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Brooks JM, Umucu E, Huck GE, Fortuna K, Sánchez J, Chiu CY, Bartels SJ. Sociodemographic characteristics, health conditions, and functional impairment among older adults with serious mental illness reporting moderate-to-severe pain. Psychiatr Rehabil J 2018; 41:224-233. [PMID: 30160508 PMCID: PMC6123826 DOI: 10.1037/prj0000316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To compare adults aged ≥50 years with serious mental illness reporting moderate-to-severe pain to older adults with serious mental illness without pain with respect to sociodemographic characteristics, health conditions, and functional impairment. METHOD Secondary data analyses were conducted using baseline assessments of 183 participants recruited for the Helping Older People Experience Success (HOPES) study from three community mental health centers. The primary outcome was self-reported, nonexperimentally induced, moderate-to-severe pain (referent = no-to-mild pain). Predictor variables consisted of sociodemographic characteristics, health conditions, and functional impairment. We conducted univariable and multivariable logistic regression analyses to examine the associations between these variables. RESULTS Sixty-one participants (33.3%) from our sample reported pain. Pain was associated with all of the sociodemographic and health-related factors in univariable analyses. In the multivariable model, only older age, pain-related activity interference, and physical and emotional health-related social limitations were significantly associated with pain. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The presence of moderate-to-severe pain in older adults with serious mental illness is associated with pain-attributable impairment of activities and social problems above and beyond the substantial functional limitations routinely experienced by this high-risk, high-need group. Given the high rates of preexisting conditions and persistent social impairment among these older adults, our findings suggest that pain may contribute to worse overall functional outcomes. Future research and clinical interventions focused on improving outcomes should include an evaluation of pain as a contributor to decreased functioning and assess the need for early intervention, nonpharmacological pain management, or other health promotion services in psychiatric rehabilitation. (PsycINFO Database Record
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Affiliation(s)
- Jessica M. Brooks
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College, Lebanon, NH
- University of North Texas, Denton, TX
| | - Emre Umucu
- Department of Rehabilitation Sciences, The University of Texas at El Paso, El Paso, Texas
| | - Garrett E. Huck
- Department of Rehabilitation and Human Services, Pennsylvania State University- Penn State Hazleton, Hazleton, PA
| | - Karen Fortuna
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College, Lebanon, NH
| | - Jennifer Sánchez
- Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, IA
| | - Chung-Yi Chiu
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Urbana, IL
| | - Stephen J. Bartels
- Department of Psychiatry, Geisel School of Medicine and Centers for Health and Aging, Dartmouth College, Lebanon, NH
- The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH
- Centers for Health and Aging, Lebanon, NH
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152
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Oliveira D, Sousa L, Aubeeluck A. What would most help improve the quality of life of older family carers of people with dementia? A qualitative study of carers' views. DEMENTIA 2018; 19:939-950. [PMID: 30079764 DOI: 10.1177/1471301218791906] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Older family carers of people with dementia provide a substantial amount of care for people with dementia in the UK. Caregiving can be stressful and burdensome for these individuals, who are also experiencing psychological and physical changes resulting from their own ageing process. However, little is known about what impacts their quality of life, how this can be improved and what we should prioritise. This brief report asks one simple question to older family carers of people living with dementia – “What would most help improve your quality of life as a carer?” Qualitative data were collected from 150 carers who completed an anonymous paper survey during the development and validation of a quality of life tool for use with this population (DQoL-OC). Participants were individuals aged 60 and over and were providing care for a family member with dementia at home in the UK. Carers were recruited from a variety of voluntary organizations, community-based carers’ groups, health services and via online forums. A thematic approach was used to analyse the carers’ comments and three main overarching themes were identified. The quality of life of older family carers can be enhanced by having more time away from caregiving, accessing health and social services that are dementia friendly and by having economic support. Future care, policies and research should aim to address these key areas in order to promote better quality of life for older carers of people with dementia. Further implications for practice, policy and research are discussed.
