1
|
Kuczynski AM, Piccirillo ML, Dora J, Kuehn KS, Halvorson MA, King KM, Kanter JW. Characterizing the momentary association between loneliness, depression, and social interactions: Insights from an ecological momentary assessment study. J Affect Disord 2024; 360:376-386. [PMID: 38823593 DOI: 10.1016/j.jad.2024.05.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 05/07/2024] [Accepted: 05/27/2024] [Indexed: 06/03/2024]
Abstract
Evidence suggests that loneliness causes people to feel more depressed. It is unknown, however, why this association occurs and whether momentary versus chronic experiences of loneliness are implicated. Theoretical accounts suggest that momentary feelings of loneliness produce two competing motivations: social reaffiliation and social withdrawal. Social affiliation is protective against depression; social withdrawal, in contrast, is a risk factor. Thus, engaging in frequent and high-quality interactions following experiences of loneliness may protect against subsequent depression. We tested this hypothesis using a random-interval experience sampling design (5x/day/day, 14 days; Nobs = 6568) with a racially/ethnically diverse sample of adults with elevated depression symptoms (N = 102). Momentary loneliness was associated with depressed mood at the same time point and ∼2.5h and ∼5h later. Frequency and quality of social interaction did not moderate these associations. Findings suggest that momentary feelings of loneliness may be an important target for clinical intervention.
Collapse
Affiliation(s)
- Adam M Kuczynski
- Department of Psychiatry and Behavioral Sciences, University of Washington, United States of America.
| | | | - Jonas Dora
- Department of Psychology, University of Washington, United States of America
| | - Kevin S Kuehn
- Department of Medicine, University of California, San Diego, United States of America
| | - Max A Halvorson
- School of Social Work, University of Washington, United States of America
| | - Kevin M King
- Department of Psychology, University of Washington, United States of America
| | - Jonathan W Kanter
- Department of Psychiatry and Behavioral Sciences, University of Washington, United States of America
| |
Collapse
|
2
|
Liu X, Yue J, Yang Y. Why So Lonely? The Direct and Indirect Associations between Developmental Trajectories of Fear of Negative Evaluation, Prosocial Behavior and Loneliness in Adolescence. J Youth Adolesc 2024; 53:1699-1710. [PMID: 38446286 DOI: 10.1007/s10964-024-01959-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
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.
Collapse
Affiliation(s)
- Xinyi Liu
- Faculty of Psychology, Southwest University, Chongqing, 400715, China
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Institute of Brain and Education Innovation, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China
| | - Jiaying Yue
- Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Ying Yang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Institute of Brain and Education Innovation, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China.
| |
Collapse
|
3
|
Fanaei H, Shoorijeh BT, Hafezinouri H, Mirzaei I, Parsi-Moud A. Impact of social isolation on corticosterone release and recovery after stroke in aged rats: A behavioral and biochemical analysis. Exp Gerontol 2024; 192:112453. [PMID: 38723916 DOI: 10.1016/j.exger.2024.112453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 06/01/2024]
Abstract
Social isolation (SI) after stroke reduces recovery. The aim of this study was to evaluate the effects of SI on corticosterone release and recovery after stroke in aged rats. A total of 64 male Wistar rats (aged 24 months) were used in the present study. All rats were housed in pairs for two weeks. After two weeks, rats were randomly assigned to one of four groups: (1) rats underwent sham surgery and kept socially isolated (control/social isolated (CO/SI) group); (2) rats underwent sham surgery and kept pair housed (control/pair housed (CO/PH) group); (3) rats underwent middle cerebral artery occlusion (MCAO) surgery and kept socially isolated (stroke/isolated (ST/SI) group); (4) rats underwent MCAO surgery and kept pair housed (stroke/pair housed (ST/PH)) group. Behaviors were assessed using the adhesive removal test, rotarod test and social interaction test at 1st, 7th, 14th and 21st days after stroke. Serum biochemical analysis was also performed on the behavioral testing days. Results showed THAT serum corticosterone and MDA levels in CO/PH group were significantly lower than CO/SI group. Serum BDNF levels in CO/PH group was significantly higher than CO/SI group. Serum corticosterone and MDA levels in ST/PH group were lower than ST/SI group. In ST/PH group, serum Total antioxidant capacity (TAC) and BDNF levels were significantly higher than ST/SI group. Biochemical analysis of certain regions of the brain (hippocampus, striatum and cerebral cortex) was performed on 21st day after stroke. In the hippocampus of CO/PH group, BDNF and TAC levels were significantly higher than CO/SI group. The hippocampal MDA level of CO/PH group were significantly lower than CO/SI group. BDNF and TAC levels in the hippocampus, striatum and cerebral cortex of ST/PH group were significantly higher and MDA level was significantly lower as compared with ST/SI group. Both ischemic groups showed sensorimotor recovery over a 21-day period, but recovery of ST/PH group was significantly greater than ST/SI group. Total social interaction time in ST/PH group was significantly longer than ST/SI group. Based on the results of this study, social interaction after stroke enhances histologic and sensorimotor recovery through reduction of HPA activity and corticosterone release, leading to increased TAC and BDNF levels.
Collapse
Affiliation(s)
- Hamed Fanaei
- Pregnancy Health Research Center, Department of Physiology, Zahedan University of Medical Sciences, Zahedan, Iran.
| | | | - Hamid Hafezinouri
- Laboratory Animal Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ilia Mirzaei
- Student Research Committee, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Abolfazl Parsi-Moud
- Student Research Committee, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| |
Collapse
|
4
|
Fernandez CC, Maddock J, Patalay P, Fett AK, Pitman A, Vaughan L, Krenz K. Proximity to high streets, social isolation and social support in British adolescents: A longitudinal analysis of sociospatial influences on social connectedness using geospatial data. Health Place 2024; 88:103260. [PMID: 38735152 DOI: 10.1016/j.healthplace.2024.103260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/22/2024] [Accepted: 04/29/2024] [Indexed: 05/14/2024]
Abstract
High streets have been shown to be central to socio-economic activity, given their diverse residential, leisure, and commercial activities. This study explores the link between adolescent social isolation and proximity to, and land use mix in, high streets. Hypothesising that greater distance from high streets might increase social isolation, measured via social activities, friend contact frequency, and social support, we used multilevel modelling with data from the Millennium Cohort Study. We did not observe a relationship between proximity to high streets and these social isolation indicators, suggesting that high streets may either not significantly influence adolescent social engagement or that young people are willing to travel greater distances.
Collapse
Affiliation(s)
| | - Jane Maddock
- MRC Unit for Lifelong Health and Ageing, UCL, London, UK
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing, UCL, London, UK; Centre for Longitudinal Studies, Social Research Institute, UCL, London, UK
| | - Anne-Kathrin Fett
- Department of Psychology, City, University of London, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Alexandra Pitman
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Laura Vaughan
- The Space Syntax Lab, Bartlett School of Architecture, UCL, London, UK
| | - Kimon Krenz
- The Space Syntax Lab, Bartlett School of Architecture, UCL, London, UK
| |
Collapse
|
5
|
Yang Y(S, Law M, Vaghri Z. New Brunswick's mental health action plan: A quantitative exploration of program efficacy in children and youth using the Canadian Community Health Survey. PLoS One 2024; 19:e0301008. [PMID: 38848408 PMCID: PMC11161078 DOI: 10.1371/journal.pone.0301008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/09/2024] [Indexed: 06/09/2024] Open
Abstract
In 2011, the New Brunswick government released the New Brunswick Mental Health Action Plan 2011-2018 (Action Plan). Following the release of the Action Plan in 2011, two progress reports were released in 2013 and 2015, highlighting the implementation status of the Action Plan. While vague in their language, these reports indicated considerable progress in implementing the Action Plan, as various initiatives were undertaken to raise awareness and provide additional resources to facilitate early prevention and intervention in children and youth. However, whether these initiatives have yielded measurable improvements in population-level mental health outcomes in children and youth remains unclear. The current study explored the impact of the Action Plan by visualizing the trend in psychosocial outcomes and service utilization of vulnerable populations in New Brunswick before and after the implementation of the Action Plan using multiple datasets from the Canadian Community Health Survey. Survey-weighted ordinary least square regression analyses were performed to investigate measurable improvements in available mental health outcomes. The result revealed a declining trend in the mental wellness of vulnerable youth despite them consistently reporting higher frequencies of mental health service use. This study highlights the need for a concerted effort in providing effective mental health services to New Brunswick youth and, more broadly, Canadian youth, as well as ensuring rigorous routine outcome monitoring and evaluation plans are consistently implemented for future mental health strategies at the time of their initiation.
Collapse
Affiliation(s)
- Yuzhi (Stanford) Yang
- Department of Psychology, Faculty of Science, Applied Science, and Engineering, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Moira Law
- Department of Psychology, Faculty of Science, St. Mary’s University, Halifax, Nova Scotia, Canada
| | - Ziba Vaghri
- Global Child Program, Integrated Health Initiative, Faculty of Business, University of New Brunswick, Saint John, New Brunswick, Canada
| |
Collapse
|
6
|
Phillips MR, Byrne J, Gibson EC, Gilbert C, Ford L, Marsh G, Chow J, Robinson GA. The brief executive language screen: sensitivity and specificity in acute to early sub-acute stroke. Top Stroke Rehabil 2024:1-13. [PMID: 38833512 DOI: 10.1080/10749357.2024.2356412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 04/23/2024] [Indexed: 06/06/2024]
Abstract
INTRODUCTION Propositional language and underlying executive functions can be impaired post-stroke and affect communication and quality of life. Current stroke screening tools are largely tailored to patients with aphasia, being either non-verbal or focussed on core language skills such as naming and repetition. The Brief Executive Language Screening Test (BELS) is a newly developed cognitive screening tool that assesses memory, oral apraxia, core language, as well as propositional language and associated executive functions that can be impacted and overlooked in stroke patients without aphasia. This study examines BELS sensitivity and specificity, and performance in acute to early sub-acute stroke relative to controls. METHOD Cross-sectional BELS data from 88 acute left and right hemisphere stroke patients (within 7 weeks of stroke) and 116 age-matched healthy controls were compared using independent samples t-tests. ROC Curve Analysis was performed to determine a cutoff score for the BELS. RESULTS Left and right stroke patients were reduced on all propositional language subtests, and executive function subtests of inhibition, strategy, and selection. Differences were also observed for Oral Apraxia, Naming, and Memory. By contrast, Word Comprehension and Repetition, and Sentence Completion Initiation (after corrections applied) did not differ between groups. A total BELS score of 79.25/100 was highly sensitive (.89) and specific (.89) when classifying stroke patients and healthy controls. CONCLUSION The BELS is brief, sensitive, suitable for bedside administration, and can aid in detection and rehabilitation of subtle executive language impairments. This in turn will help improve relationships and quality of life post-stroke.
Collapse
Affiliation(s)
- Mia R Phillips
- Queensland Brain Institute, the University of Queensland, St Lucia, QLD, Australia
| | - Jessica Byrne
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| | - Emily C Gibson
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| | - Casey Gilbert
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| | - Lucy Ford
- Queensland Brain Institute, the University of Queensland, St Lucia, QLD, Australia
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| | - Georgia Marsh
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| | - Jessica Chow
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| | - Gail A Robinson
- Queensland Brain Institute, the University of Queensland, St Lucia, QLD, Australia
- Neuropsychology Research Unit, School of Psychology, the University of Queensland, St Lucia, QLD, Australia
| |
Collapse
|
7
|
Hall LM, Moussa-Tooks AB, Sheffield JM. Associations between social engagement, internalizing symptoms, and delusional ideation in the general population. Soc Psychiatry Psychiatr Epidemiol 2024; 59:989-1002. [PMID: 37624462 DOI: 10.1007/s00127-023-02540-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 07/30/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Delusions are a hallmark feature of psychotic disorders and lead to significant clinical and functional impairment. Internalizing symptoms-such as symptoms of depression, anxiety, and trauma exposure-are commonly cited to be related to delusions and delusional ideation and are often associated with deficits in social functioning. While emerging studies are investigating the impact of low social engagement on psychotic-like experiences, little work has examined the relationship between social engagement, internalizing symptoms, and delusional ideation, specifically. METHODS Using general population data from the Nathan Kline Institute-Rockland (NKI-Rockland) database (N = 526), we examined the relationships between self-reported delusional ideation, internalizing symptoms, and social engagement and tested four indirect effect models to understand how these factors interrelate. RESULTS Delusional ideation was significantly associated with both increased internalizing symptoms (r = 0.41, p < 0.001) and lower social engagement (r = - 0.14, p = 0.001). Within aspects of social engagement, perceived emotional support showed the strongest relationship with delusional ideation (r = - 0.17, p < 0.001). Lower social engagement was also significantly associated with increased internalizing symptoms (r = - 0.29, p < 0.001). Cross-sectional models suggest that internalizing symptoms have a significant indirect effect on the association between delusional ideation and social engagement. CONCLUSIONS These findings reveal that elevated delusional ideation in the general population is associated with lower social engagement. Elevated internalizing symptoms appear to play a critical role in reducing engagement, possibly exacerbating delusional thinking. Future work should examine the causal and temporal relationships between these factors.
