Stress and perceived social isolation (loneliness)

Childhood socioeconomic position and cognitive aging in Europe: The role of depressive symptoms and loneliness

The relationship between childhood socioeconomic position (CSEP) and cognitive decline in later life remains a subject of debate, with no clear consensus. This study aims to examine the impact of CSEP on cognitive decline and the potential mediating effects of depressive symptoms and loneliness. Data were drawn from the Survey of Health, Aging and Retirement in Europe, involving 24,615 participants aged 50-90 years over an 8-year follow-up. CSEP was measured using four indicators at age 10: primary breadwinner's occupational status, overcrowding, housing quality, and the number of books. Cognitive performance, assessed across waves 5-9, included episodic memory (immediate and delayed recall) and executive function (verbal fluency). A linear mixed-effects model was applied to analyze the influence of CSEP on cognitive decline. The results indicated that individuals with disadvantaged CSEP had lower cognitive abilities in later life (interceptdisadvantaged = -0.71 for memory, interceptdisadvantaged = -1.72 for verbal fluency) and experienced a faster decline in memory (βage×disadvantaged = -0.11), though no significant impact was observed on the rate of executive function decline. Depressive symptoms (βindirect = -0.02 for memory, βindirect = -0.05 for verbal fluency) and loneliness (βindirect = -0.01 for memory, βindirect = -0.03 for verbal fluency) may partially mediate the link between disadvantaged CSEP and cognitive function. These findings suggest that early-life socioeconomic conditions play a role in cognitive abilities in later life. This evidence deepens public understanding of the mechanisms driving cognitive decline and suggest that strategies to mitigate cognitive aging should be implemented early in life.

Long-term elevated levels of loneliness are linked to lower health-related quality of life in middle-aged Australian women

Loneliness has long been associated with poor health outcomes. However, few studies have considered the dynamic nature of loneliness over time. This study aimed to identify longitudinal patterns of loneliness over 18 years and their associations with physical and mental health-related quality of life. Using data from the Australian Longitudinal Study of Women's Health, we conducted a Latent Class Analysis to identify long-term loneliness patterns. We used Multinomial logistic regression to examine baseline predictors of loneliness trajectories and linear regression to examine the association between loneliness trajectories and health-related quality of life. Baseline predictors, such as smoking, depression, anxiety, stress and low social support, were associated with higher odds of 'Increasing', 'Stable-medium' and 'Stable-high loneliness. Compared to 'Stable-low loneliness, 'Increasing' [B = -3.73 (95%CI = -5.42, -2.04)], 'Medium' [B = -3.12 (95%CI = -5.08, -1.15)] and 'High' loneliness [B = -5.67 (95%CI = -6.84, -4.49)] were associated with lower mental health-related quality of life. 'Increasing' loneliness was also associated with lower physical health-related quality of life [B = -1.06 (95%CI = -2.11, -0.02)]. Among health-related quality of life sub-scales, emotional role, social functioning and physical role were the most strongly associated with loneliness. Findings highlight the importance of addressing loneliness among women to promote their health and well-being.

Perceived need for treatment for mental disorders: A review and critical evaluation

Mental disorders are highly prevalent worldwide. Unfortunately, most people with these disorders do not receive any treatment. This is due in part to a large set of barriers that impede treatment delivery. An initial barrier is the perception that one does not need treatment. Perceived need for treatment (PNFT) refers to whether an individual sees a need to obtain an intervention for their mental health problem. Among individuals with a mental disorder, lack of perceived need is the most common reason people give for not initiating treatment. This article describes PNFT, its characteristics, correlates, and predictors. A critical evaluation of the concept challenges key notions such as whether meeting criteria for a disorder means that someone needs treatment, whether PNFT actually is the initial obstacle limiting treatment seeking, how people may seek an intervention but do not elect mental health treatment, and that PNFT is neither a necessary nor a sufficient condition for entering treatment. Several research priorities are discussed including the importance of perceived need among parents and other caregivers, evaluating whether increasing the rates of PNFT would actually increase service use, the need to study the treatment needs of many neglected groups, and considering whether PNFT influences other facets of the treatment process (e.g., adherence to treatment, dropping out early) where perceiving there no longer is a mental health problem may occur.

Associations between the neural-hematopoietic-inflammatory axis and DNA methylation of stress-related genes in human leukocytes: Data from the Washington, D.C. cardiovascular health and needs assessment

Chronic stress is associated with cardiovascular disease (CVD) risk and elevated amygdala activity. Previous research suggests a plausible connection between amygdala activity, hematopoietic tissue activity, and cardiovascular events; however, the underlying biological mechanisms linking these relationships are incompletely understood. Chronic stress is thought to modulate epigenomic modifications. Our investigation focused on associations between amygdala activity (left (L), right (R), maximum (M), and average (Av) AmygA), and splenic (SpleenA), and bone marrow activity (BMA) as determined by 18Fluorodeoxyglucose (FDG) on Positron Emission Tomography/Computed Tomography (PET/CT) scans. Subsequently, we assessed how these markers of chronic stress and hematopoietic activity might relate to the DNA methylation of stress-associated genes in a community-based cohort of African American individuals from Washington D.C. at risk for CVD. To assess the relationships between AmgyA, SpleenA, BMA, and DNA methylation, linear regression models were run and adjusted for body mass index and 10-year predicted atherosclerotic CVD risk. Among 60 participants (93.3% female, mean age 60.8), M-AmygA positively associated with SpleenA (β = 0.29; p = 0.001), but not BMA (β = 0.01; p = 0.89). M-AmygA (β = 0.37; p = 0.01 and β = 0.31; p = 0.02, respectively) and SpleenA (β = 0.73; p < 0.01 and β = 0.59; p = 0.005, respectively) were associated with both IL-1β and TNFα. Decreased M-AmygA, SpleenA, IL-1β, and TNFα were associated with methylation of NFκB1 at cg07955720 and STAT3 at cg19438966. Our findings suggest a potential association between AmygA, SpleenA, and pro-inflammatory cytokines in the setting of chronic stress, suggesting an adverse hematopoietic effect. Furthermore, findings reveal associations with epigenetic markers of NFκB and JAK/STAT pathways linked to chronic stress.

Revealing the protective mindfulness-moderation on loneliness, depression, and quality of life among spinal cord injury survivors in a mixed-methods study

PURPOSE

Loneliness, prevalent in people with spinal cord injuries (SCI), is negatively associated with mental health and quality of life. Mindfulness is a potential moderator that may buffer the negative impact of loneliness. This study aimed to explore the moderation effects of mindfulness on the relationship between loneliness, depression, and quality of life among people with SCI.

METHODS

We conducted an explanatory sequential mixed-methods study on SCI survivors in Hong Kong. Survey data (n = 72) including socio-demographics, mindfulness, loneliness, depression, and quality of life were analyzed using moderated regression with the SPSS PROCESS macro. Focus group interviews (n = 15) were analyzed using thematic analysis.

RESULTS

Mindfulness significantly moderated the positive association between loneliness and depression (B= -0.060, p = 0.006), and a cutoff value (>116.569) for moderation was identified. The mindfulness moderation on the relationship between loneliness and quality of life was insignificant. Three themes were generated: connectedness contributes to subjective well-being, mindful perceptions foster emotional resilience and happiness, and mindful perceptions enhance physical health and social connections.

CONCLUSIONS

This study revealed the protective moderation mechanism of mindfulness in buffering the negative impacts of loneliness on depression, providing a strong theoretical foundation for the use of mindfulness-based interventions in improving mental well-being among SCI survivors.