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Affiliation(s)
- Deborah Oliveira
- Institute of Mental Health, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Lidia Sousa
- Department of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal
| | - Aimee Aubeeluck
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
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153
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Stout ME, Meints SM, Hirsh AT. Loneliness Mediates the Relationship Between Pain During Intercourse and Depressive Symptoms Among Young Women. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1687-1696. [PMID: 29511895 PMCID: PMC6035118 DOI: 10.1007/s10508-017-1138-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 11/16/2017] [Accepted: 12/13/2017] [Indexed: 06/08/2023]
Abstract
Previous research suggests that women who experience pain during intercourse also experience higher rates of depressive symptoms. Loneliness might be one factor that contributes to this relationship. We hypothesized that women who experience more severe and interfering pain during intercourse would report higher rates of loneliness and higher rates of depressive symptoms. Further, we hypothesized that loneliness would mediate the relationship between pain during intercourse and depressive symptoms. A total of 104 female participants (85.6% white, 74.03% partnered, 20.9 [3.01] years old) completed an online survey including demographic information, PROMIS Vaginal Discomfort Measure, PROMIS Depression Measure, and Revised UCLA Loneliness Scale. Pearson correlations and bootstrapped mediation analysis examined the relationships among pain during intercourse, loneliness, and depressive symptoms. Pain during intercourse, loneliness, and depressive symptoms were all significantly correlated (p < .05). Results of the mediation analysis indicated that loneliness was a significant mediator of the relationship between pain during intercourse and depressive symptoms (indirect effect = 0.077; 95% CI 0.05-0.19). After accounting for loneliness, pain during intercourse was not significantly related to depressive symptoms, suggesting that loneliness fully mediated the relationship between pain during intercourse and depressive symptoms. These findings are consistent with previous studies highlighting that pain during intercourse is related to depressive symptoms. The current study adds to that literature and suggests that more frequent and severe pain during intercourse leads to more loneliness, which then leads to increased depressive symptoms. This line of work has important implications for treating women who experience depressive symptoms and pain during intercourse.
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Affiliation(s)
- Madison E Stout
- Department of Psychology, Indiana University-Purdue University at Indianapolis, 402 N Blackford St., Indianapolis, IN, 46202, USA
| | - Samantha M Meints
- Department of Psychology, Indiana University-Purdue University at Indianapolis, 402 N Blackford St., Indianapolis, IN, 46202, USA
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University at Indianapolis, 402 N Blackford St., Indianapolis, IN, 46202, USA.
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154
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Paolillo EW, Obermeit LC, Tang B, Depp CA, Vaida F, Moore DJ, Moore RC. Smartphone-based ecological momentary assessment (EMA) of alcohol and cannabis use in older adults with and without HIV infection. Addict Behav 2018; 83:102-108. [PMID: 29126667 DOI: 10.1016/j.addbeh.2017.10.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 09/22/2017] [Accepted: 10/23/2017] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Ecological momentary assessment (EMA) has been used to characterize substance use among adult populations; however, little is known about the validity of EMA and the patterns and predictors of substance use among older adults with and without HIV infection. METHODS Thirty-five (22 HIV-positive, 13 HIV-negative) older adults aged 50-74 were assessed for 14days and completed up to four smartphone-based surveys per day. RESULTS Participants completed an average of 89.5% of possible EMA surveys. EMA self-reported alcohol and cannabis use were significantly positively correlated with laboratory-assessed, self-reported days of alcohol (r=0.52, p=0.002) and cannabis (r=0.61, p<0.001) used and quantity of alcohol (r=0.42, p=0.013) and cannabis (r=0.41, p=0.016) used in the 30days prior to baseline assessment. In a subset of 15 alcohol or cannabis users, preliminary analyses of the effects of mood and pain on alcohol or cannabis use showed: 1) greater anxious mood predicted substance use at the next EMA survey (OR=1.737, p=0.023), 2) greater happiness predicted substance use later in the day (OR=1.383, p<0.001), and 3) higher pain level predicted substance use earlier in the day (OR=0.901, p=0.005). CONCLUSIONS Findings demonstrate that EMA-measured alcohol and cannabis use has convergent validity among older adults with and without HIV infection. Preliminary results showing predictors of substance use highlight the importance of gathering EMA data to examine daily variability and time-dependent antecedents of substance use among this population.
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155
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Shahane AD, Fagundes CP, Denny BT. Mending the heart and mind during times of loss: A review of interventions to improve emotional well-being during spousal bereavement. BEREAVEMENT CARE : FOR ALL THOSE WHO HELP THE BEREAVED 2018; 37:44-54. [PMID: 31548757 PMCID: PMC6756769 DOI: 10.1080/02682621.2018.1493640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Spousal loss is one of life's greatest stressors. Bereaved spouses are at risk for aberrant cognitive and affective processing. Recent work in psychoneuroimmunology and cognitive neuroscience reveals physiological biomarkers and neural mechanisms underlying acute distress and grief during bereavement that may represent targets for future interventions. We review evidence from existing pharmacological and psychotherapeutic treatment approaches for normal bereavement, complicated grief, and bereavement-related depression. We propose promising future directions, namely the development and empirical validation of novel, personalised cognitive and neurostimulatory interventions to promote adaptive emotion regulation and reduce depressive symptoms following spousal loss. Future work may substantiate which interventions to improve emotional and physical health will be best matched to the needs of a particular surviving spouse.