Collapse
Affiliation(s)
- Lauren M Hall
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA.
| | - Alexandra B Moussa-Tooks
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA
| | - Julia M Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA
| |
Collapse
|
8
|
Zheng Y, Panayiotou M, Currie D, Yang K, Bagnall C, Qualter P, Inchley J. The Role of School Connectedness and Friend Contact in Adolescent Loneliness, and Implications for Physical Health. Child Psychiatry Hum Dev 2024; 55:851-860. [PMID: 36260256 PMCID: PMC11060972 DOI: 10.1007/s10578-022-01449-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/19/2022] [Indexed: 11/29/2022]
Abstract
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.
Collapse
Affiliation(s)
- Yixuan Zheng
- Manchester Institute of Education, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Margarita Panayiotou
- Manchester Institute of Education, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Dorothy Currie
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Keming Yang
- Department of Sociology, Durham University, Durham, UK
| | - Charlotte Bagnall
- Manchester Institute of Education, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Pamela Qualter
- Manchester Institute of Education, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Joanna Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| |
Collapse
|
9
|
Grewal E, Godley J, Wheeler J, Tang KL. Use of social network analysis in health research: a scoping review protocol. BMJ Open 2024; 14:e078872. [PMID: 38803244 PMCID: PMC11129050 DOI: 10.1136/bmjopen-2023-078872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 05/10/2024] [Indexed: 05/29/2024] Open
Abstract
INTRODUCTION Social networks can affect health beliefs, behaviours and outcomes through various mechanisms, including social support, social influence and information diffusion. Social network analysis (SNA), an approach which emerged from the relational perspective in social theory, has been increasingly used in health research. This paper outlines the protocol for a scoping review of literature that uses social network analytical tools to examine the effects of social connections on individual non-communicable disease and health outcomes. METHODS AND ANALYSIS This scoping review will be guided by Arksey and O'Malley's framework for conducting scoping reviews. A search of the electronic databases, Ovid Medline, PsycINFO, EMBASE and CINAHL, will be conducted in April 2024 using terms related to SNA. Two reviewers will independently assess the titles and abstracts, then the full text, of identified studies to determine whether they meet inclusion criteria. Studies that use SNA as a tool to examine the effects of social networks on individual physical health, mental health, well-being, health behaviours, healthcare utilisation, or health-related engagement, knowledge, or trust will be included. Studies examining communicable disease prevention, transmission or outcomes will be excluded. Two reviewers will extract data from the included studies. Data will be presented in tables and figures, along with a narrative synthesis. ETHICS AND DISSEMINATION This scoping review will synthesise data from articles published in peer-reviewed journals. The results of this review will map the ways in which SNA has been used in non-communicable disease health research. It will identify areas of health research where SNA has been heavily used and where future systematic reviews may be needed, as well as areas of opportunity where SNA remains a lesser-used method in exploring the relationship between social connections and health outcomes.
Collapse
Affiliation(s)
- Eshleen Grewal
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jenny Godley
- Department of Sociology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Justine Wheeler
- Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Karen L Tang
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
10
|
Guo L, An L, Wang N, Ni T, Wang X, Zhou Y, Luo F, Zhang S, Zhang K, Yu B. Prospective association between social isolation, loneliness and lung function among Chinese middle-aged and older adults. Australas J Ageing 2024. [PMID: 38741527 DOI: 10.1111/ajag.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/14/2024] [Accepted: 04/17/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE Previous research has highlighted a heightened occurrence of social isolation and loneliness in older adults diagnosed with chronic lung diseases. Nevertheless, there exists a dearth of studies that have explored the influence of impoverished social relationships on lung function. This study aimed to examine the longitudinal association between social isolation, loneliness and lung function over 4 years among middle-aged and older Chinese adults. METHODS This study employed two waves (2011 and 2015) of data from the China Health and Retirement Longitudinal Study (CHARLS). The analysis was limited to participants aged 45 years and above and stratified based on gender (3325 men and 3794 women). The measurement of peak expiratory flow (PEF) served as an indicator for assessing lung function. Lagged dependent variable regression models, accounting for covariates, were employed to explore the relationship between baseline social isolation and loneliness and the subsequent PEF. RESULTS For women, social isolation was significantly associated with the decline in PEF at follow-up (β = -.06, p < .001) even after adjusting for all covariates; no significant correlation was observed between loneliness and PEF. Among men, there was no significant association found between either social isolation or loneliness and PEF. CONCLUSIONS Social isolation is prospectively associated with worse lung function in middle-aged and older Chinese women but not men. The results highlight the importance of promoting social relationships in public health initiatives, especially in groups that are more vulnerable.
Collapse
Affiliation(s)
- Lizhi Guo
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
- Research Centre for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Li An
- School of Education, Tianjin University, Tianjin, China
- Institute of Applied Psychology, Tianjin University, Tianjin, China
- Laboratory of Suicidology, Tianjin Municipal Education Commission, Tianjin, China
| | - Nandi Wang
- School of Education, Tianjin University, Tianjin, China
- Institute of Applied Psychology, Tianjin University, Tianjin, China
| | - Tingjuntao Ni
- School of Education, Tianjin University, Tianjin, China
- Institute of Applied Psychology, Tianjin University, Tianjin, China
- Laboratory of Suicidology, Tianjin Municipal Education Commission, Tianjin, China
| | - Xiaoling Wang
- School of Education, Tianjin University, Tianjin, China
- Institute of Applied Psychology, Tianjin University, Tianjin, China
- Laboratory of Suicidology, Tianjin Municipal Education Commission, Tianjin, China
| | - Yajing Zhou
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Fengping Luo
- Department of Psychology, Wuhan University, Wuhan, China
| | - Shuo Zhang
- School of Education, Tianjin University, Tianjin, China
- Institute of Applied Psychology, Tianjin University, Tianjin, China
- Laboratory of Suicidology, Tianjin Municipal Education Commission, Tianjin, China
| | | | - Bin Yu
- Institute of Applied Psychology, Tianjin University, Tianjin, China
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| |
Collapse
|
11
|
Jong A, Odoi CM, Lau J, J.Hollocks M. Loneliness in Young People with ADHD: A Systematic Review and Meta-Analysis. J Atten Disord 2024; 28:1063-1081. [PMID: 38400533 PMCID: PMC11016212 DOI: 10.1177/10870547241229096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
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.
Collapse
Affiliation(s)
- Angelina Jong
- King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK
| | - Clarissa Mary Odoi
- King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK
| | - Jennifer Lau
- Queen Mary University of London Wolfson Institute of Population Health, London, UK
| | - Matthew J.Hollocks
- King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK
| |
Collapse
|
12
|
Higson-Sweeney N, Cooper K, Dunn BD, Loades ME. "I'm always going to be tired": a qualitative exploration of adolescents' experiences of fatigue in depression. Eur Child Adolesc Psychiatry 2024; 33:1369-1381. [PMID: 37300578 PMCID: PMC10257178 DOI: 10.1007/s00787-023-02243-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
Adolescent depression is a prevalent and disabling condition, but current psychological treatments are only moderately effective. One way to enhance outcomes is to further our understanding of adolescent depression and improve our capacity to target the most frequently reported and problematic symptoms. A common but often neglected symptom of depression is fatigue, which is associated with considerable impairment and has the potential to interfere with adolescents' engagement in psychological therapies. Despite this, the experience of fatigue in adolescent depression and how we target it in treatment is currently poorly understood. Therefore, we aimed to explore adolescents' experiences and understandings of fatigue in depression, recruiting from clinical and community settings. Semi-structured interviews were conducted with 19 UK-based adolescents aged 14-18 years old with elevated symptoms of depression. Using reflexive thematic analysis, three themes were generated. Fatigue is a complex concept explored adolescents' understanding of fatigue as a dynamic, multifaceted symptom which had mental and physical components. Trapped in a cycle of fatigue considered the complex and reciprocal relationship between fatigue and other depressive symptoms, and the subsequent impact of limited energy on engagement with everyday activities. Finally, stigma as a barrier to help-seeking highlighted how adolescents were reluctant to seek help due to experienced stigma and the perception that fatigue was not a serious enough symptom. Findings from this study suggest that fatigue should be viewed as a psychological as well as somatic symptom of depression, with implications regarding the identification and treatment of fatigue in depression in routine clinical practice.
Collapse
Affiliation(s)
- Nina Higson-Sweeney
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
| | - Kate Cooper
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Barnaby D Dunn
- Mood Disorders Centre, University of Exeter, Exeter, EX4 4QG, UK
| | - Maria E Loades
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| |
Collapse
|
13
|
Ryan SC, Sugg MM, Runkle JD, Wertis L, Singh D, Green S. Short-term changes in mental health help-seeking behaviors following exposure to multiple social stressors and a natural disaster. Soc Sci Med 2024; 348:116843. [PMID: 38603916 PMCID: PMC11134597 DOI: 10.1016/j.socscimed.2024.116843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/23/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
In 2020, unprecedented circumstances led to significant mental health consequences. Individuals faced mental health stressors that extended beyond the devastating impact of the COVID-19 pandemic, including widespread social unrest following the murder of George Floyd, an intense hurricane season in the Atlantic, and the politically divisive 2020 election. The objective of this analysis was to consider changes in help-seeking behavior following exposure to multiple social stressors and a natural disaster. Data from Crisis Text Line (CTL), a national text-based mental health crisis counseling service, was used to determine how help-seeking behavior changed in the wake of each event. Wilcoxon rank sum tests assessed changes in help-seeking behavior for each event in 2020 as compared to the same period in 2019. AutoRegressive Integrated Moving Average (ARIMA) models examined if changes in crisis conversation volumes following each event differed. Higher median conversation volumes noted for the COVID-19 pandemic (+1 to +5 conversations), Hurricane Laura (+1 to +7 conversations) and the 2020 Election (+1 to +26 conversations). ARIMA models show substantial increases in help-seeking behavior following the declaration of a national emergency for the COVID-19 pandemic (+4.3 to +38.2%) and following the 2020 election (+3 to +24.44%). Our analysis found that the mental health response following social stressors may be distinct from natural events, especially when natural disasters occur in the context of multiple social stressors. This analysis adds to the growing body of literature considering the mental health impact of exposure to multiple co-occurring societal stressors, like police violence and a global pandemic.
Collapse
Affiliation(s)
- Sophia C Ryan
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA.
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Raleigh NC, 27695, USA
| | - Luke Wertis
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Devyani Singh
- Data Team, Crisis Text Line, New York City, New York, USA
| | - Shannon Green
- Data Team, Crisis Text Line, New York City, New York, USA
| |
Collapse
|
14
|
Dos Santos SJ, Soares FC, Gaoua N, Rangel Junior JFLB, Lima RA, de Barros MVG. Development and validation of a scale to measure social isolation in adolescents. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024. [PMID: 38682550 DOI: 10.1111/jora.12952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/21/2023] [Accepted: 04/12/2024] [Indexed: 05/01/2024]
Abstract
There is a lack of questionnaires specifically designed to assess social isolation in adolescents. We developed and validated a self-report measure of social isolation in adolescents, the Social Isolation Questionnaire (QIS). A literature review on social isolation and mental health in adolescents indicated 20 questions to form QIS. Two cross-sectional surveys with 48 and 1135 adolescents, respectively, evaluated the reproducibility and validity of QIS. The Bland-Altman plot did not indicate a systematic difference between measurements 15 days apart. Bartlett's sphericity test verified a correlation between the questions and the Kaiser-Meyer-Olkin test showed good adequacy (.896) to the factor analysis. Exploratory factor analysis suggested the exclusion of three questions (loading factors <0.3), and eigenvalues (4.9-0.8) indicated that the questionnaire should be composed of three factors (dimensions). The Cronbach's alpha indicated high internal consistency of the 17 questions (0.850 overall; Dimensions: 0.815 'feeling of loneliness'; 0.760 'friendship'; and, 0.680 'Family support'). The QIS score ranged from 0 to 131 (maximum social isolation score). The correlation between QIS and depressive symptoms (r = .543) indicated the construct validity of QIS. We evaluated QIS in the Portuguese version, thus translation and cultural adaptation are necessary to evaluate the questionnaire in other settings. We constructed and validated the QIS questionnaire, a self-administered questionnaire to assess social isolation in adolescents, composed of three dimensions; feelings of loneliness, friendship and family support. The QIS questionnaire seems a very promising tool to support practitioners and researchers in assessing social isolation among adolescents.