Do you feel betrayed? Exploring the impact of workplace-induced loneliness on interactions with varied social structures

BackgroundWorkplace loneliness is an escalating concern, affecting employee well-being and productivity. Understanding its impact on social interactions and decision-making within professional settings is crucial for developing effective interventions.ObjectiveThis study aims to explore how workplace-induced loneliness influences individuals' interactions with social groups, individuals, and computer programs, and to assess the behavioral, cognitive, and emotional outcomes of these interactions. To explain these observed phenomena, the Workplace Loneliness-Driven Social Response (WL-SR) model is proposed.MethodsA dark factory decision-making experiment was designed and conducted, where participants underwent loneliness induction before engaging in tasks that required interactions with different social structures. The study measured changes in trust, emotional responses, neural activities, and decision-making processes to evaluate the impact of loneliness.ResultsThe findings indicate that loneliness significantly increases distrust and dishonesty in interactions with social groups, leading to higher dissatisfaction and negative emotional responses. Conversely, interactions with a social individual were marked by increased reliability and more positive attributions, which mitigated feelings of loneliness. The WL-SR model, integrating stress-related fight-or-flight and tend-and-befriend responses, elucidates these outcomes.ConclusionsThis study reveals how workplace loneliness affects trust and social interactions in professional settings. It highlights the negative impact on group interactions and the potential for individual interactions to reduce loneliness. The findings contribute to the understanding of how human psychology interacts with digital communication in the workplace, emphasizing the role of computers in mediating responses to loneliness.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

The mediating effects of sleep quality in the relationship between loneliness and depression among middle-aged and older adults

Loneliness has long been recognized as a key predictor of depression in older adults, and both are related to sleep quality. However, to this day, less is known about whether sleep quality mediates their relationship. This study aimed to examine the relationship between loneliness, sleep quality, and depressive symptoms, and to further explore whether sleep quality mediates the relationship between loneliness and depressive symptoms. Using the random cluster sampling method, 1016 permanent residents aged 45 and above in Ankang City, Shaanxi Province were selected. The relationship between loneliness, sleep quality, and depressive symptoms was analyzed using binary logistic regression, and the mediating role of sleep quality between loneliness and depressive symptoms was analyzed using the PROCESS macro in SPSS 25.0 software. The average age of the participants in this study was 60.39 ± 8.50. Regression analyses showed that individuals with loneliness (OR 7.161, 95%CI: 4.889-10.490, P < 0.001) and those with poor sleep quality (OR 4.777, 95%CI: 3.301-6.913, P < 0.001) were more likely to experience depressive symptoms than individuals without loneliness and with good sleep quality. This study also found a significant mediating effect of sleep quality between loneliness and depressive symptoms [effect value = 0.066, bootstrap 95% CI: (0.037, 0.093)] with an effect size of 13.31%. Loneliness may lead to reduced sleep quality in individuals, which in turn may lead to or exacerbate depressive symptoms. Therefore, this study highlights the importance of assessing and improving sleep quality in lonely people.

Psychological Stress and Cognitive Brain Health: Policies to Reduce Dementia Risk

Alzheimer's disease and related dementias (ADRD) pose a massive public health challenge, affecting over 6.7 million Americans aged 65 and older-a number projected to double by 2050. Despite advances in pharmacological treatments, there remains no cure or method to reverse the disease. This paper highlights the role of psychological stress as a critical yet underappreciated risk factor for cognitive decline and reviews its complex interplay with behavioral, social, and biological mechanisms. Chronic psychological stress drives physiological and behavioral changes that are linked to accelerated cognitive deterioration, particularly in older adults. Early interventions can target stress management and behavioral prevention strategies, which include physical activity, healthy diet, and social engagement. Further, key barriers to meaningful policy change to prevent and slow ADRD include lack of public awareness, stigma around mental health and aging, and misaligned funding incentives. Policy initiatives can improve brain health literacy, increase equitable access to services, and enhance community-level and environmental factors to promote healthy aging. Prioritizing stress reduction and promoting early detection and prevention can meaningfully reduce ADRD risk and progression, improving public health broadly.

Improvements to mood, stress and loneliness following 12-week multivitamin supplementation in older adults: a randomised, placebo-controlled, trial

BACKGROUND

Research has indicated the potential for multivitamin-mineral (MVM) supplementation to improve aspects of wellbeing and cognitive function in older adults via a range of biological mechanisms. However, outside of cognitive function and mood, this research rarely assesses other outcomes that are pertinent to the daily lives of older adults. The current study aimed to investigate the effectiveness of a MVM supplement on meaningful outcomes of everyday functioning in older adults.

METHODS

This randomised, double-blind, placebo-controlled, parallel groups trial investigated the effects of 12-week MVM supplementation on measures of wellbeing, mood, and memory; physical health and activity; and social interaction and loneliness. Outcomes were measured at baseline and after 12 weeks in a sample of 228 (124 female) older adults ( > 70 years).

RESULTS

MVM supplementation had no effect on the primary outcome of wellbeing (p = 0.29 in males, p = 0.421 in females), but led to increased feelings of friendliness in females (p = 0.045). In males, following MVM, there were lower levels of prolonged stress reactivity (p = 0.007), lower overall stress reactivity (p = 0.019), and lower emotional loneliness (p = 0.042).

CONCLUSION

This study provides novel evidence of increased friendliness and decreased stress reactivity and loneliness following MVM supplementation in older adults. These findings support the exploration of broader functions pertinent to aspects of daily living in older adults. Sex differences in response highlight the importance of exploring effects in men and women separately and support a recommendation for the inclusion of diverse samples in future research that are representative of the population.

Unraveling depressive symptom networks: A three-year longitudinal study among Chinese junior high school adolescents

Adolescence is the peak period for the occurrence of mental health issues, particularly in the stage of junior high school. Depressive symptoms are among the most frequently experienced psychological problems. However, little is known about the symptom-level interaction features of depressive symptoms and the roles of different symptoms across the junior high school stage. To address these gaps, this study conducted a three-year longitudinal study that recruited 1301 Chinese junior high school adolescents (48.2% females; mean age = 12.46 ± 0.62, ranging from 11 to 14 in the first year). The Center for Epidemiological Studies Depression Scale was used to assess depressive symptoms. The regularized partial correlation network and the cross-lagged panel network models were used to explore the symptom-level interaction pattern. In regularized partial correlation networks, "I felt depressed" was a stable central symptom throughout the junior high school stage. Besides, "I felt lonely" and "I felt that people disliked me" were the other central symptoms in grade 7 and grade 8, and "I felt everything I did was an effort" played a central role in grade 9. Within cross-lagged panel networks, "I felt that people disliked me" and "I felt hopeless about the future" had important effects on predicting other depressive symptoms from grade 7 to 8 and from grade 8 to 9. By investigating the longitudinal interaction patterns of depressive symptoms among junior high school adolescents, the current study identifies core symptoms that could be potential prevention or intervention targets and provides a novel insight for understanding depressive symptoms during adolescence in depth.

Internet usage buffers the effect of loneliness on subjective health among informal caregivers of older adults

Informal caregivers of older adults usually suffer from loneliness, which makes them vulnerable to reduced health outcomes. This study attempted to explore whether internet usage mitigates the effects of loneliness on subjective health among informal caregivers of older adults. A sample of 1089 informal caregivers (mean age = 58.0 ± 15.7 years, 60.3% females) providing unpaid cares for older adults in the United States were investigated. Their loneliness, subjective health, and utilization of caregiving-related online resources were measured. Descriptive statistics and correlation analyses were conducted to summarize the sample's characteristics and determine the relationships among the study variables, respectively. Finally, a multivariate regression analysis with an interaction term was performed to test the moderating effect of internet usage. Results indicated that loneliness was significantly negatively associated with subjective health. Furthermore, after controlling for demographic and caregiving-related factors, the moderating effect of internet usage on the link between loneliness and subjective health was significant, namely, the negative association between loneliness and subjective health was less pronounced at higher levels of internet usage. Hence, in addition to alleviating loneliness, providing caregiving-related online services and promoting positive utilization of resources on the internet may be potential intervention targets to improve informal caregivers' health.

Academic Burden and Emotional Problems Among Adolescents: A Longitudinal Mediation Analysis

INTRODUCTION

Existing research indicates high prevalence of emotional problems among adolescents with excessive academic burden, yet the underlying reasons are not well understood. This study aimed to explore loneliness, physical activity, and sleep as potential mediating pathways between academic burden and emotional problems in adolescents.

METHODS

A longitudinal cohort study was conducted among middle and high school students in Taizhou City, Zhejiang Province, China, with data collected at three time points. The study included 2965 adolescents, with a mean age of 15.2 years (SD = 1.7), of whom 48.0% were female. Most participants came from families with middle to high economic status (94.8%). Structural equation modeling was employed to analyze the direct associations between academic burden (measured by study time and academic stress) and depressive and anxiety symptoms. Additionally, the indirect associations were explored through three mediators: loneliness, physical activity, and sleep.

RESULTS

Higher academic stress at T1 was directly associated with more severe depressive symptoms at T3. Sleep (indirect effect 0.11, 95% CI 0.09-0.13), loneliness (0.10, 0.08-0.11) and physical activity (0.01, 0.002-0.012) at T2 mediated the relationship, accounting for 31.0%, 26.8%, and 1.8% of the total association of academic stress, respectively. For anxiety symptoms, sleep (0.11, 0.09-0.14) and loneliness (0.07, 0.05-0.08) mediated the association of academic stress with longitudinal mediation effect sizes of 34.1% and 20.6%, respectively. Study time was only associated with the outcomes indirectly via academic stress.

