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

Children's experiences of living with their mental ill-health - a scoping review

PURPOSE

This study aims to identify and summarize existing qualitative empirical research on children's experiences of living with their mental ill-health.

METHODS

A scoping review with a systematic search of the databases PubMed, CINAHL, and PsychINFO was conducted. The search generated 9,864 studies, which were screened by title, abstract, and full text.

RESULTS

Forty articles were included comprising 826 children aged 8-19 years. The key findings were described in four themes: Identifying oneself with mental ill-health, Managing suffering and daily challenges, Seeking supportive and caring relationships and Navigating a complex school environment. Being identified with mental ill-health brought challenges for children's everyday struggles. Their own coping strategies as well as supportive relationships with friends and adults were important. However, the balance between support and stress was complex.

CONCLUSIONS

Children have a desire to manage and comprehend their complex everyday lives of living with mental ill-health and wish for supported yet independent decision-making. Attitudes of friends, adults and professionals are important in providing understanding and non-judgemental support, valuable for children's well-being. Open conversations about mental health and providing accessible, child-centred interventions based on the needs expressed by children are necessary. This study contributes to the literature by emphasizing the central role of children's voices in matters of mental ill-health.

Fear of Positive Evaluation and Loneliness: Mediating Role of Social Anxiety and Suppression

Loneliness is a commonly observed problem that is associated with several mental and physical health outcomes. Although research shows that fear of negative evaluation is related to loneliness, no study has examined the role of fear of positive evaluation (FPE) on loneliness. This study investigated the mediator role of social anxiety and suppression in the relationship between FPE and loneliness using an undergraduate sample (N = 467). The results show that FPE is positively associated with loneliness and that this relationship is mediated by social anxiety and suppression. This study highlights the importance of the FPE in understanding loneliness and can guide intervention programs for loneliness.

Loneliness trajectories and predictors in Spain: Results from the Spanish longitudinal study on aging and health (Edad con Salud)

BACKGROUND

In recent years, loneliness has been recognized as a public health problem, exacerbated by the COVID-19 pandemic. This study aims to identify groups of people with different trajectories of loneliness, and to explore potential determinants (sociodemographic, social, psychological, and health-related) associated with these trajectories.

METHODS

In this 12-year longitudinal study, we analyzed data on 4537 Spanish adults from a nationwide representative survey. A growth mixture modeling approach was used to identify different loneliness trajectories and logistic regressions to explore the determinants of these trajectories.

RESULTS

Two trajectory classes were identified: low-stable (87.86 %) and high-fluctuating (12.14 %). Marital status, living status, migration, social isolation, depression, suicidal ideation, and cognitive complaints were identified as significant determinants of belonging to the high-fluctuating trajectory. Conversely, social support, social trust, and life satisfaction were protective factors for this trajectory.

CONCLUSION

This study revealed the presence of diverse courses of loneliness (each showing some distinctive characteristics from the other), outlining some relevant implications for the assessment, prevention, and management of loneliness.

Loneliness and ease of communication with parents and friends: cross-sectional study of adolescents in Denmark

BACKGROUND

Loneliness in adolescence is a serious threat to quality of life. The purpose of this study was to examine the association between loneliness and ease of communication with parents and friends, and whether the association was different for boys and girls.

METHODS

The study used data from the Danish arm of the international Health Behaviour in School-aged Children (HBSC). The surveys in 2010, 2014 and 2018 included nationally representative samples of students in the age groups, 11-, 13- and 15-year-olds (n = 10,425). Loneliness was measured by one item and ease of communication with parents and friends by the HBSC Ease of Communication Measure. Multilevel multivariate logistic regression was applied to study the associations between ease of communication and loneliness. Stratified analysis and interaction analysis tested the modifying effect of sex on the associations.

RESULTS

The prevalence of loneliness wa 4.3% among boys and 7.6% among girls. There was a strong negative association between loneliness and ease of communication. Compared to participants who found it very easy to communicate with their parents, those who found it very difficult were more likely to feel lonely (OR: 7.64, 95% CI: 5.74-10.15). The association was stronger for girls (OR: 11.89 (8.30-17.02)) than for boys (OR: 3.70 (1.98-6.91)). Similarly, participants who found it very difficult to communicate with friends were more likely to feel lonely than those that found it very easy (OR: 7.71 (5.87-10.12)), again this was stronger among girls (OR: 11.96 (8.19-17.47)) than boys (OR: 4.33 (2.61-7.17)). Analyses of statistical interaction showed that sex was a strong additive effect modifier of these associations.

CONCLUSION

The study found a remarkably strong negative association between loneliness and ease of communication with parents and friends, especially for girls.

The Mediating Role of School Burnout in the Relationship Between Adolescents' Perception of Loneliness and Quality of Life

PROBLEM

Adolescence is a challenging period of development characterised by social, physical, and cognitive changes. During this period, adolescents are particularly vulnerable to experiencing loneliness, burnout, and depressive symptoms. This study was conducted to determine the mediating role of school burnout in the relationship between adolescents' perception of loneliness and quality of life.

METHODS

This descriptive and correlational study was conducted with 301 adolescent students from a public high school in the capital of Türkiye. The data were collected using the Personal Information Form, the UCLA Loneliness Scale Short Form, the Quality of Life Scale for Children, and the School Burnout Scale. Descriptive statistics, Kruskal-Wallis analysis of variance, Mann-Whitney U test, and Spearman correlation analysis were conducted to evaluate the data. The mediating role of school burnout was examined through mediating variable analysis using Model 4 with the SPSS PROCESS macro.

FINDINGS

As a result of the research, loneliness, school burnout, and quality of life of adolescents are at medium levels. Loneliness negatively impacts adolescents' quality of life, with school burnout serving as a mediating factor. Addressing school burnout may improve outcomes.

CONCLUSION

In line with the study's results, not only nurses but also teachers, counselling units and families should participate in planning traning and practices that will positively affect adolescents' loneliness, quality of life and school burnout. Social support mechanisms in schools should be strengthened.

Owners of a conspiratorial heart? Investigating the longitudinal relationship between loneliness and conspiracy beliefs

Feeling positively connected to other people is a basic human need. If this need is threatened by feeling lonely, people might become more susceptible to conspiracy theories to help make sense of their surroundings. Simultaneously, conspiracy beliefs could lead to loneliness because they can strain existing relationships. Using two pre-registered longitudinal studies, we investigated the reciprocal relationship between loneliness and conspiracy mentality (Study 1, N = 1604) and the more malleable specific conspiracy beliefs (Study 2, N = 1502) during the COVID-19 pandemic. Random-intercept cross-lagged panel models showed that people who are, on average, lonelier are also more likely to believe in conspiracy theories. However, the data provided no support for the notion that conspiracy beliefs and loneliness predicted each other over time. The research helps to understand the thus far mixed evidence on loneliness and conspiracy beliefs and adds important insights to the literature on conspiracy beliefs and need deprivation.

Experiences of loneliness and social isolation among young people with chronic physical conditions: A thematic synthesis of qualitative studies

INTRODUCTION

Young people with chronic health conditions are among the most at risk of having poor social connections, however, little is known about their experiences of loneliness and social isolation. We aimed to describe the perspectives and experiences of loneliness and social isolation among young people with chronic physical conditions.

METHODS

We searched MEDLINE, Embase, PsycINFO, CINAHL, and CENTRAL from inception to May 2023 for qualitative studies that described the perspectives of loneliness and social isolation in young people aged 10-24 years with chronic physical conditions. Findings from the included studies were analyzed using thematic synthesis.