Collapse
Affiliation(s)
- Simone José Dos Santos
- School of Physical Education, The Lifestyles and Health Research Group (GPES), University of Pernambuco, Recife, Pernambuco, Brazil
- Residência Multiprofissional Em Saúde Mental - Comissão de Residências Multiprofissionais da Universidade de Pernambuco (COREMU - UPE), Recife, Brazil
| | - Fernanda Cunha Soares
- School of Physical Education, The Lifestyles and Health Research Group (GPES), University of Pernambuco, Recife, Pernambuco, Brazil
- Postgraduate Program in Public Health, Federal University of Rio Grande Do Norte, Natal, Brazil
- Post-Graduation Program in Psychology, Federal University of Rio Grande, Rio Grande, Brazil
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nadia Gaoua
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, UK
| | - João F L B Rangel Junior
- School of Physical Education, The Lifestyles and Health Research Group (GPES), University of Pernambuco, Recife, Pernambuco, Brazil
| | - Rodrigo Antunes Lima
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Mauro Virgilio Gomes de Barros
- School of Physical Education, The Lifestyles and Health Research Group (GPES), University of Pernambuco, Recife, Pernambuco, Brazil
| |
Collapse
|
15
|
Wang JA, Wang HF, Cao B, Lei X, Long C. Cultural Dimensions Moderate the Association between Loneliness and Mental Health during Adolescence and Younger Adulthood: A Systematic Review and Meta-Analysis. J Youth Adolesc 2024:10.1007/s10964-024-01977-w. [PMID: 38662185 DOI: 10.1007/s10964-024-01977-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024]
Abstract
Cultural factors, such as country or continent, influence the relationship between loneliness and mental health. However, less is known about how cultural dimensions moderate this relationship during adolescence and younger adulthood, even if these dimensions manifest as country or continent differences. This study aims to examine the potential influence of Hofstede's cultural dimensions on this relationship using a three-level meta-analysis approach. A total of 292 studies with 291,946 participants aged 10 to 24 were included in this study. The results indicate that cultural dimensions, such as individualism vs. collectivism, indulgence vs. restraint, power distance, and long-term vs. short-term orientation, moderated the associations between loneliness and social anxiety, stress, Internet overuse, and negative affect. The association between loneliness and mental health was not moderated by cultural dimensions, such as masculinity and uncertainty avoidance. These findings suggest that culture's influence on the association between loneliness and mental health is based on a domain-specific mechanism.
Collapse
Affiliation(s)
- Jing-Ai Wang
- School of Psychology and Key Laboratory of Cognition and Personality of the Ministry of Education, Southwest University, Chongqing, 400715, China
| | - Hai-Fan Wang
- School of Psychology and Key Laboratory of Cognition and Personality of the Ministry of Education, Southwest University, Chongqing, 400715, China
| | - Bing Cao
- School of Psychology and Key Laboratory of Cognition and Personality of the Ministry of Education, Southwest University, Chongqing, 400715, China
| | - Xu Lei
- School of Psychology and Key Laboratory of Cognition and Personality of the Ministry of Education, Southwest University, Chongqing, 400715, China
| | - Changquan Long
- School of Psychology and Key Laboratory of Cognition and Personality of the Ministry of Education, Southwest University, Chongqing, 400715, China.
| |
Collapse
|
16
|
Boggero IA, Sangalli L, Brasch L, King CD. Social health in young women with chronic pain. Pain Rep 2024; 9:e1146. [PMID: 38505830 PMCID: PMC10950150 DOI: 10.1097/pr9.0000000000001146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction Chronic pain may negatively affect social functioning, but no study to date has examined the specific social impact of different chronic pain conditions in young women, and whether living with multiple chronic overlapping pain conditions (COPCs) differently influences social domains. Objectives This study aimed to assess social functioning (social isolation, hostility, informational support satisfaction, social roles, emotional support, friendships, and family relationships) among young women with chronic pain compared with pain-free controls and to test whether the number of COPCs influenced the extent of social burden. Methods Participants aged 18 to 30 years with a physician-confirmed diagnoses of migraine, fibromyalgia, or temporomandibular disorder (TMD) and pain-free controls were invited to participate from across the United States. After confirming eligibility, participants completed a 1-hour REDCap online questionnaire assessing social functioning. Results One hundred four participants (mean age 24.54 ± 3.35 years) were included (n = 26 with TMD, n = 25 with fibromyalgia, n = 25 with migraine, and n = 28 controls). All 3 chronic pain groups combined reported worse functioning than controls on friendship (P = 0.038), social isolation (P = 0.002), and social roles (P < 0.001). There were no differences on social variables between the 3 chronic pain groups (all P's > 0.05). Compared with those with 3 COPCs, participants with 1 condition reported better family relationships (P = 0.024). Conclusions Experience of chronic pain-regardless of the specific pain condition-may negatively affect some areas of social functioning in young women.
Collapse
Affiliation(s)
- Ian A. Boggero
- Division of Orofacial Pain, Department of Oral Health Science, College of Dentistry, University of Kentucky, Lexington, KY, USA
- Department of Psychology, College of Arts and Science, University of Kentucky, Lexington, KY, USA
- Department of Anesthesiology, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Linda Sangalli
- College of Dental Medicine—Illinois, Midwestern University, Downers Grove, IL, USA
| | - Lauryn Brasch
- Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Christopher D. King
- Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Pediatric Pain Research Center (PPRC), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| |
Collapse
|
17
|
Madsen KR, Damsgaard MT, Petersen K, Qualter P, Holstein BE. Bullying at School, Cyberbullying, and Loneliness: National Representative Study of Adolescents in Denmark. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:414. [PMID: 38673326 PMCID: PMC11050631 DOI: 10.3390/ijerph21040414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
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.
Collapse
Affiliation(s)
- Katrine Rich Madsen
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark; (K.R.M.); (M.T.D.)
| | - Mogens Trab Damsgaard
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark; (K.R.M.); (M.T.D.)
| | | | - Pamela Qualter
- Manchester Institute of Education, University of Manchester, Manchester M1 5AN, UK;
| | - Bjørn E. Holstein
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark; (K.R.M.); (M.T.D.)
| |
Collapse
|
18
|
Wang S, Zhang H, Lou Y, You Q, Jiang Q, Cao S. Association of social isolation and loneliness with the risk of hypertension in middle aged and older adults: Findings from a national representative longitudinal survey. J Affect Disord 2024; 349:577-582. [PMID: 38199413 DOI: 10.1016/j.jad.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 11/24/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Social isolation and loneliness have been proved to be associated with many adverse health outcomes, but their influence on hypertension remains unclear. This study aimed to assess the relationship of social isolation and loneliness with hypertension risk among middle-aged and older adults in China. METHODS We used data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. Participants were assessed for social isolation and loneliness at baseline, and hypertension was identified by self-report and blood pressure measurement at follow-up in 2015. Binary logistic regression analyses were conducted to assess the association of social isolation and loneliness with the risk of hypertension. RESULTS A total of 3711 residents were included. 13.7 % of the participants had high level of social isolation and 18.1 % felt lonely. During the four-year follow up period, 651 participants developed hypertension. People with high level of social isolation had an increased risk of hypertension (odds ratio [OR]: 1.40, 95 % confidence interval [CI]: 1.09-1.79). Similar results were found between social isolation score and hypertension risk (OR: 1.14, 95 % CI: 1.04-1.26). No significant association between loneliness and hypertension or any interaction effect of social isolation and loneliness on hypertension were observed. LIMITATIONS Limited by the structure of questionnaire, some of the information was derived by self-report, which may lead to recalling bias. CONCLUSION Social isolation, rather than loneliness was associated with hypertension for middle aged and older adults. Social support needs to be strengthened for hypertension prevention in community.
Collapse
Affiliation(s)
- Shiqi Wang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Hao Zhang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Yiling Lou
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Qiqi You
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Qingqing Jiang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Shiyi Cao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| |
Collapse
|
19
|
Han GT, Heavner HS, Rains TR, Hoang AH, Stone AL. Chronic Pain in Autistic Youth: Clinical Prevalence and Reflections on Tailoring Evidence-Based Interventions from an Interdisciplinary Treatment Team. CHILDREN (BASEL, SWITZERLAND) 2024; 11:312. [PMID: 38539347 PMCID: PMC10968925 DOI: 10.3390/children11030312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/13/2024] [Accepted: 03/02/2024] [Indexed: 06/06/2024]
Abstract
Though there is growing awareness of the overrepresentation of autistic patients in chronic pain clinics, potential adaptations for the assessment and treatment of chronic pain in this population have not yet been established. To address this gap, a retrospective review of electronic medical records and discussions by an interdisciplinary pain treatment team were summarized to inform potential biopsychosocial factors affecting the presentation, assessment, and treatment of chronic pain in autistic youth. Our sample included a record review of 95 patients receiving treatment in an interdisciplinary outpatient pediatric pain clinic. Results indicated that 9% (n = 9) of the patients presented to the clinic with a prior diagnosis of autism, but an additional 21% (n = 20) were identified as likely meeting criteria for autism based on the clinical assessment of the developmental history, behaviors observed during the clinical encounter(s), and expert clinical judgment, suggesting that the prevalence rate of autism may be closer to 30% in our outpatient pediatric pain clinic. Over half (52%) of the autistic youth presented to the clinic with widespread pain, 60% identified as female, and 6% identified as gender expansive or transgender. Qualitative insights revealed that most of the autistic patients had co-occurring sensory-processing challenges and difficulty in describing their pain, emotions, and somatic experiences and exhibited cognitive inflexibility and social challenges. We summarize our team's clinical reflections on how autism-relevant biopsychosocial vulnerability factors may contribute to the experience of pain in autistic youth and propose treatment targets and adaptations for the assessment and treatment of pain in this population. Finally, we recommend the need for interventions focused on sensorimotor integration, especially for autistic youth, and describe how pain clinics may be particularly helpful for identifying and supporting autistic females, for whom the potential role of autism in pain experiences had not been considered until receiving treatment in our clinic.
Collapse
Affiliation(s)
- Gloria T. Han
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (A.H.H.); (A.L.S.)
| | - Holly S. Heavner
- Department of Pediatric Rehabilitation, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (H.S.H.); (T.R.R.)
| | - Thomas R. Rains
- Department of Pediatric Rehabilitation, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (H.S.H.); (T.R.R.)
| | - Alan H. Hoang
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (A.H.H.); (A.L.S.)
| | - Amanda L. Stone
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (A.H.H.); (A.L.S.)
| |
Collapse
|
20
|
Patrono A, Renzetti S, Guerini C, Macgowan M, Moncada SM, Placidi D, Memo M, Lucchini RG. Social isolation consequences: lessons from COVID-19 pandemic in a context of dynamic lock-down in Chile. BMC Public Health 2024; 24:599. [PMID: 38402167 PMCID: PMC10893693 DOI: 10.1186/s12889-024-18064-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/10/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Chile did not adopt general and unified lockdowns for the whole nation but organized itself with dynamic and sometimes irregular lockdowns. These dynamics and consequences of social isolation could be generalized to other contexts of isolation such as those affecting minorities such as immigrants, prisoners, refugees. METHODS In this study, we investigated the physical and mental health symptoms associated with lifestyle changes due to lockdown among university students in Chile. We examined psychopathological variations in relation to mental health problems in a healthy young population. Our goal was to develop interventions to address these new psychosocial problems in potentially comparable post-pandemic contexts. From May 10th 2021 to June 2th 2021, 420 University students took part in an anonymous survey asking for information on habits and symptoms that emerged during the lockdown in response to the COVID-19 pandemic. Three health outcomes were assessed: digestive disorders; headache; fear of COVID-19. Covariates including conditions and lifestyle during the pandemic, SARS-CoV-2 infections in the family, financial situation and productivity were considered in the analysis. RESULTS Participants experienced headache and fear of COVID-19 quite frequently during the lockdown period. More than half of the sample also experienced social isolation. Female gender, sleep quality, memory difficulties, and a change in eating habits resulted associated with an increased risk of health outcomes such as headaches and digestive disorders. CONCLUSIONS The results of this study fit within an original pandemic context: The results of this study can help identify needs and promote solutions applicable to different contexts. Future interventions should focus on the promotion and implementation of healthy habits focused on sleep hygiene, psychoeducation on the use of mobile devices and gender medicine with the support of healthcare organizations and University.