CONCLUSIONS

Our results highlight the importance of behavioral and psychosocial differences related to academic burden in understanding the severity of mental health problems in adolescents.

Loneliness, Spiritual Well-Being, Anxiety, Depression, and Attitude to Death of Gastrointestinal Cancer Patients Treated with Rumor Resection

Gastrointestinal cancer (GIC) patients with tumor resection may experience surgical complications, economic burden, and weakened social connection, which could lead to adverse psychological status. Thus, this study aimed to explore multidimensional psychological status of these patients, encompassing loneliness, spiritual well-being, anxiety, depression, and attitudes to death. Totally, 210 GIC patients with tumor resection and 50 healthy controls (HCs) were enrolled to complete the University of California Los Angeles loneliness (UCLA-LS), functional assessment of chronic illness therapy-spiritual well-being (FACIT-Sp), hospital anxiety and depression scale-anxiety/depression (HADS-A/D), and death attitude profile-revised (DAP-R) scales. UCLA-LS score was increased (P < 0.001), while FACIT-Sp score was decreased (P < 0.001) in GIC patients than HCs. Additionally, HADS-A score (P < 0.001), anxiety rate (P < 0.001), moderate to severe anxiety rate (P < 0.001), HADS-D score (P < 0.001), depression rate (P < 0.001), and moderate to severe depression rate (P = 0.011) were all elevated in GIC patients versus HCs. Concerning attitude to death, DAP-R scores for fear of death (P < 0.001) and death avoidance (P < 0.001) were increased, and the scores for neutral (P < 0.001) and approach (P = 0.010) acceptance were declined in GIC patients than HCs. Notably, female sex, unmarried status, and drinking history were independently linked with increased UCLA-LS score, but gastric cancer was independently associated with decreased UCLA-LS score (all P < 0.050). Neoadjuvant therapy was independently related to anxiety (P = 0.012). Female sex was independently correlated with depression (P = 0.006). In conclusion, GIC patients with tumor resection experience loneliness, anxiety, depression, and reduced spiritual well-being. They tend to fear and avoid, rather than accept death.

Negative Social Exchanges During the Pandemic, Loneliness, and the Mediating Role of Stress and Feeling Misunderstood Among People at High-Risk for COVID-19 Related Complications

The goal of this study was to investigate the links between social interactions and mental health for people who are high-risk for COVID-19 complications. Specifically, we tested the relationships between negative social exchanges during the pandemic and loneliness through two mediators: stress and feeling misunderstood about one's health status. Data were collected via Amazon's MTurk from participants (N = 271) who self-identified as being high-risk for COVID-19. The results from our model showed both a direct association between negative social interactions and loneliness, and an indirect link between these variables through stress. Overall, these results highlight the importance of understanding social interactions for people who are at high-risk for COVID-19 and their mental well-being. The results and implications are discussed.

Development of loneliness and social isolation after spousal loss: A systematic review of longitudinal studies on widowhood

BACKGROUND

Spousal loss is a stressful life event that is associated with loneliness and social isolation, both of which affect mental and physical health. The primary objective of this paper was to synthesize longitudinal studies that investigated loneliness and social isolation in widowhood.

METHODS

A systematic search of the literature was conducted using three electronic databases. 26 longitudinal studies published through June 2024 were included for further analysis. Participant characteristics, study design, and key findings were extracted.

RESULTS

Most studies were from the United States or Europe, included more widows than widowers, and assessed loneliness in older adults aged >60 years. Loneliness peaked directly following spousal death, but findings were inconsistent regarding the lasting effects of widowhood. Heterogeneity in the longitudinal trajectories of loneliness was noted, with studies showing linear increases, decreases, or curvilinear relationships over time. Several factors modified the relationship between widowhood and loneliness, including volunteerism, military experience, income, and age. Widowers consistently reported greater loneliness and worse social isolation when compared with widows. Few studies investigated social isolation specifically, but those that did found that social isolation may decrease in widowhood.

CONCLUSIONS

As the world grapples with a social pandemic of loneliness and social isolation, widowed adults may be uniquely affected. Few studies investigated the longitudinal trajectory of loneliness and especially social isolation in widowhood, and those that did found heterogenous results. Future work is needed to understand why some widowed adults are uniquely affected by feelings of loneliness and social isolation while others are not, and whether potentially modifiable factors that moderate or mediate this relationship could be leveraged by psychosocial interventions.

Psychological symptoms and loneliness in unemployed people diagnosed with mental illnesses

PURPOSE

Loneliness is a pervasive phenomenon that is linked to adverse health outcomes. Unemployed individuals with mental illnesses (UMIs) constitute a high-risk group, with substantial implications for both health and vocational (re)integration. This study aims to gain deeper insights into the relationships between psychological problems and symptoms of psychopathology and loneliness in UMIs.

METHODS

Our research is based on a sample from LIPSY, a project that aims to maintain or restore employability. Two regression analyses were conducted on a sample of unemployed participants diagnosed with a mental illness (ICD-10: F-code) with the outcome variable loneliness (UCLA). In the first analysis, age, gender, education, cohabitation status, and social network size (LSNS-6) were used as predictors; in the second one, the nine symptom dimensions (SCL-90) - (1) Somatization, (2) Obsessive-Compulsive, (3) Interpersonal Sensitivity, (4) Depression, (5) Anxiety, (6) Anger-Hostility, (7) Phobic Anxiety, (8) Paranoid Ideation, (9) Psychoticism -were added.

RESULTS

Our sample included 397 participants with an average age of 35.8 years, 53.1% were female. The final regression showed significant positive associations between higher levels of education, Interpersonal Sensitivity, Depression, and the outcome loneliness, and a significant negative relationship between Somatization and loneliness.

CONCLUSION

The high scores on all SCL-90 dimensions, and the links identified between Somatization, Interpersonal Sensitivity, Depression, and loneliness highlight the importance of psychological screening and/or diagnostics in this high-risk group and offer several starting points for prevention measures as well as interventions.

Stress, hypothalamic-pituitary-adrenal axis, hypothalamic-pituitary-gonadal axis, and aggression

This comprehensive review explores the intricate relationship between the hypothalamic-pituitary-adrenal (HPA) axis, the hypothalamic-pituitary-gonadal (HPG) axis, and aggression. It provides a detailed overview of the physiology and functioning of these axes, as well as the implications for aggressive behavior. The HPA axis, responsible for the stress response, is activated in response to various stressors and can influence aggressive behavior. Glucocorticoids, such as cortisol, play a crucial role in stress-induced activation of the HPA axis and have been implicated in aggressive tendencies. Chronic stress can dysregulate the HPA axis, leading to alterations in cortisol levels and potentially contributing to aggressive behavior. The HPG axis, particularly the androgen hormone testosterone, is also closely linked to aggression. Animal and human studies have consistently shown a positive association between testosterone levels and aggression. The androgen receptors in the brain's neural circuitry play a critical role in modulating aggressive behavior. Interactions between the HPA and HPG axes further contribute to the regulation of aggression. Feedback mechanisms and crosstalk between these axes provide a complex system for the modulation of both stress and reproductive functions, which can impact aggressive behavior. Additionally,the influence of stress on reproductive functions, particularly the role of androgens in stress-induced aggression, adds further complexity to this relationship. The review also discusses the future directions and implications for clinical interventions. Understanding the neurobiological mechanisms underlying aggression requires integrating molecular, cellular, and circuit-level approaches. Translational perspectives, including animal models and human studies, can bridge the gap between basic research and clinical applications. Finally, therapeutic strategies for aggression-related disorders are explored, highlighting the importance of targeted interventions based on a comprehensive understanding of the interactions between the HPA and HPG axes. In conclusion, this review provides a comprehensive overview of the physiological and neurobiological mechanisms underlying aggression, with a specific focus on the interplay between the HPA and HPG axes. By elucidating the complex interactions between stress, hormones, and aggressive behavior, this research paves the way for future investigations and potential therapeutic interventions for aggression-related disorders.