RESULTS

We included 35 studies across 12 countries involving 723 participants (56% female). Most studies (63%) were conducted in young people with cancer. Four major themes were identified: suffering from repercussions of disease (struggling with body image and physical changes, intensified disconnection while hospitalized); hindering relationships with peers and friends (missing out on formative experiences, feeling stuck behind, restrictive parental attitudes); grappling with social exclusion (facing concerns alone, bullying and ostracism); seeking social support and self-help (reliance on family, kindness and empathy from friends, developing rapport with healthcare professionals, discovering self in adversity).

CONCLUSIONS

Symptoms, treatments, and hospitalizations limited young people's social participation and ability to maintain friendships, and this was compounded by social exclusion and bullying. Supportive friends, family, and healthcare professionals helped mitigate feelings of isolation. Interventions and strategies are needed to improve social support and foster meaningful connections. This can be achieved through education and awareness initiatives that promote inclusion in schools and the community, as well as efforts to enhance social support and continuity of care in hospitals.

More envy, more loneliness? not only that: A longitudinal study and daily diary study

Although cross-sectional studies have explored the correlation between envy and loneliness, few longitudinal studies have investigated the bidirectional association between envy and loneliness at both trait and state levels. Here, through a longitudinal study and a daily diary investigation, we examined the interrelationships between envy and loneliness at both trait and state levels. In study 1, 288 college students answered the Dispositional Envy Scale (DES) and UCLA Loneliness Scale (UCL-8 Scale) twice with a one-year interval. The results of cross-lagged analysis indicated that dispositional envy could predict trait loneliness, while not vice versa. In study 2, using the adapted items form DES and UCL-8, a 14-day diary survey from a sample of 195 college students was conducted to investigate the interrelationship between state envy and state loneliness. The results of multivariate latent growth models and hierarchical linear models indicated that state envy could positively predict state loneliness and vice versa. Taken together, these findings uncover the bidirectional relationship between envy and loneliness at both the trait and state levels.

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.

The importance of friendship: influence of peer relationships on physical and mental health in youth with spina bifida

OBJECTIVE

To evaluate associations between peer relationship factors (i.e., quality and quantity) and mental and physical health outcomes in youth with spina bifida (SB).

METHODS

One hundred and forty youth with SB (Mage = 11.43; 53.6% female) were recruited as part of a larger longitudinal study. Families of youth with SB were invited to ask the child's closest friend to participate. The study included questionnaire (youth- and parent-report) and observational peer interaction data.

RESULTS

Observational peer interaction data were associated with mental and physical health in youth with SB. The number of friends was negatively associated with withdrawn/depressed behavior. Self-reported friendship quality and peer emotional support were not associated with physical health outcomes in youth with SB. However, peer emotional support was positively associated with emotional quality of life.

CONCLUSIONS

Friendship quality, particularly observed peer interaction characteristics, was associated with better mental and physical health adjustment. The quantity of friendships was not associated with physical health outcomes but was associated with mental health outcomes. Findings have implications for clinical interventions geared toward improving social functioning in youth with SB.

Loneliness trajectories and psychological distress in youth: Longitudinal evidence from a population-based sample

This pre-registered secondary analysis aimed to examine distinct longitudinal loneliness trajectories in youth and whether these trajectories were associated with psychological distress at final follow-up in the UK Household Longitudinal Study. Participants (N = 827, 55.1% female, Time 1: M ± SD = 16.50 ± 0.50 years) provided data during Waves 9, 10 and 11. K-means longitudinal clustering analysis was used to identify clusters of participants with distinct loneliness trajectories across measurement waves. We identified four clusters demonstrating distinct trajectories of loneliness: stable low (40.7%), stable high (20.6%), moderate decreasing (19.6%) and low increasing (19.1%). Compared to 'stable low loneliness', 'stable high' and 'low increasing' loneliness clusters were significantly associated with psychological distress at Wave 11 following adjustment for sex, ethnicity, parent's highest educational achievement and Wave 9 psychological distress. The current study offers an important contribution to the literature on patterns of youth loneliness and mental health consequences.

The Loneliness of the Odd One Out: How Deviations From Social Norms Can Help Explain Loneliness Across Cultures

Loneliness is an important health risk, which is why it is important to understand what can cause persistent or severe loneliness. Previous research has identified numerous personal or relational risk factors for loneliness. Cultural predictors, however, have been considered less. The new framework of norm deviations and loneliness (NoDeL) proposes that social norms, which are defining features of culture, can help explain loneliness within and across cultural contexts. Specifically, people who deviate from social norms are suggested to be at an increased risk for feeling lonely because they are more likely to experience alienation, inauthenticity, lower self-worth, social rejection, relationship dissatisfaction, and/or unfulfilled relational needs. Given that social norms vary by social, geographical, and temporal context, they can furthermore be considered cultural moderators between individual-level risk factors and loneliness: Personal or relational characteristics, such as shyness or being single, may increase the risk for loneliness particularly if they do not fit social norms in a specific environment. Integrating previous quantitative and qualitative findings, I hence offer a framework (NoDeL) to predict loneliness and cultural differences in risk factors for it. Thus, the NoDeL framework may help prepare culture-sensitive interventions against loneliness.

Increasing student well-being through a positive psychology intervention: changes in salivary cortisol, depression, psychological well-being, and hope

The significant prevalence of mental health problems among children and adolescents is a major concern worldwide. The current study evaluates the impact of a year-long, school-based intervention, Flourishing Students, on adolescents' salivary cortisol levels, depressive symptoms, psychological well-being, and hope. Utilizing a cluster randomized design with intervention and control classes, 72 students engaged in 32 well-being lessons during academic year 2016-2017, whereas 68 students followed their standard curriculum. Depressive symptoms and psychological well-being were assessed at three time points, while the stress hormone cortisol and hope were measured at two. The results showed a slight increase in cortisol levels from baseline to post-intervention during school hours in the control group, whereas no change occurred in the intervention group. Additionally, total cortisol levels at post-intervention were slightly lower among intervention-group students compared with control group students. Questionnaire data revealed significant interaction effects on psychological well-being and hope from baseline to post-intervention, and on depression and psychological well-being from baseline to the 5-month follow-up. The intervention group scored lower in depressive symptoms and higher in psychological well-being and hope compared with the control group. These findings underscore the essential role of comprehensive assessment methods in evaluating intervention efficacy in well-being programs.

Developmental trajectories of loneliness in Chinese children: Environmental and personality predictors

BACKGROUND

This study aimed to identify the developmental trajectories of loneliness in Chinese children and examine the predictive roles of domain-specific environmental factors (i.e., family dysfunction and satisfaction of relatedness needs at school), personality factors (i.e., neuroticism and extraversion), and their interactions in these developmental trajectories.

METHODS

A total of 702 Chinese children (Mage = 8.95, SD = 0.76; 54.1 % boys) participated in assessments at six time points over three years at six-month intervals. Growth mixture modeling (GMM) was used to estimate trajectory classes for loneliness, followed by multivariate logistic regression analyses exploring associations between these classes and predictors.

RESULTS

GMM analyses identified three distinct trajectories of loneliness: "low-stable" (81.5 %), "moderate-increasing" (9.4 %), and "high-decreasing" (9.1 %). Multivariate logistic regression analyses revealed that family dysfunction and neuroticism served as risk factors for adverse loneliness trajectories, while satisfaction of relatedness needs at school and extraversion acted as protective factors. Furthermore, the interaction between family dysfunction and extraversion indicated that extraversion did not mitigate the adverse effects of high family dysfunction on children's loneliness, emphasizing the vital need to support positive family functioning among all children.

LIMITATIONS

This study did not incorporate biological variables (e.g., genetics), which are crucial in the evolutionary theory of loneliness.

CONCLUSIONS

The identification of three distinct trajectory groups of children's loneliness, along with key environmental and personality predictors, suggests that interventions should be tailored to each group's unique characteristics.