Collapse
Affiliation(s)
- Alessandra Patrono
- Department of Molecular Medicine e. Translational, v.le Europa 11, 25121, Brescia, Italy.
| | - Stefano Renzetti
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, v.le Europa 11, 25121, Brescia, Italy
| | - Cristian Guerini
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, v.le Europa 11, 25121, Brescia, Italy
| | - Mark Macgowan
- Robert Stempel College of Public Health & Social Work, School of Social Work, Florida International University, 11200 SW 8th Street, AHC-5 Room 513, Miami, Florida, 33199, USA
| | - Stefanny M Moncada
- Departamento de Gobierno, Universidad del Desarrollo, Chile, 7610658, Las Condes, Región Metropolitana, Chile
| | - Donatella Placidi
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, v.le Europa 11, 25121, Brescia, Italy
| | - Maurizio Memo
- Department of Molecular Medicine e. Translational, v.le Europa 11, 25121, Brescia, Italy
| | - Roberto G Lucchini
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, v.le Europa 11, 25121, Brescia, Italy
- Department of Environmental Health Sciences, School of Public Health, Florida International University, 11200 SW 8th St #500, Miami, FL, 33174, USA
| |
Collapse
|
21
|
Bevilacqua G, Westbury LD, Bloom I, Zhang J, Lawrence WT, Barker ME, Ward KA, Dennison EM. General self-efficacy, not musculoskeletal health, was associated with social isolation and loneliness in older adults during the COVID-19 pandemic: findings from the Hertfordshire Cohort Study. Aging Clin Exp Res 2024; 36:20. [PMID: 38308733 PMCID: PMC10838234 DOI: 10.1007/s40520-023-02676-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/08/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Social isolation and loneliness are prevalent among older adults. This study investigated factors influencing worsening social isolation and loneliness in community-dwelling older adults during the COVID-19 pandemic, focusing on musculoskeletal conditions, falls, and fractures. METHODS We studied 153 participants from the Hertfordshire Cohort Study. Baseline assessments (2019-20) included osteoporosis, clinical osteoarthritis, fractures after age 45 years, falls in previous year, and lifestyle factors. Self-efficacy was assessed using a shortened General Self-Efficacy Scale. Social isolation was assessed using the 6-item Lubben Social Network Scale. Follow-up (2020-21) assessments included social isolation and loneliness using the 6-item De Jong-Gierveld scale for emotional, social, and overall loneliness. RESULTS Baseline median age was 83.1 years. A history of smoking predicted worsening social isolation (p = 0.046). Being married (p = 0.026) and higher self-efficacy scores (p = 0.03) predicted reduced social isolation at follow-up. Greater alcohol consumption was associated with higher overall loneliness (p = 0.026). Being married was related to a 36% (95% CI: 3%, 58%) reduction in emotional loneliness (p = 0.037). No musculoskeletal condition was associated with social isolation or loneliness. However, we observed a 22% (14%, 30%; p < 0.001) reduction in emotional loneliness and a 12% (4%, 20%; p = 0.003) reduction in overall loneliness per unit increase in self-efficacy score. CONCLUSIONS No musculoskeletal condition was associated with increased social isolation or loneliness, but longitudinal studies in larger samples are required. Greater self-efficacy was associated with reduced social isolation and reduced loneliness. Interventions promoting self-efficacy in older adults may reduce isolation and loneliness in this age group.
Collapse
Affiliation(s)
- Gregorio Bevilacqua
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Leo D Westbury
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Ilse Bloom
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Jean Zhang
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Wendy T Lawrence
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
- National Institute for Health and Care Research (NIHR), Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
| | - Mary E Barker
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
- National Institute for Health and Care Research (NIHR), Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Kate A Ward
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
- MRC Unit The Gambia, London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Elaine M Dennison
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
- National Institute for Health and Care Research (NIHR), Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK.
- School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand.
| |
Collapse
|
22
|
Yang M, Wei W, Ren L, Pu Z, Zhang Y, Li Y, Li X, Wu S. How loneliness linked to anxiety and depression: a network analysis based on Chinese university students. BMC Public Health 2023; 23:2499. [PMID: 38093295 PMCID: PMC10720215 DOI: 10.1186/s12889-023-17435-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND There is conclusive evidence of a multifaceted and bidirectional relationship between loneliness and depression and anxiety. Nonetheless, more extensive research is needed to examine their relationships at a more granular level. This study employed a network analysis approach to identify the pathological mechanisms underpinning those relationships and to identify important bridge nodes as potential targets for intervention. METHODS 941 University students were included in this study. The ULS-6 (the short-form UCLA Loneliness Scale) was used to assess loneliness, the PHQ-9 (Patient Health questionnaire-9) and GAD-7 (Generalized anxiety disorder 7-item) scales were used to assess the symptoms of depression and anxiety. We constructed two network structures of loneliness-anxiety and loneliness-depression and computed bridge expected influence for each symptom. In addition, we showed a flow network of "Suicide" containing symptoms of depression and loneliness. RESULTS All edges were positive in both networks constructed and the strongest edges were present within disorder communities. The overall connection between loneliness and depression was stronger compared to anxiety. The results demonstrated that the loneliness item "People are around me but not with me" was identified as bridge symptom in both networks. Furthermore, "Suicide" was directly connected to five symptoms of depression and four items of loneliness, with the strongest connections being between it and "Feeling of worthlessness" and "Psychomotor agitation/retardation". CONCLUSIONS Our findings provide a more nuanced explanation of the link between loneliness and depression and anxiety. The results identified the bridge symptom "People are around me but not with me", which had the strongest effect on enhancing symptoms of depression and anxiety. Clinical improvements based on the findings of this study and the impact of the intervention are discussed.
Collapse
Affiliation(s)
- Mengyuan Yang
- Department of Military Medical Psychology, Air Force Medical University, 169 West Changle Road, Xi'an, 710032, Shaanxi, China
| | - Wenwen Wei
- Department of Military Medical Psychology, Air Force Medical University, 169 West Changle Road, Xi'an, 710032, Shaanxi, China
| | - Lei Ren
- Military Psychology Section, Logistics University of PAP, Tianjin, 300309, China
- Military Mental Health Services & Research Center, Tianjin, 300309, China
| | - Zhaojun Pu
- Department of Military Medical Psychology, Air Force Medical University, 169 West Changle Road, Xi'an, 710032, Shaanxi, China
| | - Yuanbei Zhang
- Department of Military Medical Psychology, Air Force Medical University, 169 West Changle Road, Xi'an, 710032, Shaanxi, China
| | - Yu Li
- Academic Affairs Office, Air Force Medical University, 169 West Changle Road, Xi'an, 710032, Shaanxi, China
| | - Xinhong Li
- Department of General Medicine, Tangdu Hospital, Xi'an, 712046, Shaanxi, China.
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, 169 West Changle Road, Xi'an, 710032, Shaanxi, China.
| |
Collapse
|
23
|
White SW, Schall C, Santos JD, Maddox BB, Hillier A, Klinger L, Pugliese C. Promoting Quality of Life: Suggestions for Mental Health Care Providers Working with Young Autistic Adults. AUTISM IN ADULTHOOD 2023; 5:347-355. [PMID: 38116052 PMCID: PMC10726189 DOI: 10.1089/aut.2022.0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
There is a growing population of autistic adults in need of supports from a service delivery system that, at present, fails to accommodate their needs adequately and equitably. Unfortunately, there is a shortage of trained behavioral health service providers to meet the needs of young autistic adults. Quality of life (QoL), or one's perception of, and satisfaction with, life in relation to held goals and expectations, has been identified as a key outcome of interest by autistic self-advocates. By supporting autistic clients to hone their strengths and interests, integrate various aspects of their identity, identify goals, and connect to appropriate resources, providers can promote clients' self-knowledge and self-determination, in the service of improving QoL. In this Perspectives article, we offer concrete recommendations to mental health providers, including those who do not specialize in autism, with the goal of supporting implementation of evidence-based strategies that improve QoL and promote self-determination among young autistic clients.
Collapse
Affiliation(s)
- Susan W. White
- Center for Youth Development and Intervention, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Carol Schall
- Autism Center for Education, Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jin Delos Santos
- Project REACH, College of Staten Island at the City University of New York, Staten Island, New York, USA
| | - Brenna B. Maddox
- TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ashleigh Hillier
- Department of Psychology, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Laura Klinger
- TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cara Pugliese
- Center for Autism Spectrum Disorders, Children's National Hospital, Washington, District of Columbia, USA
| |
Collapse
|
24
|
Morse BL, Karian V. Supporting the Young Adulthood Transitions in Women With Migraine. Nurs Womens Health 2023; 27:457-466. [PMID: 37804861 DOI: 10.1016/j.nwh.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/01/2023] [Accepted: 09/13/2023] [Indexed: 10/09/2023]
Abstract
Migraine is a painful neurological disorder that disproportionately affects women and has a significant impact on quality of life. This article summarizes the critical role of women's health nurses in supporting young adult women with migraine during major life transitions. Nurses can advocate for workplace or school disability accommodations for women with migraine. Nurses can also support young adult women with migraine by providing education about available treatment that becomes available after an individual's 18th birthday. Women's health nurses can also provide counseling on healthy lifestyle habits to sustain through life transitions, such as guidance on safe alcohol consumption and wellness approaches to migraine management. Through these interventions, women's health nurses can help women with migraine to succeed personally, professionally, and academically while effectively managing migraine symptoms.
Collapse
|
25
|
Kyron MJ, Houghton S, Lawrence D, Page AC, Hunter SC, Gunasekera S. A Short-Form Measure of Loneliness to Predict Depression Symptoms Among Adolescents. Child Psychiatry Hum Dev 2023; 54:1760-1770. [PMID: 35622303 PMCID: PMC10581951 DOI: 10.1007/s10578-022-01370-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 11/24/2022]
Abstract
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.
Collapse
Affiliation(s)
- Michael J Kyron
- Graduate School of Education, University of Western Australia, Perth, WA, 6009, Australia
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Stephen Houghton
- Graduate School of Education, University of Western Australia, Perth, WA, 6009, Australia.
- Department of Psychology, Glasgow Caledonian University, Glasgow, Scotland.
| | - David Lawrence
- Graduate School of Education, University of Western Australia, Perth, WA, 6009, Australia
| | - Andrew C Page
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Simon C Hunter
- Graduate School of Education, University of Western Australia, Perth, WA, 6009, Australia
- Department of Psychology, Glasgow Caledonian University, Glasgow, Scotland
| | - Sashya Gunasekera
- Graduate School of Education, University of Western Australia, Perth, WA, 6009, Australia
| |
Collapse
|
26
|
Wenig V, Heumann E, Stock C, Busse H, Negash S, Pischke CR, Heinrichs K. Associations of loneliness with mental health and with social and physical activity among university students in Germany: results of the COVID-19 German student well-being study (C19 GSWS). Front Public Health 2023; 11:1284460. [PMID: 38026349 PMCID: PMC10668152 DOI: 10.3389/fpubh.2023.1284460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction University students are at high risk for loneliness with a potential negative impact on health. The COVID-19 measures disrupted students' academic routine and social life, which might have affected their perception of loneliness. This study investigated the prevalence of perceived loneliness among university students in Germany during the COVID-19 pandemic and its associations with mental health, behavioral outcomes, and sociodemographic characteristics. Methods COVID-19 German student well-being study (C19 GSWS) collected data from five German universities from October 27th to November 14th, 2021, resulting in a sample of 7,203 respondents. Associations of loneliness with depressive symptoms, anxiety, social and physical activity, as well as sociodemographic characteristics, were analyzed using multivariable logistic regressions. Results A total of 20.6% of students reported loneliness. Students with depressive or anxiety symptoms had more than eight- or sixfold odds, respectively, for reporting loneliness (depressive symptoms: OR = 8.29; 95% CI: 7.21-9.52; anxiety: OR = 6.48; 95% CI: 5.65-7.43) compared with students who did not report any symptoms. Students who were less physically active were more likely to experience loneliness compared with students who were more physically active (no moderate physical activity: OR = 1.39; 95% CI: 1.21-1.59; no vigorous physical activity: OR = 1.19; 95% CI: 1.04-1.36). We found no association between loneliness and social activity. However, loneliness was associated with being single (OR = 2.93; 95% CI: 2.55-3.36), living alone (OR = 1.31; 95% CI: 1.13-1.52), or having a temporary residency status in Germany (OR = 2.24; 95% CI: 1.65-3.04). Conclusion Our findings highlight the importance of loneliness as a relevant factor associated with health. Further research is needed to determine potential protective factors to tackle loneliness and to investigate how study conditions at higher education institutions may affect students' perceived loneliness.