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Affiliation(s)
| | - Christopher P. Fagundes
- Rice University, Houston, TX
- The University of Texas MD Anderson Cancer Center, Houston, TX
- Baylor College of Medicine, Houston, TX
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156
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Nersesian PV, Han HR, Yenokyan G, Blumenthal RS, Nolan MT, Hladek MD, Szanton SL. Loneliness in middle age and biomarkers of systemic inflammation: Findings from Midlife in the United States. Soc Sci Med 2018; 209:174-181. [PMID: 29735350 PMCID: PMC6013269 DOI: 10.1016/j.socscimed.2018.04.007] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 03/15/2018] [Accepted: 04/05/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Middle-aged adults who are lonely have an elevated likelihood of death. Systemic inflammation may contribute to these increased odds. Using population-level data, this study tested if systemic inflammation is associated with loneliness in a broad age range of middle-aged adults in the United States. METHODS This study used data from the Midlife in the US (MIDUS) survey Biomarker Project, which collected data on psychological, social, and physiological measures from a sample of middle-aged adults. This sample included the 927 participants who were 35-64 years at Biomarker Project data collection. MIDUS collected baseline data from 1995-1996 and a follow-up survey was conducted from 2004-2006. The baseline Milwaukee sample of African Americans was collected in 2005-2006 and the biomarker database was collected in 2004-2009. Biomarkers were obtained from a fasting blood sample. Self-reported loneliness was categorized as feeling lonely or not feeling lonely. Hierarchical regressions examined the association between biomarkers of systemic inflammation (interleukin-6, fibrinogen, C-reactive protein) and feeling lonely, adjusted for covariates. RESULTS Twenty-nine percent of the sample reported feeling lonely most or some of the time. There was a positive significant relationship between loneliness and the three systemic inflammation biomarkers after controlling for covariates: interleukin-6 (n = 873) (b [se] = 0.07 [0.03], p = .014); fibrinogen (n = 867) (b [se] = 18.24 [7.12], p = .011); and C-reactive protein (n = 867) (b [se] = 0.08 [0.04], p = .035). CONCLUSIONS Feeling lonely is associated with systemic inflammation in middle-aged community-dwelling US adults.
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Affiliation(s)
- Paula V Nersesian
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Hae-Ra Han
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Gayane Yenokyan
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Roger S Blumenthal
- Johns Hopkins School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
| | - Marie T Nolan
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Melissa D Hladek
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Sarah L Szanton
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA; Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA.
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157
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Mumtaz F, Khan MI, Zubair M, Dehpour AR. Neurobiology and consequences of social isolation stress in animal model-A comprehensive review. Biomed Pharmacother 2018; 105:1205-1222. [PMID: 30021357 DOI: 10.1016/j.biopha.2018.05.086] [Citation(s) in RCA: 200] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 05/10/2018] [Accepted: 05/18/2018] [Indexed: 12/09/2022] Open
Abstract
The brain is a vital organ, susceptible to alterations under genetic influences and environmental experiences. Social isolation (SI) acts as a stressor which results in alterations in reactivity to stress, social behavior, function of neurochemical and neuroendocrine system, physiological, anatomical and behavioral changes in both animal and humans. During early stages of life, acute or chronic SIS has been proposed to show signs and symptoms of psychiatric and neurological disorders such as anxiety, depression, schizophrenia, epilepsy and memory loss. Exposure to social isolation stress induces a variety of endocrinological changes including the activation of hypothalamic-pituitary-adrenal (HPA) axis, culminating in the release of glucocorticoids (GCs), release of catecholamines, activation of the sympatho-adrenomedullary system, release of Oxytocin and vasopressin. In several regions of the central nervous system (CNS), SIS alters the level of neurotransmitter such as dopamine, serotonin, gamma aminobutyric acid (GABA), glutamate, nitrergic system and adrenaline as well as leads to alteration in receptor sensitivity of N-methyl-D-aspartate (NMDA) and opioid system. A change in the function of oxidative and nitrosative stress (O&NS) mediated mitochondrial dysfunction, inflammatory factors, neurotrophins and neurotrophicfactors (NTFs), early growth response transcription factor genes (Egr) and C-Fos expression are also involved as a pathophysiological consequences of SIS which induce neurological and psychiatric disorders.
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Affiliation(s)
- Faiza Mumtaz
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Muhammad Imran Khan
- Department of Pharmacy, Kohat University of Science and Technology, 26000 Kohat, KPK, Pakistan; Drug Detoxification Health Welfare Research Center, Bannu, KPK, Pakistan
| | - Muhammad Zubair
- Key Laboratory of Integrated Management of Crop Diseases and Pests, College of Plant Protection, Nanjing Agriculture University, Nanjing, 210095, PR China
| | - Ahmad Reza Dehpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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158
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Hyland P, McGinty G, Karatzias T, Murphy J, Vallières F, McHugh Power J. Can the REBT theory explain loneliness? Theoretical and clinical applications. Cogn Behav Ther 2018; 48:39-51. [PMID: 29869571 DOI: 10.1080/16506073.2018.1475505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Loneliness is a common psychological experience affecting a significant minority of the general population. Loneliness may in part be related to the existence of dysfunctional cognitive evaluations. To date, however, loneliness has yet to be explicitly assessed within a cognitive-behavioural theoretical framework. The current study sought to determine the association between negative cognitions, within the context of Rational Emotive Behaviour Therapy (REBT), and the experience of loneliness. A multinational sample of university students (n = 397) completed self-report assessments of rational and irrational beliefs, and loneliness. Structural equation modelling results found that the REBT model of psychopathology, and the REBT model of psychological health, provided satisfactory representations of loneliness, explaining 36% and 23% of variance in loneliness, respectively. Several dysfunctional ("Demandingness", "Catastrophising" and "Self-Downing" beliefs) and functional ("Preferences" and "Self-Acceptance" beliefs) cognitions were directly and indirectly associated with loneliness. These results highlight that cognitions and loneliness are meaningfully related, and indicate that cognitive-behavioural models may be useful in understanding loneliness. More specifically, current results suggest that REBT may offer a viable psychotherapeutic approach to treating loneliness.