Minibox: Custom solo or semi-group housing chambers for long term housing of rats with miniscopes

In this detailed procedure, we include open-source methodologies using 'solidworks' designs for creating solo or semi-group housing units for rats wearing miniscopes for long periods of time. Builds are optimized to preserve rat health and prevent hardware destruction. We include all prices and suggestions for purchasing strategies to reduce overall build-costs.•Chambers are optimized for long-term housing to protect rats wearing delicate headstages (e.g., miniscopes).•Designed to be low-cost, efficient supplement to operant chambers and provides numerous benefits to long-term miniscope imaging. The housing chambers can be augmented by installing cameras, commutators, or different types of floor grids depending on experimental conditions.•The chambers can also be secured to one another to create "rat-duplexes", allowing experimenters to control the degree of social isolation.

Association between interpersonal sensitivity and loneliness in college nursing students based on a network approach

BACKGROUND

The symptoms of interpersonal sensitivity and loneliness are prevalent among college nursing students. This study aims to investigate the interactions at the symptom level and elucidate the characteristics of the interpersonal sensitivity and loneliness symptoms network among Chinese college nursing students.

METHOD

A cohort of 864 college nursing students participated in the study. Interpersonal sensitivity was assessed using the Chinese Version of the Short Form of the Interpersonal Sensitivity Measure (IPSM-CS), while loneliness symptoms were evaluated using the three-item Loneliness Scale (T-ILS). Central symptoms and bridge symptoms were determined using centrality and bridge centrality indices, respectively. The stability of the network was evaluated through the case-dropping procedure.

RESULTS

The most robust direct relationship was observed between the interpersonal sensitivity symptoms 'Feel happy when someone compliments' (IPSM-CS9) and 'Make others happy' (IPSM-CS10). 'Feel happy when someone compliments' (IPSM-CS9) exhibited the highest node strength in the interpersonal sensitivity and loneliness network, with 'They would not like me' (IPSM-CS2) following closely behind. Among the loneliness symptoms, 'Relational loneliness' (T-ILS1) demonstrated the highest bridge strength, followed by 'Intimate loneliness' (T-ILS3) and 'Social loneliness' (T-ILS2). The entire network displayed robustness in both stability and accuracy assessments.

CONCLUSION

This study emphasized the importance of central symptoms (e.g., 'Feel happy when someone compliments' and 'They would not like me') and bridge symptoms (e.g., 'Relational loneliness', 'Intimate loneliness', and 'Social loneliness'). Intervening in the central symptoms may effectively enhance the self-confidence of nursing students and foster harmonious relationships with others, thereby facilitating better adaptation to interpersonal relationships. Furthermore, by addressing bridge symptoms (e.g., meeting the need for approval and providing social support), nursing students can better adjust to their studies and practice with a more positive attitude during their college years.

Screen time and insomnia among college students: the moderating effect of loneliness

Objective: Insomnia is detrimental to college student health. The purpose of this study was to examine the interaction between two risk factors of insomnia-screen time use and loneliness-in college students. Participants: Respondents were 1,001 (M age = 19.9 [SD = 2.3]) college undergraduates. Methods: Self-reported demographic information, daily screen time (social, nonsocial, or productivity), loneliness, and insomnia were collected. Analyses examined the interaction of screen time and loneliness on insomnia. Results: Insomnia significantly correlated with loneliness and total, social, and nonsocial screen time. Less lonely students had an increase in insomnia symptoms with increased total and social screen time. However, lonelier students had greater insomnia symptoms than less lonely students, regardless of screen time. Greater than 8 h of total screen time per day elevated the risk for insomnia. Conclusion: Screen time was associated with insomnia symptoms; however, loneliness better predicted insomnia among college students.

The closure of Wyoming's Program of All-Inclusive Care for the Elderly (PACE): Qualitative analysis of the impact on social isolation and loneliness

Introduction

Social isolation and loneliness are global public health concerns experienced among older adults which are commonly associated with negative physical, psychological, and social outcomes. The healthcare system has an opportunity to identify and address social isolation and loneliness in older adults. The Program of All-Inclusive Care for the Elderly (PACE) was developed to serve comprehensive social needs along with medical and behavioral needs of older adults who qualify for long-term care while still living in the community. In 2021, due to state budget reductions, Wyoming's only PACE program (WY PACE) closed, resulting in the discharge of all participants and loss of social engagement opportunities provided by this program. The objectives of this evaluation were to (1) examine the impact of the WY PACE closure on isolation and loneliness, (2) identify how older adults adapted to the loss of services addressing isolation and loneliness, and (3) identify needs for future interventions to address isolation among clients who experienced loss of supportive programs.

Methods

A mixed-methods design was used to facilitate understanding of qualitative findings while also conducting quantitative analyses to provide context for qualitative responses. Participants included 17 individuals who were either former PACE participants or their caregivers. Participants (n = 12; M = 74 years old) were predominantly non-Hispanic White (n = 8, 66%) and cisgender female (n = 7, 58%). Caregivers of participants (n = 5; M = 63 years old) were predominantly Hispanic, Latino, or of Spanish origin (n = 3, 60%) and cisgender female (n = 4, 80%).

Results

A mixed-methods design was used to facilitate understanding of qualitative findings while also conducting quantitative analyses to provide context for qualitative responses. Participants included 17 individuals who were either former PACE participants or their caregivers. Participants (n = 12; M = 74 years old) were predominantly non-Hispanic White (n = 8, 66%) and cisgender female (n = 7, 58%). Caregivers of participants (n = 5; M = 63 years old) were predominantly Hispanic, Latino, or of Spanish origin (n = 3, 60%) and cisgender female (n = 4, 80%).

Discussion

This evaluation provided preliminary insight into the impacts of the loss of programs like WY PACE on social isolation and loneliness. Creative solutions to maintain social engagement of this vulnerable population are needed.

The impacts of stress and loneliness on gambling and gaming problems: A nationwide longitudinal study

BACKGROUND

Problems related to gambling and digital gaming have been a topic of concern for years. Less attention has been paid to the probable psychosocial factors behind these problems. While previous studies have established links between stress, loneliness, and addiction, there is a lack of longitudinal research investigating how stress and loneliness affect addictive behaviors, including problem gambling and gaming.

AIMS

This study uses multilevel mixed-effects generalized linear models to analyze the between- and within-person effects of stress and loneliness on gambling and gaming problems. The interaction between stress and loneliness was also investigated.

METHODS

A representative sample of Finns (N = 1,530) answered a survey in 6-month intervals between spring 2021 and autumn 2023; 49.22% of the sample took part at all six time points. The Problem Gambling Severity Index and the Internet Gaming Disorder Test were used to measure gambling and gaming problems. The three-item UCLA Loneliness Scale was used to assess loneliness, and the Perceived Stress Scale was used to evaluate stress.

RESULTS

After controlling for gender and age, loneliness was found to increase only gaming problems at both the between- and within-person levels, but not gambling. In contrast, stress enhanced both gambling and gaming problems at the between- and within-person levels. Additionally, loneliness and stress were found to have negative interaction suggesting that their combined effect was lower than their separate effects.

CONCLUSION

The findings provide longitudinal insight into the psychosocial vulnerabilities behind problem gambling and gaming, which can be helpful in designing targeted interventions.

[Loneliness in unemployed individuals diagnosed with mental illness]

BACKGROUND

Loneliness is a widespread phenomenon, and it is associated with a variety of health problems and diseases. Unemployed individuals diagnosed with a mental illness (UMIs) are at a high risk of experiencing loneliness, with serious repercussions for their health and vocational rehabilitation. With this study we wanted to better understand the associations between sociodemographic variables, mental health, and loneliness in UMIs.

METHODS

We analyzed the data of 526 unemployed individuals that received means-tested benefits as well as at least one psychiatric diagnosis. Data were collected between September 2020 and September 2023. We conducted two robust regressions with loneliness (University of California, Los Angeles, Loneliness Scale, UCLA) as an outcome (N = 526). In the first regression, we used social network as a predictor (Lubben Social Network Scale, LSNS-6); in the second regression we included the additional predictors personal debt (yes/no), depression (Patient Health Questionnaire, PHQ-9), anxiety (Mini-Symptom-Checklist,MSCL), and somatization (MSCL) as well as age, gender, education, and living with a partner as control variables.

RESULTS

We found a significant negative association between social network and loneliness, and a significant positive association between a high level of education, depression, anxiety, and loneliness.

CONCLUSIONS

Unemployed individuals diagnosed with a mental illness in our sample exhibited high levels of depression, anxiety, somatization, and loneliness. The associations between social network, mental health, and loneliness that we found emphasize the importance of psychological screening and/or diagnostics, and they highlight areas for prevention.