Collapse
Affiliation(s)
- Vanessa Wenig
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
| | - Eileen Heumann
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
| | - Christiane Stock
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
- Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
| | - Heide Busse
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Sarah Negash
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Claudia R. Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Katherina Heinrichs
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
| |
Collapse
|
27
|
Bravata DM, Kim J, Russell DW, Goldman R, Pace E. Digitally Enabled Peer Support Intervention to Address Loneliness and Mental Health: Prospective Cohort Analysis. JMIR Form Res 2023; 7:e48864. [PMID: 37930770 PMCID: PMC10660210 DOI: 10.2196/48864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/08/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Social isolation and loneliness affect 61% of US adults and are associated with significant increases in excessive mental and physical morbidity and mortality. Annual health care spending is US $1643 higher for socially isolated individuals than for those not socially isolated. OBJECTIVE We prospectively evaluated the effects of participation with a digitally enabled peer support intervention on loneliness, depression, anxiety, and health-related quality of life among adults with loneliness. METHODS Adults aged 18 years and older living in Colorado were recruited to participate in a peer support program via social media campaigns. The intervention included peer support, group coaching, the ability to become a peer helper, and referral to other behavioral health resources. Participants were asked to complete surveys at baseline, 30, 60, and 90 days, which included questions from the validated University of California, Los Angeles Loneliness Scale, Patient Health Questionnaire 2-Item Scale, General Anxiety Disorder 7-Item Scale, and a 2-item measure assessing unhealthy days due to physical condition and mental condition. A growth curve modeling procedure using multilevel regression analyses was conducted to test for linear changes in the outcome variables from baseline to the end of the intervention. RESULTS In total, 815 ethnically and socially diverse participants completed registration (mean age 38, SD 12.7; range 18-70 years; female: n=310, 38%; White: n=438, 53.7%; Hispanic: n=133, 16.3%; Black: n=51, 6.3%; n=263, 56.1% had a high social vulnerability score). Participants most commonly joined the following peer communities: loneliness (n=220, 27%), building self-esteem (n=187, 23%), coping with depression (n=179, 22%), and anxiety (n=114, 14%). Program engagement was high, with 90% (n=733) engaged with the platform at 60 days and 86% (n=701) at 90 days. There was a statistically (P<.001 for all outcomes) and clinically significant improvement in all clinical outcomes of interest: a 14.6% (mean 6.47) decrease in loneliness at 90 days; a 50.1% (mean 1.89) decline in depression symptoms at 90 days; a 29% (mean 1.42) reduction in anxiety symptoms at 90 days; and a 13% (mean 21.35) improvement in health-related quality of life at 90 days. Based on changes in health-related quality of life, we estimated a reduction in annual medical costs of US $615 per participant. The program was successful in referring participants to behavioral health educational resources, with 27% (n=217) of participants accessing a resource about how to best support those experiencing psychological distress and 15% (n=45) of women accessing a program about the risks of excessive alcohol use. CONCLUSIONS Our results suggest that a digitally enabled peer support program can be effective in addressing loneliness, depression, anxiety, and health-related quality of life among a diverse population of adults with loneliness. Moreover, it holds promise as a tool for identifying and referring members to relevant behavioral health resources.
Collapse
Affiliation(s)
- Dena M Bravata
- Center for Primary Care and Outcomes Research, Stanford University, San Francisco, CA, United States
- Wisdo Health, Inc, New York, NY, United States
| | - Joseph Kim
- Wisdo Health, Inc, New York, NY, United States
- Department of Human Development & Family Studies, Iowa State University, Ames, IA, United States
| | - Daniel W Russell
- Wisdo Health, Inc, New York, NY, United States
- Department of Human Development & Family Studies, Iowa State University, Ames, IA, United States
| | - Ron Goldman
- Wisdo Health, Inc, New York, NY, United States
- Department of Technology Management and Innovation, Tandon School of Engineering, New York University, New York City, NY, United States
| | - Elizabeth Pace
- Peer Assistance Services, Inc, Denver, CO, United States
| |
Collapse
|
28
|
Leggett-James MP, Faur S, Kaniušonytė G, Žukauskienė R, Laursen B. The Perils of Not Being Attractive or Athletic: Pathways to Adolescent Adjustment Difficulties Through Escalating Unpopularity. J Youth Adolesc 2023; 52:2231-2242. [PMID: 37537421 DOI: 10.1007/s10964-023-01835-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/26/2023] [Indexed: 08/05/2023]
Abstract
Adolescents who lack traits valued by peers are at risk for adjustment difficulties but the mechanisms responsible for deteriorating well-being have yet to be identified. The present study examines processes whereby low athleticism and low attractiveness give rise to adolescent adjustment difficulties. Participants were public middle school students (ages 10 to 13 years, Mage = 11.54, SDage = 1.00) in the USA and Lithuania (300 girls, 280 boys; 52.7% girls). Self-reports of alcohol misuse and loneliness were collected three times during an academic year (M = 12.3 week intervals). Athleticism, attractiveness, unpopularity, and peer rejection were assessed through peer nominations. Full longitudinal mediation analyses examined direct and indirect pathways from stigmatized traits (i.e., low athleticism, low attractiveness) to adjustment difficulties (i.e., alcohol misuse, loneliness) through two indices of low peer status: unpopularity and rejection. The results indicated that the possession of stigmatized traits predicted escalating unpopularity, which, in turn, predicted increasing adjustment difficulties. Similar indirect associations did not emerge with rejection as a mediator, underscoring the unique role of power and prominence (and the lack thereof) in socioemotional development. The findings underscore the adjustment risks and interpersonal challenges that confront children and adolescents who lack traits valued by peers.
Collapse
Affiliation(s)
| | - Sharon Faur
- Florida Atlantic University, 3200 College Avenue, Fort Lauderdale, FL, 33314, USA
| | - Goda Kaniušonytė
- Mykolas Romeris University, Ateities Street, 20, LT-08303, Vilnius, Lithuania
| | - Rita Žukauskienė
- Mykolas Romeris University, Ateities Street, 20, LT-08303, Vilnius, Lithuania
| | - Brett Laursen
- Florida Atlantic University, 3200 College Avenue, Fort Lauderdale, FL, 33314, USA.
- Mykolas Romeris University, Ateities Street, 20, LT-08303, Vilnius, Lithuania.
| |
Collapse
|
29
|
Vicario-Molina I, Ortega EG, González RP, Picos AP. Factors predicting mental health in youth during the first COVID-19 lockdown in Spain. BMC Psychol 2023; 11:317. [PMID: 37803388 PMCID: PMC10559502 DOI: 10.1186/s40359-023-01367-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 09/29/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND The first COVID-19 lockdown decreed in Spain by the government resulted in a significant disruption in the daily lives of youth that may have affected their mental health. The aim of this study was to identify factors that influenced youth mental health during this period. METHODS Between March and May 2020, a sample of 1205 youths (age range 18-24 years) from across Spain completed a questionnaire that assessed sociodemographic, mental health, loneliness, coping with humour and healthy habits. Data were analysed using Structural Equation Modelling. RESULTS The proposed model showed good fit values, and significant variables explained 37% of mental health. loneliness, coping humour, healthy and unhealthy habits, and gender significantly predicted youth mental health. CONCLUSIONS The consequences of the pandemic and confinement derived from COVID-19 seemed to be especially severe for youth, increasing their mental health vulnerability. It is recommended that evaluating the long-term effects of confinement on this population, the mental health needs they may have and the support resources that would help meet them in situations of isolation, paying special attention to females.
Collapse
Affiliation(s)
- Isabel Vicario-Molina
- Department of Developmental and Educational Psychology, University of Salamanca, Avenida de la Merced s/n, Salamanca, 37005, Spain.
| | - Eva González Ortega
- Department of Developmental and Educational Psychology, University of Salamanca, Avenida de la Merced s/n, Salamanca, 37005, Spain
| | - Ruth Pinedo González
- Department of Psychology, University of Valladolid, Plaza de la Universidad, 1, Segovia, 400005, Spain
| | - Andrés Palacios Picos
- Department of Psychology, University of Valladolid, Plaza de la Universidad, 1, Segovia, 400005, Spain
| |
Collapse
|
30
|
Tandon S, Patte KA, Goldfield GS, Leatherdale ST, Chaput JP. Loneliness during COVID-19 and its association with eating habits and 24-hour movement behaviours in a sample of Canadian adolescents. Prev Med Rep 2023; 35:102287. [PMID: 37361922 PMCID: PMC10273770 DOI: 10.1016/j.pmedr.2023.102287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/27/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023] Open
Abstract
Loneliness, a feeling of distress, has aggravated due to the COVID-19 pandemic lockdowns and reduced social interactions. The objective of this study was to explore whether increased loneliness due to the COVID-19 pandemic was associated with various health behaviours in adolescence, a critical period for the development of lasting lifestyle habits. We used self-reported data from 40,521 Canadian adolescents aged 12-19 years (collected between November 2020 and June 2021) for this cross-sectional study. Logistic regression was used to predict the odds of skipping breakfast and not meeting movement behaviour guidelines [moderate-to-vigorous physical activity (≥60 min/day), recreational screen time (≤2 h/day), sleep duration (≥8 h/day)] among adolescents with increased loneliness due to the COVID-19 pandemic. We found higher odds of skipping breakfast [boys: OR 1.40 (95% CI: 1.32, 1.49), girls: OR 1.62 (95% CI: 1.53, 1.71)], exceeding screen time guidelines [boys: OR 1.43 (95% CI: 1.24, 1.66), girls: OR 1.72 (95% CI: 1.54, 1.92)], and insufficient sleep duration [boys: OR 1.38 (95% CI: 1.28, 1.48), girls: OR 1.36 (95% CI: 1.27, 1.45)] in adolescents with increased loneliness (versus decreased/stayed the same loneliness group). However, we found clinically insignificant results with moderate-to-vigorous physical activity. Future longitudinal studies in adolescents are needed to confirm the directionality of these associations. Recovery efforts are needed to support adolescent social health and establish healthy behavioural habits across the lifespan.
Collapse
Affiliation(s)
- Saniya Tandon
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Karen A Patte
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, Niagara Region, St. Catharines, Ontario, Canada
| | - Gary S Goldfield
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Jean-Philippe Chaput
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
31
|
Aasan BEV, Lillefjell M, Krokstad S, Sund ER. Trends in social inequality and how mental wellbeing vary and covary among Norwegian adolescents and their families: the Young-HUNT Study. Scand J Public Health 2023:14034948231172634. [PMID: 37776173 DOI: 10.1177/14034948231172634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
BACKGROUND The study had two aims: first, to investigate trends in socioeconomic inequalities in psychological distress and loneliness among Norwegian adolescents, and second, to study variation and covariation of psychological distress and loneliness within adolescents and between siblings within families. METHODS Multivariate mixed models were used to investigate trends in socioeconomic inequality in psychological distress and loneliness using three separate cohorts of Norwegian adolescents from the Young-HUNT study conducted in 1995-1997 (Young-HUNT1, n = 8980), 2006-2008 (Young-HUNT3, n = 8199) and 2017-2019 (Young-HUNT4, n = 8066). Register data on parental education level was used as a marker of socioeconomic position (SEP), and a unique family number was used to identify adolescents belonging to the same family. A three-level multivariate mixed model was created, consisting of the outcomes at level 1, adolescents at level 2 and families at level 3. RESULTS No statistically significant difference in scores on loneliness and psychological distress was observed between low and high parental education level in Young-HUNT1, whereas in Young-HUNT4, low parental education level was associated with a higher score on both psychological distress (β = 0.09; 95% confidence interval (CI), 0.03-0.14) and loneliness (β = 0.12; 95% CI 0.07-0.17). Analyses of covariation between psychological distress and loneliness showed that they were correlated within adolescents and strongly correlated within families across all timepoints. CONCLUSIONS Increasing socioeconomic inequalities in psychological distress and loneliness among Norwegian adolescents is worrisome. Further, the family seems to be an important arena for potential prevention of psychological distress and loneliness among adolescents, regardless of parental education level.