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Affiliation(s)
- Philip Hyland
- a School of Business , National College of Ireland , Dublin , Ireland.,b Centre for Global Health, School of Psychology , Trinity College Dublin , Ireland
| | - Gráinne McGinty
- a School of Business , National College of Ireland , Dublin , Ireland
| | - Thanos Karatzias
- c NHS Lothian, Rivers Centre for Traumatic Stress , Edinburgh , UK.,d Edinburgh Napier University , School of Health & Social Care , Edinburgh , UK
| | - Jamie Murphy
- e School of Psychology , Ulster University , Derry , Northern Ireland
| | - Frédérique Vallières
- b Centre for Global Health, School of Psychology , Trinity College Dublin , Ireland
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159
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Gerłowska J, Skrobas U, Grabowska-Aleksandrowicz K, Korchut A, Szklener S, Szczęśniak-Stańczyk D, Tzovaras D, Rejdak K. Assessment of Perceived Attractiveness, Usability, and Societal Impact of a Multimodal Robotic Assistant for Aging Patients With Memory Impairments. Front Neurol 2018; 9:392. [PMID: 29910769 PMCID: PMC5992288 DOI: 10.3389/fneur.2018.00392] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/14/2018] [Indexed: 12/31/2022] Open
Abstract
The aim of the present study is to present the results of the assessment of clinical application of the robotic assistant for patients suffering from mild cognitive impairments (MCI) and Alzheimer Disease (AD). The human-robot interaction (HRI) evaluation approach taken within the study is a novelty in the field of social robotics. The proposed assessment of the robotic functionalities are based on end-user perception of attractiveness, usability and potential societal impact of the device. The methods of evaluation applied consist of User Experience Questionnaire (UEQ), AttrakDiff and the societal impact inventory tailored for the project purposes. The prototype version of the Robotic Assistant for MCI patients at Home (RAMCIP) was tested in a semi-controlled environment at the Department of Neurology (Lublin, Poland). Eighteen elderly participants, 10 healthy and 8 MCI, performed everyday tasks and functions facilitated by RAMCIP. The tasks consisted of semi-structuralized scenarios like: medication intake, hazardous events prevention, and social interaction. No differences between the groups of subjects were observed in terms of perceived attractiveness, usability nor-societal impact of the device. The robotic assistant societal impact and attractiveness were highly assessed. The usability of the device was reported as neutral due to the short time of interaction.
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Affiliation(s)
- Justyna Gerłowska
- Faculty of Education and Psychology, Institute of Methodology and Psychological Diagnosis, UMCS, Lublin, Poland.,Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Urszula Skrobas
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | | | - Agnieszka Korchut
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | | | | | - Dimitrios Tzovaras
- Centre for Research and Technology Hellas, Information Technologies Institute, Thessaloniki, Greece
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland.,Medical Research Center, Polish Academy of Sciences, Warsaw, Poland
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160
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Wang J, Mann F, Lloyd-Evans B, Ma R, Johnson S. Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry 2018; 18:156. [PMID: 29843662 PMCID: PMC5975705 DOI: 10.1186/s12888-018-1736-5] [Citation(s) in RCA: 596] [Impact Index Per Article: 99.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 05/11/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The adverse effects of loneliness and of poor perceived social support on physical health and mortality are established, but no systematic synthesis is available of their relationship with the outcomes of mental health problems over time. In this systematic review, we aim to examine the evidence on whether loneliness and closely related concepts predict poor outcomes among adults with mental health problems. METHODS We searched six databases and reference lists for longitudinal quantitative studies that examined the relationship between baseline measures of loneliness and poor perceived social support and outcomes at follow up. Thirty-four eligible papers were retrieved. Due to heterogeneity among included studies in clinical populations, predictor measures and outcomes, a narrative synthesis was conducted. RESULTS We found substantial evidence from prospective studies that people with depression who perceive their social support as poorer have worse outcomes in terms of symptoms, recovery and social functioning. Loneliness has been investigated much less than perceived social support, but there is some evidence that greater loneliness predicts poorer depression outcome. There is also some preliminary evidence of associations between perceived social support and outcomes in schizophrenia, bipolar disorder and anxiety disorders. CONCLUSIONS Loneliness and quality of social support in depression are potential targets for development and testing of interventions, while for other conditions further evidence is needed regarding relationships with outcomes.