Prevalence and associated factors of loneliness among in-school adolescents in three South Asian countries

Objective: We aimed to determine the prevalence and factors associated with loneliness among adolescent students in three South Asian countries.Methods: We used data from the latest Global School-Based Health Survey of Afghanistan, Bangladesh, and Pakistan. A two-stage cluster sampling design was used to collect the cross-sectional survey data. Data from 8 089 in-school adolescents were analysed using STATA 14.0.Results: Among all the participants, the prevalence of loneliness was 14.9%. The prevalence of loneliness was significantly higher in females (19.7%), Afghan adolescents (35.5%), participants having anxiety-induced sleep disturbance (51.4%), often experiencing bullying (28.9%), feeling hungry often or always (23.9%), suffering parental emotional neglect (21.2%), and spending ≥ 8 hours/day leisure time (35.8%), than their counterparts. The final adjusted model of multiple logistic regression showed that females (OR = 1.36, 95% CI: 1.02 -1.80), having no close friends (OR = 2.00, 95% CI: 1.30 - 3.10), having an anxiety-induced sleep disturbance (OR = 5.25, 95% CI: 3.75 - 7.34), being bullied 1 to 2 days in the past month (OR = 2.13, 95% CI: 1.60 - 2.84), being physically attacked 2 or more times in the past year (OR = 1.69, 95% CI: 1.26 - 2.26), suffering parental emotional neglect (OR = 1.67, 95% CI: 1.18-2.34), and current tobacco user (OR = 2.70, 95% CI: 1.39 - 5.25) had significantly higher odds of having loneliness.Conclusion: We found a higher prevalence of loneliness and identified several risk factors among in-school adolescents in three South Asian countries. To reduce loneliness among in-school adolescents, target-oriented interventions, such as peer, parental, and counselling support, are needed at schools.

Temperamental Shyness, Peer Competence, and Loneliness in Middle Childhood: The Role of Positive Emotion

Guided by the conceptual frameworks of social withdrawal (Rubin, K. H., & Chronis-Tuscano, A. (2021). Perspectives on social withdrawal in childhood: Past, present, and prospects. Child Development Perspectives, 15(3), 160-167.) and emotion socialization (Eisenberg, N., Cumberland, A., & Spinrad, T. L. (1998). Parental socialization of emotion. Psychological Inquiry, 9, 241-273.; Morris, (A) S., Criss, M. M., Silk, J. S., & Houltberg, (B) J. (2017). The impact of parenting on emotion regulation during childhood and adolescence. Child Development Perspectives, 11(4), 233-238.), the current study examined multifaceted relations among temperamental shyness, peer competence, and loneliness and focused on the role of socializing and expressing positive emotion in middle childhood. Participants included 1,364 families, among whom mothers reported children's temperament when children were 4.5 years old. Mothers and alternative caregivers (usually fathers) independently rated family expressiveness when children were 8-9 years old. Mothers rated their children's peer competence, and children's positive affect with peers were observed when children were ages 8-9 and 10-11. Children self-rated their loneliness levels at ages 10-11. A path model revealed a moderated mediation effect, such that family positive expressiveness moderated the sequential mediation pathway from child temperamental shyness through child peer competence at ages 8-9 and positive affect with peers at ages 10-11 to loneliness at ages 10-11. This sequential mediation was significant only under low but not high levels of family positive expressiveness. Findings support the importance of socializing positive emotion in the context of temperamental shyness and have implications for family-based intervention strategies aimed at children exhibiting high temperamental shyness.

Developmental Trajectories of Loneliness Among Chinese Early Adolescents: The Roles of Early Peer Preference and Social Withdrawal

This study aimed to examine distinct loneliness trajectories and to explore the roles of group-level peer preference and individual-level social withdrawal (i.e., unsociability and shyness) as predictors of these trajectories. Participants were 1134 Chinese elementary school students (Mage = 10.44 years; 565 boys). Data were collected from self-reports and peer nominations. Latent class growth analysis (LCGA) was employed to identify distinct trajectories of loneliness, and multinomial logistic regression was subsequently used to examine the relationships between these trajectories and their predictors. Results showed that three loneliness trajectories were identified: high increasing, moderate decreasing, and low decreasing. Participants at baseline with higher peer preference were more likely to belong to the low decreasing trajectory subgroup rather than the other two subgroups. Furthermore, those at Time 1 with higher unsociability had lower odds of being classified into the moderate or low decreasing trajectory subgroup compared to the high increasing trajectory subgroup. Additionally, participants at baseline with higher shyness had reduced likelihoods of following the low decreasing trajectory subgroup as opposed to the other two subgroups. These results have implications for how we understand both the different subgroups of loneliness trajectories and the predictions of peer preference and social withdrawal on these trajectories in Chinese early adolescents.

Exploring the Link Between Physical Activity, Sports Participation, and Loneliness in Adolescents Before and Into the COVID-19 Pandemic: The HUNT Study, Norway

BACKGROUND

The COVID-19 pandemic's effects on adolescents' physical activity, sports involvement, and feelings of loneliness remain inadequately understood. This study aimed to explore the shifts in leisure-time physical activity, sports participation, and loneliness among adolescents before and during the pandemic, positing that the pandemic has led to decreased physical activity and sports engagement, as well as heightened loneliness, where more active adolescents experience lower loneliness levels. This study included a prior four-year follow-up cohort from the same region two decades earlier to explore the existence of typical longitudinal aging effects in a cohort not affected by the pandemic.

METHODS

Prospective and longitudinal data from two cohorts of the Young-HUNT Study two decades apart involving adolescents aged 13-19 years were utilized. The controls were as follows: Cohort 1 from the Young-HUNT1 (YH1) Survey included 2399 adolescents with follow-up in the Young-HUNT2 (YH2) Survey four years later. Cohort 2 included the Young-HUNT4 (YH4) Survey (2017-2019) of 8066 adolescents, with a subset of 1565 participants followed up in the Young-HUNT COVID Survey (YHC) (2021) after exposure to the COVID-19 pandemic and associated restrictions. Changes over time were assessed using McNemar's tests and dependent sample T-tests, while multinomial logistic regression modeled within-individual changes in loneliness, adjusting for age, gender, and other factors.

RESULTS

The findings revealed a significant decline in physical activity and sports participation in both cohorts from early to late adolescence. Additionally, there was a considerable increase in reported loneliness, more after exposure to the pandemic and especially among girls, but without any difference in historical initial levels (between cohorts). Inactive adolescents faced a greater risk of increased loneliness, while those participating in sports had a lower risk of loneliness. Physically inactive boys had a higher risk of loneliness compared with physically active boys at both time points in Cohort 2, which was higher than in the control Cohort 1. There was no historical difference between initial assessments.

CONCLUSION

Adolescents experienced a significant decrease in physical activity and sports participation, along with increased loneliness, from early to late adolescence. Given the protective benefits of physical activity against loneliness and the negative longitudinal trends observed, public health initiatives should focus on increasing physical activity and reducing sports drop-out rates among adolescents to combat rising loneliness.

Loneliness and its associations with demographic, lifestyle, social and parental factors among adolescents in Timor-Leste

Adolescent loneliness is prevalent and has serious adverse impacts on mental and physical health outcomes. This study aimed at examining factors associated with loneliness among school-going adolescents. The country of interest is a low-income country, Timor-Leste, where empirical studies are lacking. Data from the Global School-Based Student Health Survey Timor-Leste 2015 (n = 3455) were used for secondary analyses. An ordered probit model was utilized to assess demographic, lifestyle, social, and parental factors correlated with different levels of loneliness (no loneliness, moderate loneliness, and severe loneliness). Approximately 46.3% of adolescents felt moderately lonely and about 13.5% felt severely lonely. Older adolescents were more likely to experience severe and moderate loneliness than younger adolescents. Going hungry and being bullied were associated with an increased likelihood of being severely and moderately lonely. Adolescents had a higher probability of experiencing moderate and severe loneliness if they had sleep difficulties and were physically active. Having understanding parents was positively associated with the likelihood of severe loneliness. In conclusion, a large proportion of adolescents in Timor-Leste have feelings of loneliness, which have been found to be associated with demographic, lifestyle, social, and parental factors. Policymakers should recognize the correlated factors of loneliness in order to formulate a more effective intervention strategy.