SIR+ models: accounting for interaction-dependent disease susceptibility in the planning of public health interventions

Avoiding physical contact is regarded as one of the safest and most advisable strategies to follow to reduce pathogen spread. The flip side of this approach is that a lack of social interactions may negatively affect other dimensions of health, like induction of immunosuppressive anxiety and depression or preventing interactions of importance with a diversity of microbes, which may be necessary to train our immune system or to maintain its normal levels of activity. These may in turn negatively affect a population's susceptibility to infection and the incidence of severe disease. We suggest that future pandemic modelling may benefit from relying on 'SIR+ models': epidemiological models extended to account for the benefits of social interactions that affect immune resilience. We develop an SIR+ model and discuss which specific interventions may be more effective in balancing the trade-off between minimizing pathogen spread and maximizing other interaction-dependent health benefits. Our SIR+ model reflects the idea that health is not just the mere absence of disease, but rather a state of physical, mental and social well-being that can also be dependent on the same social connections that allow pathogen spread, and the modelling of public health interventions for future pandemics should account for this multidimensionality.

How Do Aging Self-Stereotypes Relate to Social Isolation in Older Adults? The Intervening Roles of Sense of Coherence and Cellphone Use

The aim of this study was to investigate the relationships among aging self-stereotype, sense of coherence (SOC), and social isolation, as well as further explore the moderating role of cellphone use in older adults. The 817 Chinese older adults were assessed with regard to aging self-stereotypes, social isolation, SOC and cellphone use. Results from mediation analyses revealed that the negative effect of aging self-stereotype on social isolation was mediated by SOC. Moderated mediation analyses further indicated that the path from SOC to social isolation was stronger and the path from aging self-stereotype to social isolation was weaker for older adults with a higher level of cellphone use. These findings indicated that negative stereotypes were related to weaker SOC and are associated with more severe social isolation. Frequent use of cellphones can alleviate the negative effect of aging self-stereotype on social isolation and enhance the positive effect of SOC on social isolation.

Associations of perceived stress with loneliness and depressive symptoms: the mediating role of sleep quality

BACKGROUND

Whether perceived stress is associated with loneliness and depressive symptoms in general adults, and to what extent sleep quality mediates the associations, remains unknown. The aim of this study was to estimate the associations of perceived stress with loneliness and depressive symptoms, and the mediating role of sleep quality in these associations.

METHODS

Cross-sectional data on 734 participants (aged 18-87 years) were analyzed. Perceived stress was assessed using the 10-item Perceived Stress Scale (PSS-10; range 0-40). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI; range 0-21). Loneliness was assessed using the three-item short form of the Revised University of California, Los Angeles (UCLA) loneliness scale (range 3-9). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression (CESD-10) Scale (range 0-30). General linear regression models, multivariable logistic regression models, and formal mediation analysis were performed.

RESULTS

After adjustment for age and sex, we found that with each 1-point increment in the perceived stress score, both the loneliness score (β = 0.07; 95% confidence interval [CI]: 0.06, 0.08) and depression score (β = 0.45; 95% CI: 0.40, 0.49) increased significantly. Robust results were observed when adjusting for more confounders. Furthermore, sleep quality mediated 5.3% (95% CI: 1.3%, 10.0%; P = 0.014) and 9.7% (95% CI: 6.2%, 14.0%; P < 0.001) of the associations of perceived stress score with loneliness score and depression score, respectively.

CONCLUSIONS

In general Chinese adults, perceived stress was positively associated with loneliness and depressive symptoms, and sleep quality partially mediated these associations. The findings reveal a potential pathway from perceived stress to mental health through sleep behaviors, and highlight the importance of implementing sleep intervention programs for promoting mental health among those who feel highly stressed.

Intervention to reduce loneliness among older adults in the community: Making friends with volunteers

AIM

This study aimed to examine the effects of providing a program that introduced volunteers to make friends with older adults to reduce loneliness and increase loneliness literacy.

METHODS

Eight community development associations in Taiwan participated in the study. In the first stage, older people living alone or with only a spouse, or those with a family, but without substantial interactions, were screened for loneliness. Older adults with a higher risk of loneliness were given priority to be invited to participate in this intervention. This 3-month intervention program was designed by each community development association and delivered at the older adults' homes. A total of 87 older persons completed both waves of the interviews.

RESULTS

Loneliness was reduced (UCLA-6 Loneliness Scale scores decreased from 13.5 to 11.6), and loneliness literacy improved (loneliness literacy scores increased from 38.9 to 42.0) compared with what it was before the program. In a generalized linear model, when controlling for covariates, loneliness was reduced, but not significantly (B = -0.934, P > 0.05), whereas loneliness literacy improved significantly for older participants (B = 2.088, P < 0.05).

CONCLUSIONS

Making friends with older adults who are lonely might improve their loneliness literacy. Geriatr Gerontol Int 2024; 24: 240-245.

Loneliness among homeless-experienced older adults with cognitive or functional impairments: qualitative findings from the HOPE HOME study

BACKGROUND

Loneliness is more common in older adults and those who face structural vulnerabilities, including homelessness. The homeless population is aging in the United States; now, 48% of single homeless adults are 50 and older. We know little about loneliness among older adults who have experienced homelessness. We aimed to describe the loneliness experience among homeless-experienced older adults with cognitive and functional impairments and the individual, social, and structural conditions that shaped these loneliness experiences.

METHODS

We purposively sampled 22 older adults from the HOPE HOME study, a longitudinal cohort study among adults aged 50 years or older experiencing homelessness in Oakland, California. We conducted in-depth interviews about participants perceived social support and social isolation. We conducted qualitative content analysis.

RESULTS

Twenty participants discussed loneliness experience, who had a median age of 57 and were mostly Black (80%) and men (65%). We developed a typology of participants' loneliness experience and explored the individual, social, and structural conditions under which each loneliness experience occurred. We categorized the loneliness experience into four groups: (1) "lonely- distressed", characterized by physical impairment and severe isolation; (2) "lonely- rather be isolated", reflecting deliberate social isolation as a result of trauma, marginalization and aging-related resignation; (3) "lonely- transient", as a result of aging, acceptance and grieving; and (4) "not lonely"- characterized by stability and connection despite having experienced homelessness.

CONCLUSIONS

Loneliness is a complex and heterogenous social phenomenon, with homeless-experienced older adults with cognitive or functional impairments exhibiting diverse loneliness experiences based on their individual life circumstances and needs. While the most distressing loneliness experience occurred among those with physical impairment and mobility challenges, social and structural factors such as interpersonal and structural violence during homelessness shaped these experiences.

Psycho-social and health predictors of loneliness in older primary care patients and mediating mechanisms linking comorbidities and loneliness

BACKGROUND

Aging is associated with many personal, social, and environmental challenges that increase the risk of loneliness. Loneliness is a painful emotional experience associated with a perceived lack of connection and intimacy. Loneliness accelerates health deterioration, but the presence of chronic health conditions (comorbidities) in older individuals may potentiate the feeling of loneliness. The relationships between health status and loneliness in older individuals have not been assessed in an integrated manner, although it is necessary for planning efficient interventions. The aim of this study was to fill in this knowledge gap, by attempting to create an integrated model of loneliness in older individuals.

METHODS

The sample consisted of 189 (58% F) older individuals (> 60 years) (mean ± SD, 78.47 ± 6.65), attendees in Primary Health Care. Different factors associated with loneliness in the older population were assessed, and classified as demographic, environmental, physical (health-related), and psychological, in addition to functional abilities. A set of standard questionnaires was used to assess psychological factors and functional abilities. The hierarchical regression model assessed the effect of particular blocks of factors on status loneliness. The second aim was to analyze how psychological factors mediate associations between health status (comorbidity level) and loneliness.

RESULTS

Indicated that increasing comorbidity, anxiety, lack of positive moods, not having hobbies/activities, low perception of social support, impaired cognitive function, and suppression of emotion expression, are significant predictors of loneliness. Mediation analysis informed us of how to help patients with comorbidities feel less lonely. Interventions that were suggested were those that can reduce anxiety and depression, improve cognitive abilities and emotional regulation control, and enhance social support.

CONCLUSIONS

Results can help understand the pathophysiology loops linking poor health status (comorbidity level) of older individuals and loneliness, and have significant potentials from the translational perspectives, as a decision-support tool.