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Affiliation(s)
- Jingyi Wang
- Division of Psychiatry – University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF England
| | - Farhana Mann
- Division of Psychiatry – University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF England
| | - Brynmor Lloyd-Evans
- Division of Psychiatry – University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF England
| | - Ruimin Ma
- Division of Psychiatry – University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF England
| | - Sonia Johnson
- Division of Psychiatry – University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF England
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE England
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161
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Paolillo EW, Tang B, Depp CA, Rooney AS, Vaida F, Kaufmann CN, Mausbach BT, Moore DJ, Moore RC. Temporal Associations Between Social Activity and Mood, Fatigue, and Pain in Older Adults With HIV: An Ecological Momentary Assessment Study. JMIR Ment Health 2018; 5:e38. [PMID: 29759960 PMCID: PMC5972192 DOI: 10.2196/mental.9802] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/09/2018] [Accepted: 03/19/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Social isolation is associated with an increased risk for mental and physical health problems, especially among older persons living with HIV (PLWH). Thus, there is a need to better understand real-time temporal associations between social activity and mood- and health-related factors in this population to inform possible future interventions. OBJECTIVE This study aims to examine real-time relationships between social activity and mood, fatigue, and pain in a sample of older PLWH. METHODS A total of 20 older PLWH, recruited from the University of California, San Diego HIV Neurobehavioral Research Program in 2016, completed smartphone-based ecological momentary assessment (EMA) surveys 5 times per day for 1 week. Participants reported their current social activity (alone vs not alone and number of social interactions) and levels of mood (sadness, happiness, and stress), fatigue, and pain. Mixed-effects regression models were used to analyze concurrent and lagged associations among social activity, mood, fatigue, and pain. RESULTS Participants (mean age 58.8, SD 4.3 years) reported being alone 63% of the time, on average, (SD 31.5%) during waking hours. Being alone was related to lower concurrent happiness (beta=-.300; 95% CI -.525 to -.079; P=.008). In lagged analyses, social activity predicted higher levels of fatigue later in the day (beta=-1.089; 95% CI -1.780 to -0.396; P=.002), and higher pain levels predicted being alone in the morning with a reduced likelihood of being alone as the day progressed (odds ratio 0.945, 95% CI 0.901-0.992; P=.02). CONCLUSIONS The use of EMA elucidated a high rate of time spent alone among older PLWH. Promoting social activity despite the presence of pain or fatigue may improve happiness and psychological well-being in this population.
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Affiliation(s)
- Emily W Paolillo
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - Bin Tang
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Colin A Depp
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States.,VA San Diego Healthcare System, San Diego, CA, United States.,The Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, San Diego, CA, United States
| | - Alexandra S Rooney
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Florin Vaida
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Christopher N Kaufmann
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States.,VA San Diego Healthcare System, San Diego, CA, United States.,The Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, San Diego, CA, United States
| | - Brent T Mausbach
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - David J Moore
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Raeanne C Moore
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States.,VA San Diego Healthcare System, San Diego, CA, United States
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163
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Abdellaoui A, Nivard MG, Hottenga JJ, Fedko I, Verweij KJH, Baselmans BML, Ehli EA, Davies GE, Bartels M, Boomsma DI, Cacioppo JT. Predicting loneliness with polygenic scores of social, psychological and psychiatric traits. GENES BRAIN AND BEHAVIOR 2018; 17:e12472. [PMID: 29573219 DOI: 10.1111/gbb.12472] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/31/2018] [Accepted: 03/08/2018] [Indexed: 12/14/2022]
Abstract
Loneliness is a heritable trait that accompanies multiple disorders. The association between loneliness and mental health indices may partly be due to inherited biological factors. We constructed polygenic scores for 27 traits related to behavior, cognition and mental health and tested their prediction for self-reported loneliness in a population-based sample of 8798 Dutch individuals. Polygenic scores for major depressive disorder (MDD), schizophrenia and bipolar disorder were significantly associated with loneliness. Of the Big Five personality dimensions, polygenic scores for neuroticism and conscientiousness also significantly predicted loneliness, as did the polygenic scores for subjective well-being, tiredness and self-rated health. When including all polygenic scores simultaneously into one model, only 2 major depression polygenic scores remained as significant predictors of loneliness. When controlling only for these 2 MDD polygenic scores, only neuroticism and schizophrenia remain significant. The total variation explained by all polygenic scores collectively was 1.7%. The association between the propensity to feel lonely and the susceptibility to psychiatric disorders thus pointed to a shared genetic etiology. The predictive power of polygenic scores will increase as the power of the genome-wide association studies on which they are based increases and may lead to clinically useful polygenic scores that can inform on the genetic predisposition to loneliness and mental health.