Loneliness and posttraumatic stress in U.S. adolescents: A longitudinal study

BACKGROUND

Loneliness and posttraumatic stress (PTS) are common in adolescence. However, there has been little longitudinal research on their association. To address this deficit, this study examined the longitudinal association between these phenomena in a sample of U.S. school students while also exploring if gender was important in this context.

METHODS

Data were analysed from 2807 adolescents (52.1 % female; age at baseline 11-16 years (M = 12.79)) who were followed over a one-year period. Information was obtained on loneliness in year 1 using a single-item question, while PTS was assessed with the self-report Child Post-Traumatic Stress - Reaction Index (CPTS-RI). A full path analysis was performed to assess the across time associations.

RESULTS

Almost one-third of the students reported some degree of loneliness while most students had 'mild' PTS. In the path analysis, when controlling for baseline PTS and other covariates, loneliness in year 1 was significantly associated with PTS in year 2 (β = 0.06, 95%CI: 0.02, 0.09). Similarly, PTS in year 1 was significantly associated with loneliness in year 2 (β = 0.19, 95%CI: 0.15, 0.23). An interaction analysis further showed that loneliness was higher in girls with PTS than in their male counterparts.

LIMITATIONS

The use of a single-item measure to assess loneliness that used the word 'lonely' may have resulted in underreporting.

CONCLUSION

Loneliness and PTS are bidirectionally associated in adolescence. Efforts to reduce loneliness in adolescence may help in combatting PTS, while clinicians should intervene to address loneliness if detected in adolescents with PTS.

Associations of state and chronic loneliness with interpretation bias: The role of internalizing symptoms

Loneliness is common and, while generally transient, persists in up to 22% of the population. The rising prevalence and adverse impacts of chronic loneliness highlight the need to understand its underlying mechanisms. Evolutionary models of loneliness suggest that chronically lonely individuals demonstrate negative interpretation biases towards social information. It may also be that such biases are exacerbated by momentary increases in state loneliness, or elevated anxiety or depression. Yet, little research has tested these possibilities. The current study aimed to advance understandings of loneliness by examining associations of chronic loneliness with individual differences in negative interpretation bias for social (relative to non-social) stimuli, and testing whether these associations change in the context of increased state loneliness and current levels of anxiety and depressive symptoms. These aims were explored in 591 participants who completed an interpretation bias task before and after undergoing a state loneliness induction. Participants also self-reported chronic loneliness, anxiety, and depression. Linear mixed models indicated that only state (but not chronic) loneliness was associated with more positive interpretations of non-social stimuli, with greater anxiety and depressive symptoms predicting more negative interpretations. Implications of these findings for present theoretical models of loneliness are discussed.

Why So Lonely? The Direct and Indirect Associations between Developmental Trajectories of Fear of Negative Evaluation, Prosocial Behavior and Loneliness in Adolescence

Fear of negative evaluation and prosocial behavior have been identified as predictive factors influencing the development of loneliness in adolescence, representing typical factors in the cognitive and behavioral processes of re-affiliation. The elucidation of plausible direct and indirect pathways linking these pivotal factors to adolescents' loneliness need further exploration. This study aimed to investigate the direct and indirect relationships between the fear of negative evaluation, prosocial behavior, and adolescents' loneliness through the lens of developmental changes. A total of 533 adolescents (49.0% girls, Mage = 15.18 years, SD = 0.71) participated in this longitudinal study, assessed at three timepoints over a span of two years with 12-month intervals. Latent growth modeling uncovered direct associations between the developmental trajectories of both fear of negative evaluation and prosocial behavior with the developmental trajectory of adolescents' loneliness. The developmental trajectory of fear of negative evaluation exhibited an indirect association with the developmental trajectory of loneliness through the mediating role of prosocial behavior. These findings highlighted the roles of cognitive and behavioral re-affiliation processes, both independently and as mediators, in influencing adolescent loneliness, suggesting that interventions aimed at reducing fear of negative evaluation and promoting prosocial behavior could effectively mitigate adolescents' loneliness.

Loneliness in the Digital World: protocol for a co-produced ecological momentary assessment study in adolescents

INTRODUCTION

Loneliness has been identified as an important public health issue, peaking during adolescence. Previous research has suggested that social interaction is a key factor in loneliness, and positive social interaction can act as a protective factor against loneliness. However, it is unclear whether there are differing impacts of in-person and online social interaction on adolescents' loneliness and mental health. Ecological Momentary Assessment (EMA) designs are ideally suited for better understanding these associations.

METHOD AND ANALYSIS

In the 'Loneliness in the Digital World' study, we will use a co-developed EMA design to capture daily social interactions, loneliness and mental health such as positive and negative emotions, depression and anxiety in approximately 200 adolescents aged 12-15 years. We will combine this with comprehensive information gathered from online surveys. Analysing the data using techniques such as dynamic structural equation modelling, we will examine, among other research questions, the associations between online and in-person social interaction and feelings of loneliness. The results can help inform interventions to support adolescents with high levels of loneliness and poor mental health.

ETHICS AND DISSEMINATION

We received the ethics approval for the data collection from The Academic and Clinical Central Office for Research and Development, followed by the College of Medicine and Veterinary Medicine Ethics panel at University of Edinburgh, and finally reviewed by East of Scotland Research Ethics Service. The results will be disseminated through journal publications, conferences and seminar presentations and to relevant stakeholders such as teachers.

The Role of School Connectedness and Friend Contact in Adolescent Loneliness, and Implications for Physical Health

The current study investigated how adolescents' loneliness relates to school connectedness, classmate support, teacher support, and offline and online communication with friends. We also examined the association between loneliness, physical health, and sleep. Data came from the Scottish Health Behavior in School-aged Children (HBSC). The total sample was 2983 adolescents (F = 1479 [49.6%]) aged 14-17 years (M = 15.66, SD = 0.39) from 117 secondary schools in Scotland. Results showed that (1) higher teacher support, classmate support, and offline contact with friends predicted lower levels of loneliness, (2) online friendship engagement predicted higher levels of loneliness, and (3) poor health and sleep were positively associated with loneliness. The study offers new findings, highlighting the role played by classmates/peers and teachers in reducing loneliness. Supporting previous research, we also found associations between loneliness, poor sleep, and worse physical health.

Parents' use of digital technology for social connection during the COVID-19 pandemic: A mixed-methods study

INTRODUCTION

The COVID-19 pandemic (2020-2021) resulted in isolation due to social distancing rules and lockdowns, during which technology was used to enable families and friends to maintain contact. Despite loneliness being high in parents, little is known about which parents are more likely to experience loneliness and strategies to support them.

METHOD

This mixed-methods study examines which parents were lonely during the pandemic and how digital technologies were used to reduce loneliness and social isolation. Data were collected during the first UK lockdown from May to July 2020 via an online survey (N = 145) and follow-up interviews (n = 13).

RESULTS

Loneliness reported during lockdown was greater than retrospective reporting of loneliness for all respondents, but it was higher in single parents, those caring for children with specific needs, and those with lower household incomes before and during lockdown. Parents rapidly adapted to and experimented with using technology for social connection during the lockdown, which helped to reduce feelings of isolation and loneliness. Video calling was found to be useful for making connections and enhancing social presence, but parents also experienced anxieties and difficulties with its use. There were mixed views about technology use; some were keen to continue using technology for socializing after the lockdown ended, but for others, it was only a temporary measure.

