, researchers, and educators. Specifically, the new self-report instrument identifies adolescents who are at risk of loneliness and its associated adverse outcomes and in doing has the potential to offer new insights into prevention and intervention.

Loneliness trajectories

This special section brings together five studies using group-based modeling to capture developmental trajectories of loneliness from age 7 through age 20. Together, the findings from these studies provide further evidence that developmental trajectories of loneliness are likely not best understood at a continuum but reflect distinct subpopulations that differ both where they start out and how they change over time in terms of mean levels of loneliness. Furthermore, adolescents who show chronically high loneliness or increasing loneliness over time exhibit poorer psychological and physical health, including greater incidence of depressive symptoms and more frequent suicide attempts. The findings from these studies also suggest that individuals experiencing increases in loneliness with age fare worse as well in terms of both physical and psychological health.

Trajectories of loneliness in adolescents with congenital heart disease: associations with depressive symptoms and perceived health

PURPOSE

Acquiring close peer relationships is an important developmental task in adolescence. This task may be particularly demanding for adolescents with congenital heart disease (CHD), who face disease-specific challenges putting them at risk for social isolation and loneliness. This study compared cross-sectional levels of loneliness in adolescents with and without CHD; examined the longitudinal course of loneliness and identified different developmental trajectory classes in adolescents with CHD; and investigated to what extent these trajectory classes are accompanied by differences in depressive symptoms and perceived health.

METHODS

A total of 429 adolescents with simple to complex CHD participated in the present longitudinal study consisting of three measurement waves with 9-month intervals (M(age) = 15.75 years at T1; 53.4% boys). The control sample at time 1 (T1) consisted of 403 adolescents who were matched in terms of age and sex.

RESULTS

Patients and controls did not differ in loneliness levels at T1. In adolescents with CHD, latent class growth analysis identified five trajectory classes (i.e., chronically high, high decreasing, moderate stable, low increasing, and stable low), which were meaningfully distinguished on depressive symptoms and several domains of perceived health. In general, adolescents in the chronically high loneliness trajectory reported the most depressive symptoms and the poorest perceived health, whereas adolescents in the low stable trajectory reported the opposite pattern.

CONCLUSIONS

Findings demonstrate that chronic feelings of loneliness are associated with worsened perceived health in adolescents with CHD. Intervention programs targeting patients' adjustment should be sensitive to the presence of such feelings.

Understanding loneliness during adolescence: developmental changes that increase the risk of perceived social isolation

Loneliness is typically defined in terms of feeling states. In this review, we take a somewhat different approach, describing loneliness in terms of perceived social isolation. Vulnerabilities to perceived social isolation differ across the lifespan. Unique properties of adolescence are identified that carry special risk for perceived social isolation. These include (but are not limited to) developmental changes in companions, developmental changes in autonomy and individuation, identity exploration, cognitive maturation, developmental changes in social perspective taking, and physical maturation. Scholars are encouraged to consider loneliness through the lens of perceived social isolation so as to better understand how the experience of physical isolation varies across adolescence.

Investigating hypervigilance for social threat of lonely children

The hypothesis that lonely children show hypervigilance for social threat was examined in a series of three studies that employed different methods including advanced eye-tracking technology. Hypervigilance for social threat was operationalized as hostility to ambiguously motivated social exclusion in a variation of the hostile attribution paradigm (Study 1), scores on the Children's Rejection-Sensitivity Questionnaire (Study 2), and visual attention to socially rejecting stimuli (Study 3). The participants were 185 children (11 years-7 months to 12 years-6 months), 248 children (9 years-4 months to 11 years-8 months) and 140 children (8 years-10 months to 12 years-10 months) in the three studies, respectively. Regression analyses showed that, with depressive symptoms covaried, there were quadratic relations between loneliness and these different measures of hypervigilance to social threat. As hypothesized, only children in the upper range of loneliness demonstrated elevated hostility to ambiguously motivated social exclusion, higher scores on the rejection sensitivity questionnaire, and disengagement difficulties when viewing socially rejecting stimuli. We found that very lonely children are hypersensitive to social threat.