Collapse
Affiliation(s)
- Bodil Elisabeth Valstad Aasan
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Monica Lillefjell
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Erik R Sund
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| |
Collapse
|
32
|
Wei Y, Tang J, Zhao J, Liang J, Li Z, Bai S. Association of loneliness and social isolation with mental disorders among medical residents during the COVID-19 pandemic: A multi-center cross-sectional study. Psychiatry Res 2023; 327:115233. [PMID: 37567113 PMCID: PMC10172154 DOI: 10.1016/j.psychres.2023.115233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Loneliness and social isolation usually increase the risk of mental disorders. However, this association among Chinese medical residents during the COVID-19 pandemic remains unclear. METHODS This study was conducted in September 2022; 1,338 medical residents from three hospitals in Northeastern China were included in the final analysis. The data were collected via online self-administered questionnaires. Adjusted odds ratios and 95% confidence intervals were determined for adjusting for potential confounders by binary logistic regression. RESULTS Among the 1,338 participants, 12.93% (173), 9.94% (133), and 9.72% (130) had experienced major depression, major anxiety, and suicidal ideation, respectively. Further, 24.40% (327) and 44.50% (596) of the total participants had experienced loneliness and social isolation. Loneliness increased the risk of major depression, major anxiety, and suicidal ideation (all p<0.001); Compared with the lowest quartile, the odds ratios of the highest quartile were 4.81, 4.63, and 5.34. The same result was obtained in relation to social isolation (all p<0.001). CONCLUSIONS The findings of this study revealed a considerable prevalence of loneliness, social isolation, and mental disorders among Chinese medical residents during the COVID-19 pandemic. Both loneliness and social isolation increased the risk of major depression, major anxiety, and suicidal ideation.
Collapse
Affiliation(s)
- Yingliang Wei
- Department of Orthopedics, Shengjing Hospital of China Medical University.
| | - Jun Tang
- Department of thoracic surgery, Shengjing hospital of China Medical University; Department of postgraduate Administration, Shengjing Hospital of China Medical University.
| | - Jianzhu Zhao
- Department of oncology, Shengjing hospital of China Medical University.
| | - Jiajian Liang
- Department of Orthopedics, Shengjing Hospital of China Medical University.
| | - Zhiyuan Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Song Bai
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China.
| |
Collapse
|
33
|
Hysing M, Petrie KJ, Harvey AG, Lønning KJ, Sivertsen B. Loneliness Across the COVID-19 Pandemic: Risk Factors in Norwegian Young People. CLINICAL PSYCHOLOGY IN EUROPE 2023; 5:e10483. [PMID: 38356899 PMCID: PMC10863635 DOI: 10.32872/cpe.10483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 07/17/2023] [Indexed: 02/16/2024] Open
Abstract
Background There is evidence of increasing levels of loneliness in Norwegian young people before the COVID-19 pandemic. It is not clear how the COVID-19 pandemic, and the associated necessary restrictions, impacted on these trends. Aims To examine how loneliness in young people changed across the pandemic, how loneliness relates to demographic characteristics and how different pandemic restrictions impacted loneliness. Method We analyzed data from three waves of a Norwegian national higher education student survey (the SHoT-study). Data was examined from 2018 from a total of 49,836 students, 2021 from 62,212 students, and from 2022 from 53,362 (response rates 31-35%). Loneliness was measured by "The Three-Item Loneliness Scale" (T-ILS). Results There was a sharp increase in loneliness from 2018 to 2021, and a reduction in levels of loneliness in 2022, although at increased levels compared to prior to the pandemic. Females consistently report higher levels of loneliness than males, with a larger difference during the peak of the pandemic. There were higher rates of loneliness in geographical regions with higher COVID rates and greater pandemic-related restrictions during 2021. Loneliness was lower among students reporting more days on campus in 2021 and for those with lectures on campus in 2022, both with dose-response associations. Conclusions Loneliness is a major public health problem among young adults in higher education. Loneliness increased during the pandemic and has decreased but is still not back to pre-pandemic levels. The results suggest the importance of open campuses and in-person lectures, for increased social connectedness among young people.
Collapse
Affiliation(s)
- Mari Hysing
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Keith J. Petrie
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Allison G. Harvey
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Kari-Jussie Lønning
- Modum Bad Psychiatric Hospital, Vikersund, Norway
- The Student Welfare Organization in Oslo and Akershus (SiO), Oslo, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Research & Innovation, Helse-Fonna HF, Haugesund, Norway
| |
Collapse
|
34
|
Zhang J, Loman L, Oldhoff JM, Schuttelaar MLA. Beyond Anxiety and Depression: Loneliness and Psychiatric Disorders in Adults with Atopic Dermatitis. Acta Derm Venereol 2023; 103:adv9378. [PMID: 37605893 PMCID: PMC10461544 DOI: 10.2340/actadv.v103.9378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/20/2023] [Indexed: 08/23/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Junfen Zhang
- Department of Dermatology, University of Groningen, University Medical Centre Groningen, the Netherlands.
| | - Laura Loman
- Department of Dermatology, University of Groningen, University Medical Centre Groningen, the Netherlands
| | - Jantje M Oldhoff
- Department of Dermatology, University of Groningen, University Medical Centre Groningen, the Netherlands
| | - Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Centre Groningen, the Netherlands
| |
Collapse
|
35
|
Lim MH, Manera KE, Owen KB, Phongsavan P, Smith BJ. The prevalence of chronic and episodic loneliness and social isolation from a longitudinal survey. Sci Rep 2023; 13:12453. [PMID: 37528108 PMCID: PMC10393986 DOI: 10.1038/s41598-023-39289-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/22/2023] [Indexed: 08/03/2023] Open
Abstract
Loneliness and social isolation, experienced more long-term, has been shown to increase mortality and lead to poorer health outcomes in specific cohorts. However, it is unclear what the prevalence of chronic loneliness and social isolation is, and which demographic groups are most at risk of reporting more chronic forms. A psychometrically validated classification system was used to identify people who met criteria for episodic and chronic loneliness and social isolation using the Household Income and Labour Dynamics in Australia (HILDA) survey waves 14-18. The prevalence of loneliness (overall 34%; 21% episodic, 13% chronic) far exceeded that of social isolation (overall 17%; 13% episodic, 4% chronic). There was consistency in the demographic characteristics (from age, sex, household type, income) of those who experienced loneliness and social isolation. However, people with a long-term health condition had an elevated risk of episodic loneliness (AOR 1.24, 95% CI 1.11-1.39) and a markedly higher risk of chronic loneliness (AOR 2.01, 95% CI 1.76-2.29), compared with those without a long-term health condition. Loneliness, both episodic and chronic subtypes, is more prevalent than social isolation. However, both chronic loneliness and social isolation remains neglected and poorly targeted within current practice and policy.
Collapse
Affiliation(s)
- Michelle H Lim
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Victoria, Australia.
| | - Karine E Manera
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Katherine B Owen
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Philayrath Phongsavan
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Ben J Smith
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
36
|
Wong ELY, Qiu H, Cheung AWL, Leung HHW, Chen FY, Yeoh EK. Association of social isolation with health status among community-dwelling Chinese older adults living with homecare services: a cross-sectional survey in Hong Kong. Front Public Health 2023; 11:1099734. [PMID: 37333567 PMCID: PMC10272830 DOI: 10.3389/fpubh.2023.1099734] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/11/2023] [Indexed: 06/20/2023] Open
Abstract
Background Defined as having few social relationships or infrequent social contact with family, friends, and the community, social isolation is a public health crisis. We aimed to evaluate the prevalence of social isolation and explore the association between social isolation and health status among community-dwelling Chinese Older Adults living with homecare services. Methods This is a cross-sectional survey with a structured questionnaire conducted among older adults aged ≥60 in the Central Kowloon District of Hong Kong during 2017-2018. Social isolation was assessed by the Lubben Social Network Scale-6 and a score less than 12 was defined as socially isolated. Six aspects of health status including fall risk, cognitive function, depression, activities of daily living (ADL), instrumental activities of daily living (IADL), and functional mobility were measured by standardized instruments. Multi-criteria decision analysis (MCDA) was applied to estimate an index to represent the overall health status of the respondents. Multivariate logistic/linear regression models were applied to examine the associations between social isolation and health status after adjusting the sociodemographic characteristics. Results Among the 1,616 participants included in this analysis, the mean age was 80.9 years, 66.3% were female and 41.4% were identified as socially isolated. Compared with the non-isolated group, the socially isolated group had higher proportions of males, divorced or unmarried, ever smoking and drinking, living alone, and living in public housing without religion. After adjusting for confounders, the odds ratios (OR) comparing the socially isolated vs. non-isolated groups were 2.52 (95%CI: 1.79, 3.56) for high fall risk, 1.51 (1.17, 1.94) for cognitive impairment, and 1.78 (1.31, 2.43) for depression. The socially isolated group increased the odds of abnormal ADL, IADL, and functional mobility by 105-150%, and decreased the overall health score by 5.30 (3.42, 7.18). Conclusion We demonstrated the association of social isolation with poorer physical function and mental health and overall health status among the community-dwelling Chinese older adults living with homecare services. These findings provided new knowledge about the association of social isolation with both physical and mental function for daily living even for those receiving an integrated homecare service in the community. It implies that an unmet healthcare need existed when comparing the service scope of the current homecare services in the community. It also highlighted the need for targeted prevention and intervention initiatives among community-dwelling old adults to alleviate social isolation for better health and good functioning in the community.
Collapse
Affiliation(s)
- Eliza Lai-Yi Wong
- Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Hong Qiu
- Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Annie Wai-Ling Cheung
- Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Hera Hiu-Wah Leung
- Department of Management Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Frank Youhua Chen
- Department of Management Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Eng-Kiong Yeoh
- Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| |
Collapse
|
37
|
Chang H, Ruan W, Chen Y, Cai L, Liu X. Gender differences in the relationship between loneliness and health-related behavioral risk factors among the Hakka elderly in Fujian, China. Front Psychiatry 2023; 14:1196092. [PMID: 37333935 PMCID: PMC10272343 DOI: 10.3389/fpsyt.2023.1196092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/17/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction To explore gender differences in the relationship between loneliness and health-related behavioral risk factors (BRFs) among the Hakka elderly. Methods Loneliness was measured by the UCLA Loneliness Scale Short-form (ULS-8). Seven BRFs were examined. Mann-Whitney U, Kruskal-Wallis, and post hoc tests were conducted to compare the differences in ULS-8 scores among the Hakka elderly with different BRFs. Generalized linear regression models were employed to examine the associations of specific BRF and its number with the ULS-8 scores among the Hakka elderly in male, female, and total samples. Results Physical inactivity (B = 1.96, p < 0.001), insufficient leisure activities participation (B = 1.44, p < 0.001), unhealthy dietary behavior (B = 1.02, p < 0.001), and irregular sleep (B = 2.45, p < 0.001) were positively correlated with the ULS-8 scores, whereas drinking (B = -0.71, p < 0.01) was negatively associated with the ULS-8 scores in the total sample. In males, insufficient leisure activities participation (B = 2.35, p < 0.001), unhealthy dietary behavior (B = 1.39, p < 0.001), and irregular sleep (B = 2.07, p < 0.001) were positively associated with the ULS-8 scores. In females, physical inactivity (B = 2.69, p < 0.001) and irregular sleep (B = 2.91, p < 0.001) was positively correlated with the scores of ULS-8, while drinking (B = -0.98, p < 0.05) was negatively associated with the ULS-8 scores. More BRFs were significantly related to greater loneliness (p < 0.001). Conclusion There are gender differences in the relationship between loneliness and BRFs among the Hakka elderly, and individuals with more BRFs were more likely to feel loneliness. Therefore, the co-occurrence of multiple BRFs requires more attention, and integrated behavioral intervention strategies should be adopted to reduce the loneliness of the elderly.