Autistic traits predict social avoidance and distress: The chain mediating role of perceived stress and interpersonal alienation

Social avoidance and distress are the primary aspects of social anxiety. Nonautistic people with high levels of autistic traits are more likely to exhibit social avoidance and distress. However, research has yet to reveal how autistic traits induce social avoidance and distress. To fill this gap, the present study recruited 708 participants to complete the 25-item Autism Spectrum Quotient, Social Avoidance and Distress Scale, Chinese Perceived Stress Scale, and Interpersonal Alienation Subscale. The results indicated that autistic traits significantly predicted social avoidance and distress in nonautistic people. In addition, autistic traits induced social avoidance and distress through perceived stress and interpersonal alienation, respectively. Importantly, perceived stress and interpersonal alienation (including the subdimensions of interpersonal alienation: sense of loneliness, sense of social isolation, and alienation between family members) partially mediated the relationships between autistic traits and social avoidance and distress. Overall, autistic traits predict social avoidance and distress via perceived stress and interpersonal alienation. This finding extends the hypothetical model of clinical anxiety in autism spectrum disorders. Furthermore, reducing perceived stress and interpersonal alienation in nonautistic people with high levels of autistic traits may be a valid intervention method to prevent and eliminate their social avoidance and distress.

Loneliness among older adults who have experienced homelessness: qualitative findings from the HOPE HOME study

Background

Loneliness is more common in older adults and those who face structural vulnerabilities, including homelessness. The homeless population is aging. We know little about loneliness among older adults who have experienced homelessness. We aimed to describe the loneliness experience among older adults who have experienced homelessness and the individual, social, and structural conditions that shaped these loneliness experiences.

Methods

We purposively sampled 22 older adults from the HOPE HOME study, a longitudinal cohort study among adults aged 50 years or older experiencing homelessness in Oakland, California. We conducted in-depth interviews about participants' perceived social support and social isolation. We conducted qualitative content analysis.

Results

Twenty participants discussed loneliness experience, who had a median age of 57 and were mostly Black (80%) and men (65%). We developed a typology of participants' loneliness experience and explored the individual, social, and structural conditions under which each loneliness experience occurred. We categorized the loneliness experience into four groups: 1) "lonely - distressed", characterized by physical impairment and severe isolation; 2) "lonely - rather be isolated", reflecting deliberate social isolation as a result of trauma, marginalization and aging-related resignation; 3) "lonely - transient", as a result of aging, acceptance and grieving; and 4) "not lonely" - characterized by stability and connection despite having experienced homelessness.

Conclusions

Loneliness is a complex and heterogenous social phenomenon, with older adults who have experienced homelessness exhibiting diverse loneliness experiences based on their individual life circumstances and needs. While the most distressing loneliness experience occurred among those with physical impairment and mobility challenges, social and structural factors such as interpersonal and structural violence during homelessness shaped these experiences.

Senior volunteers: addressing loneliness in times of COVID-19

Volunteering in old age plays an important role in addressing feelings of loneliness, but little research has been conducted on the impact of engaging in volunteering activities during the COVID-19 pandemic. This study investigates the longitudinal impact of volunteering on feelings of loneliness. We analyzed data from 31,667 adults aged 50 years and older in the Survey of Health, Ageing and Retirement in Europe (SHARE), across three consecutive waves (one before the pandemic and two during the COVID-19 pandemic). Binary logistic regression analyses were conducted for loneliness, using volunteering and several control variables as independent variables, and found that even after controlling for previous loneliness, volunteering has a protective effect against experiencing feelings of loneliness. Those who participated in volunteering activities before or during the second pandemic period had a lower risk of loneliness during the second pandemic period. Volunteering during the second pandemic period, before and during the second pandemic period, and during all three periods measured in the study was negatively associated with the odds of feeling lonely. Encouraging volunteering among older adults can be a useful strategy to prevent loneliness during future emergency situations like the COVID-19 outbreak.

Beyond Anxiety and Depression: Loneliness and Psychiatric Disorders in Adults with Atopic Dermatitis

There is a lack of knowledge concerning loneliness and psychiatric disorders other than anxiety and depression in patients with atopic dermatitis. This cross-sectional study was conducted within the Lifelines Cohort Study, in the Netherlands, by sending an atopic dermatitis questionnaire to adult participants (n = 135,950) in 2020. Psychiatric disorders were measured with a self-reported question and validated instrument (Mini International Neuropsychiatric Interview; M.I.N.I.), and loneliness was assessed with the validated 6-item De Jong Gierveld Loneliness Scale. In total, 56,896 subjects (mean age 55.8 years, 39.7% males) were included. Atopic dermatitis showed positive associations with self-reported chronic fatigue syndrome, burnout, depression, social phobia, panic disorder, attention deficit hyperactivity disorder, and eating disorder in the participants' lifetimes. Based on the M.I.N.I., atopic dermatitis was positively associated with panic disorder and at least 1 anxiety disorder. In addition, subjects with atopic dermatitis were more likely to experience loneliness compared with those without atopic dermatitis. These associations were observed only in the moderate-to-severe, but not mild, atopic dermatitis group. This study raises awareness that a significant proportion of adults with atopic dermatitis feel lonely and are affected by several psychiatric disorders, especially those severely affected by atopic dermatitis. Further studies are required to evaluate if interdisciplinary care, such as the collaboration between dermatologists and psychiatrists, could optimize medical care for this vulnerable patient group.

Potential pathways of association from green space to smartphone addiction

Green space is increasingly known to improve physical and mental health. Based on these benefits, green space might also be expected to help mitigate related harmful behavioral patterns, such as obsessive Internet use and relevant addictions. In response, we conducted a study on smartphone addiction, a new form of Internet addiction. We carried out a cross-sectional investigation in August 2022. We recruited 1011 smartphone users across China, measured the Normalized Difference Vegetation Index (NDVI) in their residential neighborhoods (in 1, 2, and 3 km buffers), and captured data on smartphone addiction via the Smartphone Addiction Scale - Short version (SAS-SV). Potential mediators between green space and smartphone addiction, including physical activity, stress, and loneliness, were also reported by participants using the Physical Activity Rating Scale-3 (PRS-3), Depression, Anxiety and Stress Scale-21 Items (DASS-21), and 8-items UCLA Loneliness Scale scales (ULS-8). Multiple linear regression was employed to examine the relationships between green space and smartphone addiction. Structural equation modeling was performed to examine the potential pathways between these variables. Unexpectedly, NDVI in 1 km buffers was positively associated with smartphone addiction. By contrast, population density, an indicator of urbanization, was associated with lower levels of smartphone addiction levels in all NDVI buffer sizes. Meanwhile, we found NDVI was strongly associated with population density as well as other indicators of urbanization. Generally, our findings are unexpected and suggest that greenness may serve as an indicator of urbanization at national levels and that urbanization may buffer against smartphone addiction. During the hot summer, green space and indoor facilities may have competitive land uses, so future research should examine whether this association exists in other seasons and scenarios. We also recommend alternative models to systematically evaluate the effects of different components of residential environments.

Loneliness and trust issues reshape mental stress of expatriates during early COVID-19: a structural equation modelling approach

OBJECTIVES

To explore relationship among perceived stress regarding loneliness, interpersonal trust and institutional trust of expatriates during the early COVID-19 period (from 30^th March to 30^th May 2020).

METHODS

Data from  21,439 expatriates were extracted from COVIDiSTRESS global survey. The outcome variable was perceived stress. The explanatory variables were age, perceived loneliness, trust (interpersonal and institutional). Pairwise correlation, and structural equation modelling were used to determine relationship among outcome and explanatory variables.

RESULTS

The majority of the expatriates were female (73.85%), married (60.20%), had college degree (47.76%), and employed (48.72%). Over 63% of the total expatriates reported that the COVID-19 pandemic changed their lives. The average age of the respondents was 40.4 years (± 13.7), and the average score of perceived stress, loneliness, interpersonal and institutional trust were 25.5, 7.4, 14.2 and 40.4, respectively. We found a moderate correlation of perceived stress with age, perceived loneliness, interpersonal trust and institutional trust (p < 0.001). They were also found moderately related to each other. Structural equation modelling evaluated that a lack of trust can cause loneliness among expatriates, which later lead to perceived stress. Interpersonal trust was more likely to be associated with stress than institutional trust, whereas perceived loneliness mediated between both trusts and perceived stress.

CONCLUSION

Perceived stress can be reduced through trusting others and alleviating the loneliness. Making strong linkage among migrants as well as between migrants and local community is important to ensure proper mental wellbeing of expatriates.