CONCLUSION

Although technology was invaluable during the pandemic, it was not a panacea, and the way parents used it was influenced by their approach to technology and existing social behaviors and networks.

Attributions of Loneliness-Life Story Interviews with Older Mental Health Service Users

There is growing evidence on the prevalence and impact of loneliness, particularly among older people. However, much less is known about the personal origins of loneliness and how it persists, or not, over an individual's life course. This study aimed to increase understanding of the personal experiences of loneliness among older adults across the life course. Central to this study was giving voice to the participants and allowing them to define loneliness, what it meant to them, and how it affected them throughout their lives. This qualitative study employed 18 life story interviews with older adults attending a mental health service. We explored their personal experiences of loneliness and the situations and factors associated with loneliness across the life course. We identified three distinct typologies of loneliness: those who experienced (1) chronic loneliness since childhood, (2) chronic loneliness after a life-changing event in midlife, and (3) loneliness which remained situational/transitional, never becoming chronic. This study found the seeds of chronic life course loneliness are often determined in childhood. Early detection and intervention may prevent situational loneliness from becoming chronic. More research is needed from a life course approach to help understand and address the causes and consequences of loneliness.

Comparing frequencies of adolescent suicide attempters pre- and during COVID-19 pandemic school terms

BACKGROUND

The COVID-19 pandemic had and still have a major impact on adolescent mental health and consequently on suicidal behavior. However, few studies have investigated whether the pandemic has changed the patterns and the triggers of suicidality peaks in adolescents, e.g., seasonal patterns or family conflicts. We hypothesized that the pandemic modified suicidality rates: an increment of suicide attempts would be observed in the first semester of the academic year during COVID-19 pandemic compared to the same period of previous academic year; and the precipitating factors would be more related to social stressors during the pandemic school year.

METHODS

A retrospective cross-sectional study was conducted to assess the precipitating factors, also including school-related factors and cognitive skills, of adolescent suicide attempters occurred in the first and second semesters of the year before the pandemic lockdown (study periods 1 and 2) and the year after (study periods 3 and 4).

RESULTS

The sample consisted of 85 adolescents aged between 12 and 17 recruited consecutively from March 2019 to March 2021 at emergency ward because of suicide attempt. Forty-eight adolescents (55.3% of the sample) were attended before the lockdown (pre-pandemic group) and 38 (44.7%) the year after. The results showed a higher proportion of female suicide attempters in period 4 (Sept 2020-Feb 2021) respect to period 3 (Mar 2020-Aug 2020), i.e., pandemic semesters compared with the increment observed between period 2 and 1 (prepandemic semesters; Fisher's exact test = 4.73; p = 0.026). The multinomial regression models showed a significant effect in the frequency of adolescents who attempted suicide (ratio χ2 = 15.19, p = 0.019), accounted by the differences between period 4 (Sept 2020-Feb 2021) and period 1 (Mar 2019-Aug 2019), with depressive symptoms being a significant contributing factor (Exp(b) = 0.93; p = 0.04). Additionally, social triggers and age were found to be significant risk factors for suicide attempts in the first semester of the pandemic academic year (period 4) compared to the same semester of the pre-pandemic year (period 2; Exp(b) = 0.16, p = 0.01, and Exp(b) = 1.88, p = 0.006, respectively).

CONCLUSIONS

During the pandemic, the decrement between first and second semester of the number of females attempting suicide was more pronounced than in the prepandemic school year -though this findings lacked statistical power due to very limited sample size-. Change in the frequency of adolescent attempting suicide in the different school periods was associated with greater severity of depressive symptoms. Social relations in back-to-school after the lockdown were also associated with the number of adolescents attempting suicide.

Trajectories of Loneliness During Adolescence Predict Subsequent Symptoms of Depression and Positive Wellbeing

There is a need to identify the outcomes of changes in loneliness during adolescence, and to consider this within a multidimensional framework of loneliness. This study considered the effects of different trajectories of change in Isolation Loneliness and in Friendship Loneliness upon both positive wellbeing and symptoms of depression. To achieve this, 1782 (43% female; 12.92 years old at the start of the study, SD = 1.60) young people took part in a longitudinal study with four data points across 2 years. Four Isolation Loneliness trajectories and five Friendship Loneliness trajectories were identified. Youth who experienced low levels of Isolation Loneliness that subsequently increased appear to be at particular risk for poor outcomes. Similarly, initially high levels of Friendship Loneliness that decreased rapidly, or which began at a low level and only increased marginally, seem to also be a risk. Loneliness is a multi-dimensional construct and its development during adolescence impacts upon young people's depressive symptomatology and positive mental wellbeing.

Loneliness in Young People with ADHD: A Systematic Review and Meta-Analysis

Many studies focus on problematic peer functioning in attention deficit/hyperactivity disorder (ADHD) but loneliness has been studied less. This paper examined (1) The loneliness level differences between young people (below 25 years old) with ADHD and those without ADHD, and (2) The association between loneliness and mental health difficulties in young people with ADHD. Six electronic databases were searched and 20 studies were included. A random effects meta-analysis was carried out in RStudio using the metafor package for the first question, while a narrative synthesis summarized the findings for the second question. The meta-analysis (n = 15) found that young people with ADHD reported significantly higher loneliness than those without ADHD, with a small-to-medium weighted pool effect (Hedges' g = 0.41) and high heterogeneity (I2 = 75.1%). For the second question (n = 8), associations between loneliness and mental health difficulties in ADHD was found (r = 0.05-0.68). Targeted research and interventions on loneliness in young people with ADHD is needed.

Longitudinal relationships across emotional distress, perceived emotion regulation, and social connections during early adolescence: A developmental cascades investigation

Early adolescence is a vulnerable period for emotional distress. Both emotion regulation and social connection to peers and family adults are understood to be associated with distress. However, existing longitudinal work has not explored these constructs jointly in a way that estimates their reciprocal relationships over adolescence. We present a three-wave random-intercepts cross-lagged panel model of reciprocal relationships between emotional distress, perceived emotion regulation, and social connections during early adolescence, among 15,864 participants from education settings in disadvantaged areas of England, over three annual waves (at ages 11/12, 12/13, and 13/14 years). Findings showed that emotional distress and perceived emotion regulation share a negative relationship over time, and that higher perceived emotion regulation predicts greater family connection in the initial stages of early adolescence (from age 11-12 to 12-13 years). Findings also indicated that connection to peers is positively associated with family connection, but also positively predicts slightly greater distress in the later stages of early adolescence (from age 12-13 to 13-14 years). Findings indicate a risk of negative spiral between emotional distress and perceived emotion regulation in early adolescence, and that social connection may not necessarily play the role we might expect in reducing distress.

Alcohol use among in-school adolescents in Sierra Leone

OBJECTIVE

To examine the prevalence of alcohol use and its associated factors among in-school adolescents in Sierra Leone.

DESIGN

Data for the study was sourced from the 2017 Sierra Leone Global School-Based Student Health Survey, a nationally representative survey conducted among in-school adolescents aged 10-19 years using a multistage sampling methodology. Percentages were used to present the prevalence of alcohol use among in-school adolescents. Multivariable binary logistic regression analysis was performed to examine the factors associated with alcohol use among in-school adolescents. The results were presented using adjusted odds ratios (aOR) with their respective 95% confidence interval (CI).

SETTING

Sierra Leone.

PARTICIPANTS

A weighted sample of 1730 in-school adolescents in Sierra Leone.

OUTCOME MEASURE

Current alcohol use.