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Affiliation(s)
- A Abdellaoui
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M G Nivard
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - J-J Hottenga
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - I Fedko
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - K J H Verweij
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - B M L Baselmans
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - E A Ehli
- Avera Institute for Human Genetics, Sioux Falls, South Dakota
| | - G E Davies
- Avera Institute for Human Genetics, Sioux Falls, South Dakota
| | - M Bartels
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - D I Boomsma
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - J T Cacioppo
- Department of Psychology, University of Chicago, Chicago, Illinois
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164
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Smith SE, Tallentire VR, Pope LM, Laidlaw AH, Morrison J. Foundation Year 2 doctors' reasons for leaving UK medicine: an in-depth analysis of decision-making using semistructured interviews. BMJ Open 2018; 8:e019456. [PMID: 29500208 PMCID: PMC5855199 DOI: 10.1136/bmjopen-2017-019456] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To explore the reasons that doctors choose to leave UK medicine after their foundation year two posts. SETTING All four regions of Scotland. PARTICIPANTS Foundation year two doctors (F2s) working throughout Scotland who were considering leaving UK medicine after foundation training were recruited on a volunteer basis. Maximum variation between participants was sought. PRIMARY AND SECONDARY OUTCOME MEASURES Semistructured interviews were coded using template analysis. Six perspectives, described by Feldman and Ng, were used as the initial coding template. The codes were then configured to form a framework that explores the interplay of factors influencing Foundation Year 2 (F2) doctors' decisions to leave UK medicine. RESULTS Seventeen participants were interviewed. Six perspectives were explored. Structural influences (countrywide and worldwide issues) included visas, economic and political considerations, structure of healthcare systems and availability of junior doctor jobs worldwide. Organisational influences (the National Health Service (NHS) and other healthcare providers) included staffing and compensation policies, the working environment and the learning environment. Occupational influences (specific to being a junior doctor) comprised the junior doctor contract, role and workload, pursuit of career interests and the structure of training. Work group influences (relationships with colleagues) included support at work, task interdependence and use of locums. Personal life influences consisted of work-life balance, and support in resolving work-life conflict. The underlying theme of 'taking a break' recurred through multiple narratives. CONCLUSIONS F2s give reasons similar to those given by any professional considering a change in their job. However, working within the NHS as an F2 doctor brought specific challenges, such as a need to make a choice of specialty within the F2 year, exposure to workplace bullying and difficulties in raising concerns. Despite these challenges, most F2s did not view their decision to leave as a permanent job change, but as a temporary break from their current working lives.
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Affiliation(s)
- Samantha E Smith
- Centre for Medical Education, University of Edinburgh, Edinburgh, UK
| | | | - Lindsey M Pope
- Gilmorehill Campus, University of Glasgow Medical School, Glasgow, UK
| | - Anita H Laidlaw
- Population and Behavioural Health Sciences, Medical and Biological Sciences, University of St Andrews, St Andrews, UK
| | - Jill Morrison
- General Practice and Primary Care, University of Glasgow Medical School, Glasgow, UK
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165
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Affiliation(s)
- Alexandra E. D’Agostino
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
- Department of Psychiatry, Stony Brook Medicine, Stony Brook, NY, USA
| | - David Kattan
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Turhan Canli
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
- Department of Radiology, Stony Brook University, Stony Brook, NY, USA
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166
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Necka EA, Atlas LY. The Role of Social and Interpersonal Factors in Placebo Analgesia. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 138:161-179. [PMID: 29681323 DOI: 10.1016/bs.irn.2018.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Placebo effects are beneficial clinical outcomes that emerge as a result of nonspecific contextual factors, transmitted primarily by the treating physician and the social, physical, and behavioral cues he or she displays. The patient-provider therapeutic alliance is critical for determining placebo effects and health outcomes. In this chapter, we review the recent literature, suggesting that provider social characteristics modulate placebo and clinical outcomes. We highlight the importance of studying not only the provider but also the patient's perception of the provider, which is subject to the influence of the patient's psychosocial orientation, such as their psychosocial motivations and perceptions of their interpersonal relationships broadly. We argue that psychosocial orientation can exaggerate the influence of the patient-provider relationship on placebo effects and can directly affect the likelihood of placebo effects emerging by modulating the underlying biological systems that support them. Here, we examine patient loneliness, or perceived social isolation, as a case example for understanding how patients' psychosocial orientation may affect placebo effects across diseases. We propose psychosocial mechanisms by which loneliness might modulate placebo effects across medical outcomes, and focus in particular on how loneliness might specifically alter behaviorally conditioned immune responses and placebo analgesia. Future studies should directly measure social factors to formally test the effects of social isolation on placebo effects and better elucidate the role of psychosocial and interpersonal factors in placebo effects and clinical outcomes.