Collapse
Affiliation(s)
- Huajing Chang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Wenqian Ruan
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yating Chen
- Department of Health Management, School of Health Management, Fujian Medical University, Fuzhou, China
| | - Longhua Cai
- Department of Health Management, School of Health Management, Fujian Medical University, Fuzhou, China
| | - Xiaojun Liu
- Department of Health Management, School of Health Management, Fujian Medical University, Fuzhou, China
| |
Collapse
|
38
|
Schütz R, Bilz L. [Loneliness in childhood and adolescence. On the prevalence of a mental health risk factor among 11- to 15-year-old German students]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023:10.1007/s00103-023-03728-x. [PMID: 37261459 DOI: 10.1007/s00103-023-03728-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/19/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Loneliness is an increasingly present topic in both public and scientific discourse. There is increasing research on the prevalence of loneliness and health-related correlates in adults. However, there are only a few findings on loneliness in childhood and adolescence in Germany. Therefore, this study aims to present findings on the prevalence of loneliness among 11- to 15-year-old German students and examines associations with socio-demographic characteristics. METHODS The Health Behaviour in School-aged Children (HBSC) study is a global research collaboration under the auspices of the World Health Organization (WHO). In the federal state of Brandenburg, Germany, the study collected data from 3819 children and adolescents in grades 5, 7, and 9 (Mage = 13.5, SD = 1.6) at schools for general education. Loneliness was assessed using the University of California, Los Angeles (UCLA) Loneliness Scale and a single item. RESULTS Of the respondents, 13.2% reported feeling lonely most of the time and 3.6% always. Loneliness was more prevalent among girls and non-binary students, as well as among older students and children and adolescents of lower socioeconomic status. DISCUSSION The findings indicate that loneliness is a widespread phenomenon among children and adolescents. The result that girls, older pupils and children, and adolescents with lower family wealth report feeling lonelier is consistent with findings from other countries and provides starting points for planning prevention measures. Further research is needed in Germany on possible health-related correlates of loneliness.
Collapse
Affiliation(s)
- Raphael Schütz
- Institut für Gesundheit, Fakultät für Soziale Arbeit, Gesundheit und Musik, Brandenburgische Technische Universität Cottbus-Senftenberg, Universitätsplatz 1, 01968, Senftenberg, Deutschland.
| | - Ludwig Bilz
- Institut für Gesundheit, Fakultät für Soziale Arbeit, Gesundheit und Musik, Brandenburgische Technische Universität Cottbus-Senftenberg, Universitätsplatz 1, 01968, Senftenberg, Deutschland
| |
Collapse
|
39
|
Reine I, Miķelsone M, Guðmundsson H, Ivanovs A, Tomsone S, Guðmundsson HS. Loneliness, social isolation and ageing: a methodological approach to compare Latvian and Icelandic older populations in the course of COVID-19 pandemic. RESEARCH SQUARE 2023:rs.3.rs-2870118. [PMID: 37205568 PMCID: PMC10187401 DOI: 10.21203/rs.3.rs-2870118/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Background Feelings of loneliness and social isolation are common among the elderly, affecting both health and wellbeing. The COVID-19 pandemic has altered social connections through health precautions, restrictions and other factors. However, limited research has been conducted on how older people's health and wellbeing in different countries has been impacted by the COVID-19 pandemic. The aim of this study was to develop methodology that would allow us to compare elderly populations, aged 67 + in Latvia and Iceland, and to discuss the potential impact of diverging factors on the association between loneliness, social isolation and health. Methods Quantitative data on 420 respondents from Wave 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was utilized in Latvia. Data on health and wellbeing of elderly in Iceland from a HL20 study with 1033 respondents was used to provide comparative analytic material for studying the differences between Latvia and Iceland, and within each country. Results The study revealed considerable differences between the countries regarding the frequency of loneliness and social isolation. About 80% of Latvian respondents felt socially isolated and 45% were lonely, compared to 42.7% socially isolated and 30% lonely Icelanders. In general, more elderly people in Latvia experienced difficulties than their peers in Iceland. Social isolation tends to differ across genders and age groups in both countries. This is related to marital and employment status, financial situation, and education. COVID-19 had a stronger deteriorating effect on mental and physical health among both lonely Latvian and Icelandic respondents. However, health deterioration was stronger amongst more socially isolated Icelanders compared to Latvians. Conclusions The study suggests that social isolation is a contributing factor and increases the risk of loneliness, which might have been enhanced by restrictions during the COVID-19 pandemic.
Collapse
|
40
|
Banerjee A, Kaur Chawla S, Kohli N. The 100 Top-Cited Studies on Loneliness: A Bibliometric Analysis. Cureus 2023; 15:e37246. [PMID: 37162789 PMCID: PMC10164348 DOI: 10.7759/cureus.37246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2023] [Indexed: 05/11/2023] Open
Abstract
The present study explores characteristics of the top 100 most-cited articles on loneliness. A systematic search was carried out using the Thomson Reuters Web of Science Core Collection to collect studies on loneliness from inception to June 1, 2022. The initial search resulted in 6,250 search results, which included articles, book chapters, conference proceedings, editorials, and letters. Two authors independently screened the literature and extracted the data. The study supervisor removed any discrepancies. Top 100 papers (articles and reviews) on loneliness published in English were extracted. Data analysis and visualization were performed on Excel, Web of Science (WoS) Data Analyzer, and VOSviewer 1.6.16. The total number of citations of the 100 top-cited articles was 42,044, ranging from 203 to 2,201 per article. All of the studies were published from 1989 to 2021, and the years with the highest number of top-cited articles published were 2003 and 2008. Most publications were from the following journals: Computers in Human Behavior, Developmental Psychology, Psychological Science, Psychology, and Aging (n=4 each). The most cited article was titled "UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure" by Russell, DW, in the Journal of Personality Assessment. The most productive institute was the University of Chicago. The two most productive authors were Cacioppo, JT, and Hawkley, LC. Of the 100 top-cited publications, 87 were original articles and 13 were reviews. The top three WoS categories were psychology multidisciplinary, gerontology, and psychiatry. In total, 37 author keywords were elicited and further clubbed into eight distinct clusters. The study provides new insight into loneliness research, which may help doctors, researchers, and stakeholders achieve a more comprehensive understanding of trends and influential contributions to the field and highlight under-researched areas, which could be the basis for future investigation.
Collapse
Affiliation(s)
- Aditya Banerjee
- Department of Psychology, University of Allahabad, Prayagraj, IND
| | | | - Neena Kohli
- Department of Psychology, University of Allahabad, Prayagraj, IND
| |
Collapse
|
41
|
Nahman-Averbuch H, Li R, Boerner KE, Lewis C, Garwood S, Palermo TM, Jordan A. Alterations in pain during adolescence and puberty. Trends Neurosci 2023; 46:307-317. [PMID: 36842946 DOI: 10.1016/j.tins.2023.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/16/2023] [Accepted: 01/27/2023] [Indexed: 02/26/2023]
Abstract
During adolescence and puberty, alterations in pain, both experimental and clinical, are observed. In addition, adolescents undergo extensive biopsychosocial changes as they transition from childhood to adulthood. However, a better understanding of how the biopsychosocial changes during adolescence impact pain is needed to improve pain management and develop targeted pain interventions for adolescents. This review synthesizes the literature on alterations in pain during adolescence in humans, describes the potential biopsychosocial factors impacting pain during adolescence, and suggests future research directions to advance the understanding of the impact of adolescent development on pain.
Collapse
Affiliation(s)
- Hadas Nahman-Averbuch
- Washington University Pain Center and Division of Clinical and Translational Research, Department of Anesthesiology, Washington University in St Louis School of Medicine, St. Louis, MO, USA.
| | - Rui Li
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Katelynn E Boerner
- Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Christopher Lewis
- Division of Endocrinology and Diabetes, Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA; Transgender Center at St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, USA
| | - Sarah Garwood
- Transgender Center at St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, USA
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA; Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Abbie Jordan
- Department of Psychology and Centre for Pain Research, University of Bath, Bath, United Kingdom
| |
Collapse
|
42
|
Amate-Fortes I, Guarnido-Rueda A, Martínez-Navarro D, Oliver-Márquez FJ. Social Isolation, Healthy Habits, Inequality and Mental Health in the United States. APPLIED RESEARCH IN QUALITY OF LIFE 2023; 18:1-27. [PMID: 37359221 PMCID: PMC9999329 DOI: 10.1007/s11482-023-10155-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/15/2023] [Indexed: 06/28/2023]
Abstract
The objective of this work is to deepen the analysis of the socioeconomic determinants of mental health, paying special attention to the impact of inequality, not only in income distribution but also in gender, racial, health and education inequality, social isolation, including new variables to measure loneliness, and healthy habits, on the mental health status. For this purpose, a cross-sectional model for a sample of 2735 counties in the United States is estimated using Ordinary Least Squares in its robust version to solve the detected heteroscedasticity problems. The results obtained show that inequality, social isolation and certain lifestyles, such as smoking or insomnia, are detrimental to mental health, while sexual activity prevents mental distress. On the other hand, poor counties suffer more cases of suicide, with food insecurity being the main problem for mental health. Finally, we found detrimental effects of pollution on mental health.
Collapse
Affiliation(s)
- Ignacio Amate-Fortes
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120 Almeria, Spain
| | - Almudena Guarnido-Rueda
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120 Almeria, Spain
| | - Diego Martínez-Navarro
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120 Almeria, Spain
| | - Francisco J. Oliver-Márquez
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120 Almeria, Spain
| |
Collapse
|
43
|
Cena L, Trainini A, Zecca S, Bonetti Zappa S, Cunegatti F, Buizza C. Loneliness, affective disorders, suicidal ideation, and the use of psychoactive substances in a sample of adolescents during the COVID-19 pandemic: A cross-sectional study. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2023. [PMID: 36883299 DOI: 10.1111/jcap.12412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/01/2023] [Accepted: 02/19/2023] [Indexed: 03/09/2023]
Abstract
PROBLEM The global coronavirus (COVID-19) pandemic has been challenging for adolescents. Indeed, with the closure of schools and social centers and reduction of extracurricular activities, increased social isolation has compounded difficulties in and with school performance, loneliness, and social networking. Increased risk of mental health problems, substance abuse, affective disorders, suicidal ideation, and suicide has been reported in adolescents. METHODS This cross-sectional study assesses the association between loneliness, depression, anxiety, suicidal ideation, the use of social networks, and school achievement in a sample of Italian adolescents during the COVID-19 pandemic. This study also explores emotional dysregulation through the association between affective disorders (depression and anxiety), substance use, and social networks. The sample comprises adolescents in the first and second grades of high school during the pandemic; participants received an email explaining the purpose of the e-research. Data were collected using the Strengths and Difficulties Questionnaire, the Achenbach System of Empirically Based Assessment, and the Loneliness Scale. FINDINGS A total of 505 adolescents completed the web survey. Data revealed that students experienced difficulties with loneliness, problems with school achievement, and extracurricular activities. The mean scores for depression and anxiety were close to the borderline range. A total of 14.3% of adolescents intentionally harmed themselves or attempted suicide. CONCLUSIONS This study raises concerns about the impacts of the pandemic on adolescents that require the attention of adult reference figures who deal with adolescents, such as parents, teachers, and healthcare professionals. Results indicate the necessity of providing early interventions aimed at the prevention of psychopathologies and the promotion of adolescent mental health due to the pandemic.
Collapse
Affiliation(s)
- Loredana Cena
- Department of Clinical and Experimental Sciences (DSCS), Section of Neuroscience, University of Brescia, Brescia, Italy
| | - Alice Trainini
- Department of Clinical and Experimental Sciences (DSCS), Section of Neuroscience, University of Brescia, Brescia, Italy
| | - Sara Zecca
- Department of Clinical and Experimental Sciences (DSCS), Section of Neuroscience, University of Brescia, Brescia, Italy
| | - Sofia Bonetti Zappa
- Department of Clinical and Experimental Sciences (DSCS), Section of Neuroscience, University of Brescia, Brescia, Italy
| | - Federica Cunegatti
- Department of Clinical and Experimental Sciences (DSCS), Section of Neuroscience, University of Brescia, Brescia, Italy
| | - Chiara Buizza
- Department of Clinical and Experimental Sciences (DSCS), Section of Neuroscience, University of Brescia, Brescia, Italy
| |
Collapse
|
44
|
Lay-Yee R, Matthews T, Moffitt T, Poulton R, Caspi A, Milne B. Are trajectories of social isolation from childhood to mid-adulthood associated with adult depression or suicide outcomes. Soc Psychiatry Psychiatr Epidemiol 2023; 58:373-382. [PMID: 36456781 PMCID: PMC9715405 DOI: 10.1007/s00127-022-02389-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE Social isolation has been shown to have negative effects on mental health outcomes though little is known about trajectories across the life course. We examined the relationship between trajectory groups and selected mental health outcomes in mid-adulthood. METHODS We previously created a typology of social isolation based on onset during the life course and persistence into adulthood, using group-based trajectory analysis of longitudinal data from a New Zealand birth cohort. The typology comprises four groups: 'never-isolated', 'adult-only', 'child-only', and 'persistent (child-adult) isolation'. We undertook logistic regression analyses of three mental health outcomes with trajectory group as the predictor, adjusting for sex and a range of familial and child-behavioural factors. RESULTS Lifetime suicide attempt, and depression and suicide ideation in mid-adulthood were each associated with adult-only but not child-only social isolation. Depression in mid-adulthood was also associated with persistent child-adult social isolation. CONCLUSION Although our findings are associational and not causal, they indicate that interrupting persistent social isolation may help to prevent adult depression whereas halting adult social isolation may ameliorate both depression and suicide outcomes.