RESULTS

The prevalence of alcohol use among in-school adolescents was 10.7% (7.3, 15.3). In-school adolescents in senior secondary schools were more likely to use alcohol compared with those in junior secondary school (aOR=2.13; 95% CI 1.37, 3.30). The odds of alcohol use was higher among in-school adolescents who were truant at school relative to those who were not (aOR=2.24; 95% CI 1.54, 3.26). Also, in-school adolescents who were bullied (aOR=1.85; 95% CI 1.24, 2.76), ever engaged in sexual intercourse (aOR=2.06; 95% CI 1.39, 3.06), and used marijuana (aOR=3.36; 95% CI 1.72, 6.53) were more likely to use alcohol compared with those who were not. However, in-school adolescents who reported that their parents understood their problems (aOR=0.52; 95% CI 0.33, 0.82) had a lower likelihood of consuming alcohol.

CONCLUSION

Our study has shown that alcohol use is prevalent among in-school adolescents in Sierra Leone. Grade level, experiences of being bullied, history of sexual intercourse, truancy at school, and previous use of marijuana were the factors influencing alcohol use among in-school adolescents. The findings emphasise the necessity of creating school-based health interventions in Sierra Leone that can effectively identify in-school adolescents potentially vulnerable to alcohol-related issues. Also, existing policies and programmes aimed at reducing alcohol use among in-school adolescents need to be strengthened.

The relationship between loneliness and the experiences of everyday stress and stressor-related emotion

Loneliness influences how people experience and respond to stressors, which may account for its role as a risk factor for morbidity and mortality. The present study was motivated by emerging evidence that affective responses to minor daily events have long-term implications for health and well-being. Specifically, we evaluated how individual differences in loneliness relate to the frequency of everyday stressors and stressor-related negative emotions. A diverse community sample of 255 adults (age 25-65 years) completed ecological momentary assessments (EMA), during which they reported recent stressors and current negative affect (NA) five times a day for 14 days. Multilevel logistic analyses indicated that there was a quadratic association between loneliness and likelihood of reporting stressors, controlling for demographics, social isolation, depressive symptoms, and context (current activities, current location). Multilevel regression indicated that loneliness was unrelated to the concurrent effect of stressors on NA but significantly larger lagged stressor effects were observed among individuals in the low and high ranges of loneliness. These findings suggest that individuals with high levels of loneliness are more likely to experience everyday stressors and have prolonged emotional responses following stressors.

Bullying at School, Cyberbullying, and Loneliness: National Representative Study of Adolescents in Denmark

AIMS

The aim was to examine how loneliness was associated with bullying victimization at school and online.

METHODS

We used data from the Danish arm of the international Health Behavior in School-aged Children (HBSC) study from 2022. The study population was a nationally representative sample of 11-15-year-olds who completed the internationally standardized HBSC questionnaire at school, n = 5382. Multilevel logistic regression was applied to study the associations between bullying victimization and loneliness.

RESULTS

The prevalence of reporting loneliness often or very often was 9.0%; 6.3% of the sample experienced habitual bullying victimization at school, and 4.8% incurred cyberbullying. There was a strong and graded association between loneliness and bullying victimization at school and cyberbullying. The associations were significant for boys and girls, and the association between exposure to bullying at school and loneliness was steeper for boys than girls. The gradients were steeper for physical bullying than for cyberbullying. Students exposed to habitual bullying in both contexts had an adjusted OR (95% CI) of 11.21 (6.99-17.98) for loneliness.

CONCLUSION

Exposure to bullying at school and cyberbullying are strongly associated with loneliness. It is important to reduce bullying at school and on the internet and to promote effective interventions to reduce continuing loneliness.

Identifying characteristics of adolescents with persistent loneliness during COVID-19: A multi-country eight-wave longitudinal study

Background

Elevated loneliness experiences characterise young people. While loneliness at this developmental juncture may emerge from age-typical upheaval in social relationships, there is little data on the extent to which young people experience high and persistent levels of loneliness, and importantly, who is most vulnerable to these experiences. Using the widespread social restrictions associated with the COVID-19 pandemic, which precipitated loneliness in many, we aimed to examine adolescents' loneliness profiles across time and the demographic predictors (age, sex, and country) of more severe trajectories.

Methods

Participants aged 12-18 years, recruited into a multi-wave study (N = 1039) across three sites (UK, Israel, and India) completed a 3-item loneliness measure fortnightly across 8 timepoints during the pandemic.

Results

Latent class growth analysis suggested 5 distinct trajectories: (1) low stable (33%), (2) low increasing (19%), (3) moderate decreasing (17%), (4) moderate stable (23%), and (5) high increasing (8%). Females and older adolescents were more likely to experience persistently high loneliness.

Conclusions

These findings indicate a need for interventions to reduce loneliness in adolescents as we emerge from the pandemic, particularly for those groups identified as being at highest risk.

Profiles of Loneliness and Ostracism During Adolescence: Consequences, Antecedents, and Protective Factors

This longitudinal study (N = 1078, 46% boys; 54% girls) examined profiles of loneliness and ostracism during adolescence and their consequences and antecedents. Longitudinal latent profiles analyses identified four distinct profiles: (1) High emotional loneliness (25%), High and increasing social loneliness (15%), High peer exclusion and high social impact (9%) and No peer problems (51%). Subsequent internalizing problems were typical for the High and increasing social loneliness profile and externalizing problems for the High emotional loneliness and High peer exclusion and high social impact profiles. Furthermore, effortful control, prosocial skills, and relationship quality with parents and teachers were highest in the No peer problems profile, whereas the High and increasing social loneliness profile had the lowest self-esteem and was characterized by low surgency/extraversion, high affiliativeness, and high negative affectivity.

The relationship between loneliness and problematic social media usage in Chinese university students: a longitudinal study

BACKGROUND

A significant number of cross-sectional studies have explored the correlation between loneliness and problematic social media use. However, the causal relationship between these two key variables remains controversial, and the developmental relationship over time is unclear.

METHODS

We conducted a one-year longitudinal study with 538 Chinese college students using questionnaires and employing cross-lagged and latent growth models to investigate the causal relationship and developmental dynamics between loneliness and problematic social media use.

RESULTS

The results indicate that (a) loneliness and problematic social media use mutually and positively influence each other, establishing a bidirectional causal relationship; (b) Chinese college students experience a gradual increase in levels of loneliness and problematic social media use during their time in college; and (c) the intercept and slope of loneliness significantly and positively affect the intercept and slope of problematic social media use, and conversely, the intercept and slope of problematic social media use significantly and positively influence the intercept and slope of loneliness.

CONCLUSION

These findings reveal the longitudinal relationship between loneliness and problematic social media use among Chinese college students and offer insights for researchers and educators to intervene in college students' loneliness and problematic social media use from a developmental perspective.

Associations between social loneliness trajectories and chronotype among adolescents

Late chronotype during adolescence is a critical risk factor for poor physical and mental health among adolescents. While social loneliness is confirmed to negatively influence sleep behaviors, the long-term effect of social loneliness on chronotype remains unknown. This study aims to investigate whether social loneliness trajectories from middle childhood to adolescence are associated with chronotype in late adolescence and examine the potential sex differences in these associations. Data were obtained from 2398 adolescents who participated in the Child and Adolescent Behaviors in Long-Term Evolution project. Chronotype was calculated as the midpoint of sleep on free days adjusted for sleep debt. Group-based trajectory modeling and multiple linear regression were employed to establish social loneliness trajectories and determine their associations with chronotype. Social loneliness trajectories were significantly associated with chronotype and varied by sex. Specifically, boys following a high-decreasing trajectory had earlier chronotype during late adolescence than did those following a low-decreasing trajectory (B =  - 0.07; p < 0.05). By contrast, girls following a low-to-moderate-increasing trajectory exhibited later chronotype than did those following a low-stable trajectory (B = 0.07; p < 0.01). Social loneliness trajectories, especially those displaying significant fluctuations over time, are critical indicators influencing chronotype among adolescents. Furthermore, these trajectories and their associations with chronotype display sex differences. These findings highlight the need for early interventions for psychological factors such as social loneliness to ensure that the late chronotype can be prevented. In addition, sex variations must be considered.