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Affiliation(s)
- Elizabeth A Necka
- Section on Affective Neuroscience and Pain, National Center for Complementary and Integrative Health, NIH, Bethesda, MD, United States.
| | - Lauren Y Atlas
- Section on Affective Neuroscience and Pain, National Center for Complementary and Integrative Health, NIH, Bethesda, MD, United States; National Institute on Drug Abuse, NIH, Bethesda, MD, United States
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167
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Mugoya GC, Hooper LM, Tomek S, George Dalmida S, Bolland A, Ufomadu J, Bolland J. The interrelationships among pain interference, depressive symptoms, loneliness, and employment status: a moderated mediation study. Clin Rehabil 2018; 32:967-979. [PMID: 29457478 DOI: 10.1177/0269215518758483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To explore the mediating effect of loneliness on the relationship between pain interference and depressive symptoms and to determine whether this mechanism is contingent on employment status. DESIGN Cross-sectional study. SUBJECTS A total of 876 adult caregivers of adolescents living in extremely impoverished conditions. ANALYSIS Mediation and moderated mediation analyses using standard path-analytic approaches. RESULTS The mean age of the sample was 39.0 (SD = 12.8) years and 80.7% ( n = 707) identified as female. Almost half (48.9%, n = 425) of the participants did not report any pain, while 32.5% ( n = 285) reported non-disabling pain, and 19.0% ( n = 166) reported disabling pain. The mean depressive symptoms score was 16.20 (SD = 10.6), and the mean loneliness score was 40.09 (SD = 10.5). Loneliness mediated the effect of both non-disabling and disabling pain on depressive symptoms. However, the indirect effect of pain interference on depressive symptoms through loneliness was more pronounced among participants reporting disabling pain (coefficient, 2.11; Boot 95% confidence interval (CI) (1.25-3.01)) than non-disabling pain (coefficient, 0.99; Boot 95% CI (0.25-1.76)). Moderated mediation results showed that the indirect effect of pain interference on depressive symptoms, via loneliness varied in magnitude as a function of employment status among participants reporting disabling pain but not those reporting non-disabling pain. CONCLUSION Loneliness provides an important link in the relationship between depressive symptoms and pain interference. Furthermore, employment status is an important factor to consider, especially among individuals reporting disabling pain with comorbid depressive symptoms.
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Affiliation(s)
- George Ct Mugoya
- 1 Department of Educational Studies in Psychology, Research Methodology, and Counseling, The University of Alabama, Tuscaloosa, AL, USA
| | - Lisa M Hooper
- 2 Department of Counseling and Human Development, University of Louisville, Louisville, KY, USA
| | - Sara Tomek
- 1 Department of Educational Studies in Psychology, Research Methodology, and Counseling, The University of Alabama, Tuscaloosa, AL, USA
| | | | - Anneliese Bolland
- 4 Institute for Social Science Research, The University of Alabama, Tuscaloosa, AL, USA
| | - Joy Ufomadu
- 1 Department of Educational Studies in Psychology, Research Methodology, and Counseling, The University of Alabama, Tuscaloosa, AL, USA
| | - John Bolland
- 4 Institute for Social Science Research, The University of Alabama, Tuscaloosa, AL, USA
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168
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Alexandra P, Angela H, Ali A. Loneliness in people with intellectual and developmental disorders across the lifespan: A systematic review of prevalence and interventions. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:643-658. [DOI: 10.1111/jar.12432] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2017] [Indexed: 01/06/2023]
Affiliation(s)
| | | | - Afia Ali
- University College London; London UK
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169
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Threats to Belonging among Breast Cancer Survivors: Consequences for Mental and Physical Health. CURRENT BREAST CANCER REPORTS 2018. [DOI: 10.1007/s12609-018-0262-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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170
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Canli T, Yu L, Yu X, Zhao H, Fleischman D, Wilson RS, De Jager PL, Bennett DA. Loneliness 5 years ante-mortem is associated with disease-related differential gene expression in postmortem dorsolateral prefrontal cortex. Transl Psychiatry 2018; 8:2. [PMID: 29317593 PMCID: PMC5802527 DOI: 10.1038/s41398-017-0086-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 11/14/2017] [Indexed: 01/11/2023] Open
Abstract
Subjective social isolation, loneliness, is associated with poor mental and physical health, but the underlying molecular mechanisms are poorly understood. Here we analyzed loneliness data collected on average 5 years ante-mortem and RNA gene expression at death in postmortem dorsolateral prefrontal cortex (DLPFC) from 181 participants in the Rush Memory and Aging Project (MAP), a longitudinal, prospective cohort study of common chronic conditions of aging. Our analytic protocol controlled for biographical variables (age, sex, education), psychological and health variables (depressive symptoms, interval between assessment and autopsy, slope of cognitive decline, AD pathology, presence of infarcts) and RNA integrity. Our results are based on a pre-ranked Gene Set Enrichment Analysis (GSEA) at FDR-corrected q-values <0.05, using these collections from the Molecular Signatures Database (v6.0 MSigDB): (1) Hallmarks, (2) Canonical, (3) Gene Ontology (GO), (4) Chemical and Genetic Perturbations, (5) Immunologic Signatures, (6) Oncogenic Signatures, and (7) Cancer Modules. We now report on 337 up-regulated and 43 down-regulated gene sets, among which the most significant ones were associated with Alzheimer's disease, psychiatric illness, immune dysfunction, and cancer. These gene sets constitute attractive targets for future studies into the molecular mechanisms by which loneliness exacerbates a wide range of neurodegenerative, psychiatric, and somatic illnesses.