Emotion regulation mediates the relationship between social frailty and stress, anxiety, and depression

Social frailty refers to an inability to meet basic social needs and has been identified as a threat to physical and mental health. Although social frailty has been linked with many adverse health and well-being outcomes, potential mediators of the relationship between social frailty and well-being remain poorly understood. Emotion regulation refers to the capacity to alter the experience of emotions to behave in accordance with a desired goal. The present study was designed to provide the first direct test of whether emotion regulation mediates the relationships between social frailty and important well-being outcomes (stress, anxiety, and depression). A total of 790 participants completed validated measures of social frailty, stress, anxiety, depression, and emotion regulation. In line with our preregistered hypotheses, higher social frailty predicted increased stress, anxiety, and depression, and each of these relationships were partially mediated by emotion regulation capacity. These data provide novel evidence that emotion regulation abilities may serve as a protective factor against the negative consequences of social frailty.

Global prevalence of social isolation among community-dwelling older adults: A systematic review and meta-analysis

BACKGROUND

While the world's population ages, social isolation has continued to increase globally. However, no review exists on the prevalence of social isolation among community-dwelling older adults, and the global prevalence remains uncertain. This study aims to estimate the global prevalence of social isolation among community-dwelling older adults and to identify potential covariates including study characteristics (methodological diversity) or populations (clinical diversity) that contribute to the heterogeneity.

METHODS

This review searched through seven search engines and databases. The meta-analysis was conducted using the metafor package in the R software. The random-effects model was used to calculate the prevalence rates. Cochran's Q statistics and I² statistics were used to assess the statistical heterogeneity of prevalence estimates. Studies were appraised using the Newcastle-Ottawa Scale and the Grading of Recommendations, Assessment, Development, and Evaluations criteria for the quality of individual articles and the certainty of the evidence, respectively.

RESULTS

A total of 41 studies were selected from databases and reference lists. The pooled prevalence rate was 25% (95% CI: 21.0-30.0). The sample size was found to be a significant covariate of the prevalence estimate in the subgroup analysis.

CONCLUSIONS

We found 13 high-quality studies, but the overall quality of evidence very low. This study provides the prevalence of social isolation in community-dwelling older adults, identifying vulnerable groups for targeted intervention. Well-designed observational research with standard measures is recommended for future studies.

Does Problematic Use of Social Network Mediate the Association between Bullying Victimization and Loneliness among Lebanese Adolescents?

(1) Background: Bullying victimization has been associated with several behavioral outcomes, particularly loneliness. Similarly, an increase in social network use has been identified in recent years, particularly during the COVID-19 pandemic, and has been shown to be associated with bullying and loneliness. Investigating the mediating factors of loneliness among bullied adolescents is useful for taking preventive measures in the Lebanese population. This study aims to examine the association between bullying victimization and loneliness among Lebanese adolescents while considering the indirect effect of problematic social network use. (2) Methods: We carried out a cross-sectional study, between January and April 2022, that enrolled 379 adolescent Lebanese students (64.9% females, mean age 16.07 ± 1.19 years) who were current residents of Lebanon (15 to 18 years), and were from the five governorates of Lebanon (Beirut, Mount Lebanon, North, South and Bekaa). The snowball method was applied to select our sample; an electronic copy of the questionnaire was created using the Google Forms software and an online strategy was designed to collect the data. (3) Results: Negative social comparison and addictive consequences of problematic use of social network mediated the association between bullying victimization and loneliness. Higher bullying victimization was significantly associated with higher negative social comparison and addictive consequences of problematic use of social network, which in turn were significantly associated with more loneliness. Finally, higher bullying victimization was directly significantly associated with more loneliness. (4) Conclusions: Studying the mediating factors of loneliness in bullied adolescents can improve our understanding of this topic, allowing us to propose new interventions to prevent psychological problems in adolescents. Future studies are needed to further clarify the physiological processes that underlie the associations between social triggers and loneliness during adolescence.

Breaking the vicious cycle: The interplay between loneliness, metabolic illness, and mental health

Loneliness, or perceived social isolation, is a leading predictor of all-cause mortality and is increasingly considered a public health epidemic afflicting significant portions of the general population. Chronic loneliness is itself associated with two of the most pressing public health epidemics currently facing the globe: the rise of mental illness and metabolic health disorders. Here, we highlight the epidemiological associations between loneliness and mental and metabolic health disorders and argue that loneliness contributes to the etiology of these conditions by acting as a chronic stressor that leads to neuroendocrine dysregulation and downstream immunometabolic consequences that manifest in disease. Specifically, we describe how loneliness can lead to overactivation of the hypothalamic-pituitary-adrenal axis and ultimately cause mitochondrial dysfunction, which is implicated in mental and metabolic disease. These conditions can, in turn, lead to further social isolation and propel a vicious cycle of chronic illness. Finally, we outline interventions and policy recommendations that can reduce loneliness at both the individual and community levels. Given its role in the etiology of the most prevalent chronic diseases of our time, focusing resources on alleviating loneliness is a vitally important and cost-effective public health strategy.

Social interaction, psychotic disorders and inflammation: A triangle of interest

Social interaction difficulties are a hallmark of psychotic disorders, which in some cases can be definitely traced back to autoimmunological causes. Interestingly, systemic and intrathecal inflammation have been shown to significantly influence social processing by increasing sensitivity to threatening social stimuli, which bears some resemblance to psychosis. In this article, we review evidence for the involvement of systemic and intrathecal inflammatory processes in psychotic disorders and how this might help to explain some of the social impairments associated with this group of disorders. Vice versa, we also discuss evidence for the immunomodulatory function of social interactions and their potential role for therapeutic interventions in psychotic disorders.

Sex-specific impacts of social isolation on loneliness, depressive symptoms, cognitive impairment, and biomarkers: Results from the social environment and biomarker of aging study

OBJECTIVES

To investigate sex-specific associations between social isolation and psychological outcomes and biomarkers among community-dwelling middle-aged and older adults using a nationally representative population-based cohort study.

METHODS

Data from 757 participants from the Social Environment and Biomarkers of Aging Study (SEBAS) were retrieved for analysis, and all participants were stratified by sex. The associations between social isolation and psychological outcomes (loneliness, depressive symptoms, and cognitive impairment) at the 4-year follow-up were examined by multivariate logistic regression models, and associations between social isolation and biomarkers at the 4-year follow-up were examined by multivariate generalized linear models (GLMs).

RESULTS

For men, social isolation was not associated with the development of loneliness. However, being married (adjusted odds ratio (aOR) 0.32 [95% confidence interval (CI) 0.13-0.74], p<0.001) was associated with a lower risk of loneliness, indicating potential protective effects of marriage for men. On the other hand, social isolation was associated with a 2-fold higher risk of loneliness in women (aOR 2.26 [1.01-5.09], p<0.001). Social isolation was not associated with depressive symptoms after adjusting for other demographics. For men, being married (aOR 0.51 [0.26-0.99], p<0.05) or having good self-reported health (aOR 0.44 [0.21-0.92], p<0.05) was protective against depressive symptoms. For women, only good self-reported health (aOR 0.30 [0.13-0.70], p<0.01) provided protective effects against depressive symptoms. Similarly, other demographic factors (being married and having a higher educational level) but not social isolation were associated with lower risks of cognitive impairment. No significant associations were noted between social isolation and selected biomarkers.

CONCLUSIONS

Sex-different associations between social isolation and loneliness were noted; the effects of demographic factors, such as being married, self-reported health status, and high education levels, on subsequent loneliness, depression, and cognitive function were also sex-different. Further intervention studies are needed to explore sex-specific approaches to deal with the interplay of social isolation, loneliness, psychological outcomes and other demographic factors.

Guardianship from being present: the moderation of mindfulness in the longitudinal relationship of loneliness to quality of life and mental health problems among the oldest old

Since the pace of population aging is getting faster than in the past, the population aging has been a serious social concern. The Quality of life (QOL) of the older adults, especially the oldest old, and their mental health problems need more public attention, for the purpose of enhancing their late well-being. Therefore, the current study aims to investigate the longitudinal relationship between loneliness to quality of life and mental health problems, considering the moderation effect of mindfulness among the oldest old. A total of 457 Chinese oldest-old completed questionnaires measuring mindfulness, loneliness, QOL, and mental health problems at baseline, and completed QOL and mental health problems again at six-month follow-up. Results showed that the longitudinal positive association between loneliness and mental health problems was significant (r = .401, p < .01). Nevertheless, loneliness was positively correlated with QOL (r = .242, p < .01). Additionally, mindfulness significantly moderated the association between loneliness and mental health problems. Specifically, higher mindfulness was associated with a weaker longitudinal relationship between loneliness and mental health problems. However, mindfulness did not moderate the relationship between loneliness and QOL. These findings indicated that loneliness can be a risk factor of mental health problems, and mindfulness can buffer the adverse effect of loneliness on mental health problems among the oldest old. Limitations and implications were discussed.