Adolescents' and young people's experiences of social relationships and health concerns during COVID-19

PURPOSE

To illuminate the meaning of social relationships and health concerns as experienced by adolescents and young people during the COVID-19 pandemic.

METHODS

A longitudinal qualitative study was conducted. Data reported from 172 adolescents and young people aged 12-24 years in five countries; Chile, South Africa, Sweden, the United Kingdom and the United States collected from May 2020 to June 2021 were analysed via thematic analysis.

RESULTS

Adolescents and young peoples' experiences of social relationships and health concerns were described in seven themes: Family proximity, conflicts and frustration; difficulties and challenges related to limited living space; peer relations and maintaining friendship in times of social distancing; the importance of school as a place for interaction; vulnerability, emotional distress and uncertainty about the future; health concerns and sense of caring for others; and worries and concerns related to financial hardship. These reports show that the changes to everyday life that were introduced by public responses to the pandemic generated feelings of loneliness, vulnerability, and emotional distress, as well as increased sense of togetherness with family.

CONCLUSIONS

The everyday lives of adolescents and young people were restricted and affected more by the consequences of the pandemic than by the COVID-19 virus. These experiences had various impacts on well-being and mental health, where some individuals felt more exposed and vulnerable to emotional distress and loneliness than others. Family and peer relationships could be protective and support a sense of togetherness and belonging. Hence, social relationships are important to provide emotional support. Support for adolescents and young people should be tailored accordingly around social and emotional concerns, to encourage health and well-being.

A Short-Form Measure of Loneliness to Predict Depression Symptoms Among Adolescents

The purpose of this study was to produce a short-form measure of loneliness and assesses its prediction of depressive symptoms relative to a comprehensive measure. Western Australian adolescents completed the Friendship Related Loneliness and Isolation subscales of the Perth Aloneness Scale (PALs) three times over 18 months (T 1 n = 1538; T 2, n = 1683; T 3, n = 1406). Items were reduced while preserving predictability. Follow-up confirmatory factor analyses and predictive models with the reduced and full PALs were then tested. A reduced six-item scale (PALs-6) preserved the two-factor structure of the PALs and showed strong prediction of very elevated depressive symptoms (Sensitivity = 0.70, Specificity = 0.78, AUC = 0.81); it was less successful in predicting future symptoms (Sensitivity = 0.67, Specificity = 0.64, AUC = 0.74). The PALs-6 provides a brief measure of adolescent loneliness for clinicians and researchers that also predicts very elevated levels of depression.

Loneliness in the Norwegian adolescent population: prevalence trends and relations to mental and self-rated health

BACKGROUND

Loneliness has become a significant public health problem and should be addressed with more research over a broader period. This study investigates the variations in the prevalence of loneliness among a nationally representative study population of Norwegian adolescents over the last three decades and whether age, gender, self-rated health, and mental distress are associated with these changes.

METHODS

Adolescents aged 13-19 years completed the structured and validated questionnaires from the three waves of the Young-HUNT Study: 1995-1997, 2006-2008, and 2017-2019. Loneliness was measured with one item asking, 'Are you lonely?'. Hopkins Symptom Checklist-5 was used to measure mental distress (cut-off ≥ 2). Self-rated health was assessed by a single question 'How is your health at the moment?' Measures were provided by self-report. Descriptive analyses were stratified by age, gender, self-rated health, and mental distress. Linear-by-Linear association test across survey years was performed to test time trends of loneliness. Logistic regression was used to analyze the cross-sectional associations of self-rated health and mental distress with loneliness, adjusting for sociodemographic factors in all three waves of Young-HUNT.

RESULTS

Loneliness prevalence doubled from 5.9% in 1995/97 to 10.2% in 2017/19 in the total population sample. The highest loneliness prevalence and an increase from 8.9% in 1995/97 to 16.7% in 2017/19 was observed in girls of 16-19 years. Among mentally distressed adolescents, loneliness increased from 22.3% in 1995/97 to 32.8% in 2006/08 and lowered to 27% in 2017/19. Increasing loneliness prevalence was seen in those with poor self-rated health, i.e., 14.6% in 1995-97 and 26.6% in 2017-19. Mental distress and poor self-rated health were associated with higher odds of loneliness in each wave (p < 0.001).

CONCLUSION

The results highlight the increasing burden of loneliness in the Norwegian adolescent population, especially girls. Those with mental distress and poor self-rated health have a higher risk of experiencing loneliness. Thus, health-promoting upbringing environments for children and adolescents that support mutual affinity, social support, integration, and belongingness in adolescents' daily arenas are essential.

Examining the impact of a universal social and emotional learning intervention (Passport) on internalising symptoms and other outcomes among children, compared to the usual school curriculum: study protocol for a school-based cluster randomised trial

BACKGROUND

School-based universal social and emotional learning (SEL) interventions implemented during the transition to adolescence may be efficacious in preventing the development of mental health difficulties. This protocol describes a two-arm parallel cluster randomised controlled trial to investigate the impact of a universal SEL intervention (Passport, compared to usual provision) on internalising symptoms (primary outcome), emotion regulation, well-being, loneliness, social support, bullying, academic attainment, and health-related quality of life in English primary school pupils aged 9-11 years. A developer-led trial demonstrated the feasibility, acceptability, and utility of Passport; this will be the first independent trial.

METHODS

Sixty primary schools will be recruited across the Greater Manchester city region and surrounding areas, involving 2400 pupils aged 8-9 at baseline. Schools will be allocated to the intervention arm to implement Passport over 18 weekly sessions or to the control arm to implement the usual school curriculum. Random allocation will be at school level following completion of baseline measures, with minimisation to ensure balance across trial arms in school size and free school meal eligibility. Measures will be collected at baseline, post-intervention (12 months post-baseline), and at 12 months follow-up (24 months post-baseline). The primary outcome analysis (intervention effects on internalising symptoms at post-intervention) will comprise a two-level (school, child) hierarchical linear model, following the intention-to-treat principle. Additional analyses will be undertaken to assess intervention effects on secondary outcomes, maintenance effects for all outcomes, intervention compliance moderator effects, subgroup moderator effects, and mechanisms underpinning intervention effects on the primary outcome. A mixed-methods implementation and process evaluation will examine factors that influence implementation, and a health economic evaluation will assess the cost-effectiveness of the intervention.

DISCUSSION

Findings will provide educators with crucial knowledge of whether and how increasing emotion regulation through a universal intervention impacts internalising symptoms and a range of related outcomes. Findings will also inform policy related to the promotion of mental health among children and young people. If the intervention is found to be efficacious in reducing internalising symptoms and is also cost-effective, it may offer high potential as a preventative intervention for widespread implementation.

TRIAL REGISTRATION

ISRCTN12875599; registered on 24 November 2022.

Self-reported childhood family adversity is linked to an attenuated gain of trust during adolescence

A longstanding proposal in developmental research is that childhood family experiences provide a template that shapes a capacity for trust-based social relationships. We leveraged longitudinal data from a cohort of healthy adolescents (n = 570, aged 14-25), which included decision-making and psychometric data, to characterise normative developmental trajectories of trust behaviour and inter-individual differences therein. Extending on previous cross-sectional findings from the same cohort, we show that a task-based measure of trust increases longitudinally from adolescence into young adulthood. Computational modelling suggests this is due to a decrease in social risk aversion. Self-reported family adversity attenuates this developmental gain in trust behaviour, and within our computational model, this relates to a higher 'irritability' parameter in those reporting greater adversity. Unconditional trust at measurement time point T1 predicts the longitudinal trajectory of self-reported peer relation quality, particularly so for those with higher family adversity, consistent with trust acting as a resilience factor.