Collapse
Affiliation(s)
- Roy Lay-Yee
- Centre of Methods and Policy Application in the Social Sciences, School of Social Sciences, Faculty of Arts, University of Auckland, Auckland, New Zealand.
| | - Timothy Matthews
- Department of Social Genetic and Developmental Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Terrie Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Richie Poulton
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Barry Milne
- Centre of Methods and Policy Application in the Social Sciences, School of Social Sciences, Faculty of Arts, University of Auckland, Auckland, New Zealand
- Department of Statistics, Faculty of Science, University of Auckland, Auckland, New Zealand
| |
Collapse
|
45
|
Vasan S, Eikelis N, Lim MH, Lambert E. Evaluating the impact of loneliness and social isolation on health literacy and health-related factors in young adults. Front Psychol 2023; 14:996611. [PMID: 36777213 PMCID: PMC9911678 DOI: 10.3389/fpsyg.2023.996611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/03/2023] [Indexed: 01/28/2023] Open
Abstract
Objectives In current study, we aim to extend previous research by investigating the unique impact of loneliness on health literacy and health-related factors of young adults, after controlling for social isolation, depressive symptomology, and social anxiety, as well as evaluate how social isolation and loneliness differ in their impact on health literacy, and health-related factors among young adults, after accounting for abovementioned concomitant variables. Methods Using a cross-sectional study design, 521 young adults completed an online survey in 2020, where they self-reported their loneliness, social isolation, health-related factors, and health literacy data. Results Increased loneliness was associated with decrease in several health literacy domains (e.g., poorer social support for health, lower appraisal of health information, among others) and increase in some health-related factors (e.g., higher perceived stress, higher negative affect), among young adults, even after controlling for social anxiety, depressive symptomology, and social isolation. Contrastingly, increase in social isolation was associated with changes in some health-related factors - more somatic health complaints, higher alcohol use, poorer cognitive and physical functioning, and lower scores for only one health literacy domain (i.e., social support for health) among young adults, after adjusting for the influence of social anxiety, depressive symptomology, and loneliness. Conclusion Even after accounting for the influence of several co-occurring social and mental health symptoms, higher loneliness was associated poorer health literacy and health-related factors in young adults. We also found loneliness and social isolation may differ in the mechanisms through which they impact health literacy and health-related factors in young adults.
Collapse
|
46
|
Monnig MA, Clark SE, Avila JC, Sokolovsky AW, Treloar Padovano H, Goodyear K, Aston ER, Haass-Koffler CL, Tidey JW, Ahluwalia JS, Monti PM. COVID-19-Related Stressors and Clinical Mental Health Symptoms in a Northeast US Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1367. [PMID: 36674123 PMCID: PMC9858791 DOI: 10.3390/ijerph20021367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/30/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Research has linked specific COVID-19-related stressors to the mental health burden, yet most previous studies have examined only a limited number of stressors and have paid little attention to their clinical significance. This study tested the hypothesis that individuals who reported greater COVID-19-related stressors would be more likely to have elevated levels of anxiety, posttraumatic stress symptoms, and serious psychological distress. METHODS An online survey was administered to a convenience sample from 18 June to 19 July 2020, in US states that were most affected by COVID-19 infections and deaths at the time. Individuals who were 18 or older and residents of five Northeast US states were eligible to participate (N = 1079). In preregistered analyses, we used logistic regression models to test the associations of COVID-19 stressors with symptoms on the Generalized Anxiety Disorder-7 (GAD-7), Impact of Event Scale-Revised, and K6, adjusting for sociodemographic covariates. RESULTS COVID-19-related stressors (i.e., essential worker status, worry about COVID-19 infection, knowing someone hospitalized by COVID-19, having children under 14 at home, loneliness, barriers to environmental rewards, food insecurity, loss of employment) were associated with meeting thresholds (i.e., positive screening) for anxiety, posttraumatic stress, and/or serious psychological distress. Loneliness and barriers to environmental rewards were associated with all mental health outcomes. LIMITATIONS We used a non-probability sample and cannot assume temporal precedence of stressors with regard to development of mental health symptoms. CONCLUSIONS These findings link specific stressors to the mental health burden of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Mollie A. Monnig
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| | - Samantha E. Clark
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| | - Jaqueline C. Avila
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| | - Alexander W. Sokolovsky
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| | - Hayley Treloar Padovano
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, USA
| | - Kimberly Goodyear
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, USA
| | - Elizabeth R. Aston
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| | - Carolina L. Haass-Koffler
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, USA
| | - Jennifer W. Tidey
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, USA
| | - Jasjit S. Ahluwalia
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| | - Peter M. Monti
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
- Center for Addiction and Disease Risk Exacerbation, Brown University, Providence, RI 02912, USA
| |
Collapse
|
47
|
Keyes H, Gradidge S, Gibson N, Harvey A, Roeloffs S, Zawisza M, Forwood S. Attending live sporting events predicts subjective wellbeing and reduces loneliness. Front Public Health 2023; 10:989706. [PMID: 36684908 PMCID: PMC9848399 DOI: 10.3389/fpubh.2022.989706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/09/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction This study explored whether attending live sporting events (LSEs) improved subjective wellbeing and loneliness, above and beyond demographic predictors. Methods Secondary data from 7,249 adults from the Taking Part 2019-20 survey (UK household survey of participation in culture and sport) were analyzed. Multiple linear regressions captured the effect of attending LSEs (yes/no) on wellbeing variables (happiness, anxiety, a sense that life is worthwhile and life satisfaction) and loneliness, with gender, Index of Multiple Deprivation (IMD), age group, health and employment as covariates. Results For life satisfaction, a sense that life is worthwhile, and loneliness, inclusion of LSE attendance in the model improved model fit significantly, although ΔR2 values were small (ΔR2 = 0.001-0.003). For happiness and anxiety, the inclusion of LSE attendance did not alter model fit. LSE attendance was associated with increased life satisfaction (b = 0.171, p < 0.001), a greater sense of life being worthwhile (b = 0.230, p < 0.001), and reduced loneliness (b = -0.083, p < 0.01). Conclusion LSE attendance has positive associations with some aspects of subjective wellbeing (life satisfaction and a sense of life being worthwhile) and loneliness, above and beyond demographic predictors. Whilst the variance explained is small, it is comparable to demographic predictors (e.g., being in employment). As even small-sized differences in SWB can have meaningful outcomes (e.g., for mortality), we conclude that LSE attendance may still offer a scalable, accessible and effective means of improving the public's wellbeing and reducing loneliness.
Collapse
|
48
|
Zandy M, El Kurdi S, Samji H, McKee G, Gustafson R, Smolina K. Mental health-related healthcare service utilisation and psychotropic drug dispensation trends in British Columbia during COVID-19 pandemic: a population-based study. Gen Psychiatr 2023; 36:e100941. [PMID: 36875149 PMCID: PMC9971830 DOI: 10.1136/gpsych-2022-100941] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/28/2023] [Indexed: 03/02/2023] Open
Abstract
Background The impact of the COVID-19 pandemic on the population's mental health is vital for informing public health policy and decision-making. However, information on mental health-related healthcare service utilisation trends beyond the first year of the pandemic is limited. Aims We examined mental health-related healthcare service utilisation patterns and psychotropic drug dispensations in British Columbia, Canada, during the COVID-19 pandemic compared with the prepandemic period. Methods We conducted a retrospective population-based secondary analysis using administrative health data to capture outpatient physician visits, emergency department visits, hospital admissions and psychotropic drug dispensations. We examined time trends of mental health-related healthcare service utilisation and psychotropic drug dispensations between January to December 2019 (prepandemic period) and January 2020 to December 2021 (pandemic period). In addition, we calculated age-standardised rates and rate ratios to compare mental health-related healthcare service utilisation before and during the first two years of the COVID-19 pandemic, stratified by year, sex, age and condition. Results By late 2020, except for emergency department visits, utilisation of healthcare services recovered to prepandemic levels. Between 2019 and 2021, the monthly average rate for overall mental health-related outpatient physician visits, emergency department visits and psychotropic drug dispensations increased significantly by 24%, 5% and 8%, respectively. Notable and statistically significant increases were observed among 10-14 year-olds (44% in outpatient physician visits, 30% in emergency department visits, 55% in hospital admissions and 35% in psychotropic drug dispensations) and 15-19 year-olds (45% in outpatient physician visits, 14% in emergency department visits, 18% in hospital admissions and 34% in psychotropic drug dispensations). Additionally, these increases were more prominent among females than males, with some variation for specific mental health-related conditions. Conclusions The increase in mental health-related healthcare service utilisation and psychotropic drug dispensations during the pandemic likely reflects significant societal consequences of both the pandemic and pandemic management measures. Recovery efforts in British Columbia should consider these findings, especially among the most affected subpopulations, such as adolescents.
Collapse
Affiliation(s)
- Moe Zandy
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Sylvia El Kurdi
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Hasina Samji
- BC Centre for Disease Control, Vancouver, British Columbia, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.,School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.,BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Geoff McKee
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Reka Gustafson
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Kate Smolina
- BC Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
49
|
Abstract
PURPOSE OF REVIEW Mental illness is a global challenge, exacerbated by the coronavirus pandemic. Research suggests access to local green spaces is associated with better mental health, yet access is not always equitable. Evaluation of how nature-based interventions protect and support mental health is therefore required. RECENT FINDINGS Accessible local green spaces are associated with better mental health. They encourage active behaviours and social interaction, reduce loneliness and stress. Green views from the home are associated with increased self-esteem, life satisfaction and happiness and reduced depression, anxiety and loneliness. Nature-based interventions and green social prescriptions effectively target vulnerable groups, resulting in significant reductions in depression, anxiety and anger alongside positive mental health outcomes. SUMMARY Although existing evidence is encouraging, robust, high-quality research that strengthens the evidence base and informs future clinical practice and policy decision making is needed. Evidence of the long-term effectiveness in individuals with diagnosed mental illness is also required to ascertain the potential social and wider returns on investment. Barriers to use of green social prescriptions like mental health symptoms and geographical accessibility need to be overcome to increase accessibility and uptake of green social prescriptions for the prevention and treatment of mental illness.
Collapse
|
50
|
Winfield A, Sugar C, Fenesi B. The impact of the COVID-19 pandemic on the mental health of families dealing with attention-deficit hyperactivity disorder. PLoS One 2023; 18:e0283227. [PMID: 36928863 PMCID: PMC10019744 DOI: 10.1371/journal.pone.0283227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic uprooted regular routines forcing many children to learn from home, requiring many adults to work from home, and cutting families off from support outside the home. Public health restrictions associated with the pandemic caused widespread psychological distress including depression and anxiety, increased fear, panic, and stress. These trends are particularly concerning for families raising neuroatypical children such as those with Attention-Deficit Hyperactivity Disorder (ADHD), as these children are already more likely than their typically developing peers to experience comorbid mental health issues, and to experience greater distress when required to stay indoors. Families with children who have ADHD are also at greater risk for experiencing heightened familial stress due to the challenges associated with managing ADHD behavioural symptoms, greater parental discord and divorce, and greater financial difficulties compared to other families. The current study engaged families comprised of at least one child diagnosed with ADHD to elucidate 1) the unique ways that the COVID-19 pandemic affected their mental health and 2) the specific barriers these families faced to maintaining optimal mental wellbeing. METHODS AND FINDINGS A total of 33 participants (15 parent-child dyads) engaged in virtual interviews. Content analysis revealed that the most frequently identified mental health effects for families were increased child anxiety and disconnectedness, as well as deteriorating parental mental health. The most frequently identified barriers to maintaining optimal mental wellbeing were lack of routine, lack of social interaction and social supports, and uncertainty and fear. CONCLUSIONS Findings underscore areas of need during times of large-scale social isolation, specifically for families with children who have ADHD. This work contributes to a growing body of research aimed at creating safeguards to support mental wellbeing for vulnerable families during times of crisis.
Collapse
Affiliation(s)
- Alexis Winfield
- Faculty of Education, Western University, London, Ontario, Canada
| | - Carly Sugar
- Faculty of Education, Western University, London, Ontario, Canada
| | - Barbara Fenesi
- Faculty of Education, Western University, London, Ontario, Canada
| |
Collapse
|