Emotions and Food Consumption: Emotional Eating Behavior in a European Population

Emotion can reflect in the perception of food consumption. An increase in food intake during emotional and psychological conditions may have a negative impact on human health. The aim of this cross-sectional study was to determine the associations between food consumption, emotional eating behavior, and emotional conditions such as stress, depression, loneliness, boredom eating, maintaining vigilance and alertness, and emotional food consolation. We used a Motivations for Food Choices Questionnaire (Eating Motivations, EATMOT) to determine the emotional aspects of food consumption in 9052 respondents living in 12 European countries between October 2017 and March 2018. Ordinal linear regression was used to identify the associations between the emotional eating behavior and emotional conditions such as stress, depression, loneliness, emotional consolation, and reasons to improve physical and psychological conditions. The regression models confirmed the associations between food consumption, emotional conditions, and emotional eating behavior. Associations were found between the emotional eating behavior and stress (odds ratio (OR) = 1.30, 95% confidence interval (CI) = 1.07-1.60, p = 0.010), depressive mood (OR = 1.41, 95% CI = 1.40-1.43, p < 0.001), loneliness (OR = 1.60, 95% CI = 1.58-1.62, p < 0.001), boredom (OR = 1.37, 95% CI = 1.36-1.39, p < 0.001), and emotional consolation (OR = 1.55, 95% CI = 1.54-1.57, p < 0.001). Emotional eating was associated with an effort to improve physical and psychological conditions, such as controlling body weight (OR = 1.11, 95% CI = 1.10-1.12, p < 0.001), keeping awake and alert (OR = 1.19, 95% CI = 1.19-1.20, p < 0.001) and consumption to feel good (OR = 1.22, 95% CI = 1.21-1.22, p < 0.001). In conclusion, emotions might provoke emotional eating behavior. The appropriate way to handle stress, depression, or other emotional states is important in conditions of being emotionally overwhelmed. The public should be educated on how to handle different emotional states. The focus should be moved somehow from emotional eating and the consumption of unhealthy food to healthy lifestyle practices, including regular exercise and healthy eating habits. Thus, it is necessary to halt these negative health effects on human health through public health programs.

A health impact assessment of gender inequities associated with psychological distress during COVID19 in Australia's most locked down state-Victoria

BACKGROUND

Since March 2020, when the COVID19 pandemic hit Australia, Victoria has been in lockdown six times for 264 days, making it the world's longest cumulative locked-down city. This Health Impact Assessment evaluated gender disparities, especially women's mental health, represented by increased levels of psychological distress during the lockdowns.

METHODS

A desk-based, retrospective Health Impact Assessment was undertaken to explore the health impacts of the lockdown public health directive with an equity focus, on the Victorian population, through reviewing available qualitative and quantitative published studies and grey literature.

RESULTS

Findings from the assessment suggest the lockdown policies generated and perpetuated avoidable inequities harming mental health demonstrated through increased psychological distress, particularly for women, through psychosocial determinants.

CONCLUSION

Ongoing research is needed to elucidate these inequities further. Governments implementing policies to suppress and mitigate COVID19 need to consider how to reduce harmful consequences of these strategies to avoid further generating inequities towards vulnerable groups within the population and increasing inequalities in the broader society.

Social isolation is linked to classical risk factors of Alzheimer's disease-related dementias

Alzheimer's disease and related dementias is a major public health burden-compounding over upcoming years due to longevity. Recently, clinical evidence hinted at the experience of social isolation in expediting dementia onset. In 502,506 UK Biobank participants and 30,097 participants from the Canadian Longitudinal Study of Aging, we revisited traditional risk factors for developing dementia in the context of loneliness and lacking social support. Across these measures of subjective and objective social deprivation, we have identified strong links between individuals' social capital and various indicators of Alzheimer's disease and related dementias risk, which replicated across both population cohorts. The quality and quantity of daily social encounters had deep connections with key aetiopathological factors, which represent 1) personal habits and lifestyle factors, 2) physical health, 3) mental health, and 4) societal and external factors. Our population-scale assessment suggest that social lifestyle determinants are linked to most neurodegeneration risk factors, highlighting them as promising targets for preventive clinical action.

Are social support, loneliness, and social connection differentially associated with happiness across levels of introversion-extraversion?

This study examines whether extraversion moderates the association between subjective happiness and measures of social connectedness using data from Canadian residents, aged 16+, recruited online during the third wave of the COVID-19 pandemic (21 April 2021-1 June 2021). To accomplish this aim we tested the moderating effect of extraversion scores on the association between Subjective Happiness scores and several social health measures: Perceived Social Support, Loneliness, social network size, and time with friends. Among 949 participants, results show that lower social loneliness (p < .001) and higher social support from friends (p = .001) and from family (p = .007) was more strongly correlated with subjective happiness for people with low extraversion compared to those with high extroversion. Anti-loneliness interventions should consider the need to promote social connections among individuals across the introversion-extraversion continuum.

Childhood Adversity, Emotional Well-Being, Loneliness, and Optimism: a National Study

Optimism and loneliness, which reflect the expected inverse associations with excess morbidity and mortality, are theoretically and empirically associated with early adversities and offer potential avenues for clinical support. The current study first estimates latent classes of adverse childhood experiences and, second, assesses the role of these experiences on later reports of optimism and loneliness in late adolescence and emerging adulthood, and the role of emotional regulation and common mental disorders. Surveys were conducted in a longitudinal household sample of adolescents recruited in 2013 (average age of 20 at wave 6 follow-ups). The analytic sample included 1177 female and male respondents representative of their age group in the USA at baseline. Latent classes were estimated based on 10 indicators of childhood adversity. Respondents were assigned to classes using posterior probabilities of latent class membership, and class membership was used to predict psychological outcomes in multivariable models. Three latent classes of childhood adversity were identified in the current sample, representing low childhood adversity (81.5%), higher probability of family dysfunction with lower levels of interpersonal abuse (13.4%), and high adversity including higher probabilities of parental discord and violence as well as child abuse (5.1%). Both classes of respondents who faced greater childhood adversity were more likely to report greater loneliness and lower optimism in emerging adulthood. Results were attenuated by measures of emotional well-being. Addressing adolescent loneliness and supporting optimistic outlooks in emerging adulthood are two pathways with potential benefits to reduce mental and physical morbidities.

Support Needs and Coping Strategies in Non-Alcoholic Fatty Liver Disease (NAFLD): A Multidisciplinary Approach to Potential Unmet Challenges beyond Pharmacological Treatment

Non-alcoholic fatty liver disease (NAFLD) is the most frequently occurring chronic liver disease, affecting approximately 25–30% of the adult general population worldwide. NAFLD reflects excess hepatic accumulation of fat in the absence of increased alcohol intake, and, due to its close association with obesity, is frequently referred to as the ‘hepatic manifestation’ of metabolic syndrome. Indeed, a high percentage of individuals with NAFLD present with a combination of the cardio-metabolic comorbidities that are associated with the metabolic syndrome. In addition to its well-established link with the metabolic syndrome and increased risk for cardiovascular disease, NAFLD has also been associated with certain mental health issues (e.g., depression and stress). Although this link is now being increasingly recognized, there are still unmet needs regarding the holistic management of patients with NAFLD, which could further contribute to feelings of social isolation and loneliness. The latter conditions are also increasingly reported to pose a substantial risk to overall health and quality of life. To date, there is limited research that has explored these issues among patients with NAFLD, despite existing data which indicate that perceived loneliness and isolation may pose an additional health risk. Notably, many features associated with NAFLD have been related to these concepts, such as perceived stigma, fatigue, stress, and confusion regarding this diagnosis. As such, this review aimed to assess such potential problems faced by patients with NAFLD, and to explore the possibility of unmet support needs which could lead to perceived social isolation. Moreover, the importance of a compassionate approach towards such patients is discussed, together with potential coping strategies. Future research directions and the need for a multidisciplinary approach are also highlighted.