Developing an interpretation bias modification training task for alleviating loneliness in young people

OBJECTIVE

Loneliness is common among young people and is associated with negative health outcomes. Because loneliness is associated with a bias for interpreting social situations as threatening, cognitive bias modification for interpretation (CBM-I) training is a potential early intervention tool. We developed and delivered a single session of mental imagery enhanced digital CBM-I training, assessing feasibility, acceptability, and magnitude of change in interpretational style and loneliness.

METHOD

CBM-I training materials were developed using a co-creation approach with 18-25-year-olds with experience of loneliness. Another group of 18-25-year-olds with high loneliness received either online CBM-I (n = 29) or control (n = 27) training.

RESULTS

CBM-I training uptake and retention rates were 88% and 92%, respectively. Participants found the training acceptable. The CBM-I group showed a reduction in social threat interpretations (d = 0.77), an increase in social benign interpretations (d = 0.84), and a decrease in loneliness (d = 0.56). The control group showed a small reduction in social threat interpretations (d = 0.21), no change in social benign interpretations (d = 0.04), and an increase in loneliness (d = 0.41).

CONCLUSIONS

Interpretation biases relevant to youth loneliness may be modifiable, and CBM-I training could reduce feelings of loneliness. This informs psychological models of loneliness, and the development of CBM-I interventions targeting loneliness in young people.

A Developmental Pathway from Early Inhibitory Control to Social Connectedness

Social connections are critical for mental and physical health; however, the developmental pathways to children's social connectedness outcomes are not well understood. This study examined the pathways from children's inhibitory control at 4 years to two social connectedness outcomes - loneliness and friendship quality at age 10 - through behavioral problems at age 7. As part of a longitudinal study (N = 291, 54% girls), children's inhibitory control was assessed via a Go/No-Go task when children were 4 years old. Mothers reported on children's behavioral problems at ages 4 and 7 years. Children reported on their friendship quality and loneliness at ages 7 and 10 years. Greater inhibitory control at 4 years predicted lower behavioral problems at 7 years, which in turn predicted better friendship quality and lower loneliness at 10 years. Indirect effects from inhibitory control at 4 years to loneliness and friendship quality at 10 years via behavioral problems at 7 years were significant. Findings suggest that inhibitory control in early childhood may play a key role for the development of social connectedness in middle childhood via its impact on children's behavioral problems.

Mental health and loneliness in Scottish schools: A multilevel analysis of data from the health behaviour in school-aged children study

BACKGROUND

Adolescent loneliness and poor mental health represent dual public health concerns. Yet, associations between loneliness and mental health, and critically, how these associations vary in school settings are less understood.

AIMS

Framed by social-ecological theory, we aimed to identify key predictors of adolescent mental health and examine school-level variation in the relationship between loneliness and mental health.

SAMPLE

Cross-sectional data on adolescents from the 2018 wave of the Health Behaviour in School-aged Children study (HBSC) in Scotland were used (N = 5286).

METHODS

Mental health was measured as a composite variable containing items assessing nervousness, irritability, sleep difficulties and feeling low. Loneliness was measured via a single item assessing how often adolescents felt 'left out'. Multilevel models were used to identify social-ecological predictors of mental health, associations with loneliness and between-school variation.

RESULTS

Loneliness, as well as demographic, social and school factors, was found to be associated with mental health. Mental health varied across schools, with the between-school difference greater among adolescents with high levels of loneliness. Additionally, the negative effect of loneliness on mental health was stronger in schools with lower average mental health scores.

CONCLUSIONS

The findings suggest that schools can play an important role in shaping adolescent mental health. Our study uniquely identifies that school-based interventions targeting mental health may be especially necessary among lonely adolescents, and programmes aimed at tackling loneliness may be more beneficial in schools with poorer mental health.

Prevalence and Predictors of Loneliness Among Youth During the Time of COVID-19: A Multinational Study

BACKGROUND

Given the restrictions associated with COVID-19, feelings of loneliness among youth may increase.

AIMS

The aims of the current study were to assess the prevalence of loneliness among young people at the time of COVID-19 and to identify whether selected variables related to the pandemic predicted the level of loneliness.

METHOD

A cross-sectional study using WhatsApp and Facebook social media platforms was conducted to survey 1,057 young people aged 15 to 24 years from six Middle Eastern countries. Participants completed survey items including demographic and COVID-19-related questions; the Depression, Anxiety and Stress Scale (DASS); the Satisfaction With Life Scale (SWLS); and the UCLA Loneliness Scale.

RESULTS

The prevalence of experienced loneliness was 1 (0.1%), 625 (59.1%), 429 (40.6%), and 2 (0.2%), reflecting low, moderate, moderately high, and high experiences for loneliness, respectively. History of depression or anxiety, being dissatisfied with life, and having depression at the time of COVID-19 were significant predictors of loneliness among youth. The model was significant (F = 44.95, p < .05) and accounted for 29.8% of the variance in UCLA Loneliness Scale scores.

CONCLUSIONS

We found that the high prevalence rate of loneliness during the COVID-19 pandemic was correlated with depression and impaired life satisfaction among Middle Eastern youth. Thus, special attention and interventional action plans need to be developed taking into consideration the youths' special situation during COVID-19.

Loneliness During the School Years: How It Affects Learning and How Schools Can Help. THE JOURNAL OF SCHOOL HEALTH 2023;93:428-435. [PMID: 36861756 DOI: 10.1111/josh.13306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

BACKGROUND

Substantial evidence links loneliness to poor academic outcomes and poor employment prospects. Schools have been shown to be places that mitigate or aggravate loneliness, suggesting a need to consider how schools can better support youth experiencing loneliness.

METHODS

We conducted a narrative review on loneliness in childhood and adolescence to examine the literature on how loneliness changes over the school years and how it influences learning. We also examined whether there were increases in loneliness because of the COVID-19 pandemic and associated school closures, and whether schools can be places for loneliness interventions/prevention.

FINDINGS

Studies describe how loneliness becomes more prevalent during the adolescent years and why that is the case. Loneliness is associated with poor academic outcomes and poor health behaviors that impact learning or turn students away from education. Research shows that loneliness increased during the COVID-19 pandemic. Evidence suggests that creating positive social classroom environments, where teacher and classmate support are available, is crucial in combatting youth loneliness.

CONCLUSIONS

Adaptations to the school climate can be made to meet the needs of all students, reducing loneliness. Investigation of the impacts of school-based loneliness prevention/intervention is crucial.

The developmental course of loneliness in adolescence: Implications for mental health, educational attainment, and psychosocial functioning

The present study examined patterns of stability and change in loneliness across adolescence. Data were drawn from the Environmental Risk (E-Risk) Longitudinal Twin Study, a UK population-representative cohort of 2,232 individuals born in 1994 and 1995. Loneliness was assessed when participants were aged 12 and 18. Loneliness showed modest stability across these ages (r = .25). Behavioral genetic modeling indicated that stability in loneliness was explained largely by genetic influences (66%), while change was explained by nonshared environmental effects (58%). Individuals who reported loneliness at both ages were broadly similar to individuals who only reported it at age 18, with both groups at elevated risk of mental health problems, physical health risk behaviors, and education and employment difficulties. Individuals who were lonely only at age 12 generally fared better; however, they were still more likely to finish school with lower qualifications. Positive family influences in childhood predicted reduced risk of loneliness at age 12, while negative peer experiences increased the risk. Together, the findings show that while early adolescent loneliness does not appear to exert a cumulative burden when it persists, it is nonetheless a risk for a range of concomitant impairments, some of which can endure.