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Affiliation(s)
- Turhan Canli
- Departments of Psychology and Psychiatry, Stony Brook University, Stony Brook, NY, USA.
| | - Lei Yu
- 0000 0001 0705 3621grid.240684.cRush Alzheimer’s Disease Center, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL USA
| | - Xiaoqing Yu
- 0000000419368710grid.47100.32Biostatistics Department, Yale School of Public Health, Yale University, New Haven, CT USA
| | - Hongyu Zhao
- 0000000419368710grid.47100.32Biostatistics Department, Yale School of Public Health, Yale University, New Haven, CT USA
| | - Debra Fleischman
- 0000 0001 0705 3621grid.240684.cRush Alzheimer’s Disease Center, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL USA
| | - Robert S. Wilson
- 0000 0001 0705 3621grid.240684.cRush Alzheimer’s Disease Center, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL USA
| | - Philip L. De Jager
- 0000000419368729grid.21729.3fDepartment of Neurology, Columbia University, New York, NY USA
| | - David A. Bennett
- 0000 0001 0705 3621grid.240684.cRush Alzheimer’s Disease Center, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL USA
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171
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172
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Chang EC. Relationship between loneliness and symptoms of anxiety and depression in African American men and women: Evidence for gender as a moderator. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2017.08.035] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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173
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Cancer-related loneliness mediates the relationships between social constraints and symptoms among cancer patients. J Behav Med 2017; 41:243-252. [PMID: 28983735 DOI: 10.1007/s10865-017-9892-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/29/2017] [Indexed: 12/15/2022]
Abstract
Cancer patients have high rates of persistent and disabling symptoms. Evidence suggests that social constraints (e.g., avoidance and criticism) negatively impact symptoms, but pathways linking these variables have yet to be identified. This study examined whether cancer-related loneliness (i.e., feeling socially disconnected related to having cancer) mediated the relationships between social constraints and symptoms (i.e., pain interference, fatigue, sleep disturbance, and cognitive complaints) in patients with various cancers (N = 182). Patients (51% female, mean age = 59) were recruited from the Indiana Cancer Registry and completed questionnaires assessing social constraints, cancer-related loneliness, and symptoms. Structural equation modeling was used to evaluate the hypothesized relationships among variables. The model demonstrated good fit. Consistent with our hypothesis, cancer-related loneliness mediated the relationships between social constraints and each symptom. Findings suggest that addressing cancer-related loneliness in symptom management interventions may mitigate the negative impact of social constraints on outcomes.
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174
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Meng J, Hao L, Wei D, Sun J, Li Y, Qiu J. BDNF Val66Met polymorphism modulates the effect of loneliness on white matter microstructure in young adults. Biol Psychol 2017; 130:41-49. [PMID: 28988974 DOI: 10.1016/j.biopsycho.2017.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 09/15/2017] [Accepted: 10/02/2017] [Indexed: 12/18/2022]
Abstract
Loneliness is a common experience. Susceptibility to loneliness is a stable trait and is heritable. Previous studies have suggested that loneliness may impact regional gray matter density and brain activation to social stimuli, but its relation to white matter structure and how it may interact with genetic factors remains unclear. In this study, we investigated whether and how a common polymorphism (Val66Met) in the brain-derived neurotrophic factor gene modulated the association between loneliness and white matter microstructure in 162 young adults. The tract-based spatial statistics analyses revealed that the relationships between loneliness and white matter microstructures were significantly different between Val/Met heterozygotes and Val/Val homozygotes. Specifically, loneliness was significantly correlated with reduced fractional anisotropy and increased radial diffusivity in widespread white matter fibers within Val/Met heterozygotes. It was also significantly correlated with increased radial diffusivity in Met/Met genotypes but showed no significant association with white matter measures in Val/Val genotypes. Furthermore, the associations between loneliness and fractional anisotropy (or radial diffusivity) in Val/Met heterozygotes turned out to be global effects. These results provide evidence that loneliness may interact with the BDNF Val66Met polymorphism to shape the microstructures of white matter, and the Val/Met heterozygotes may be more susceptible to social environment.
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Affiliation(s)
- Jie Meng
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Department of Psychology, Southwest University, Chongqing 400715, China
| | - Lei Hao
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; Department of Psychology, Beijing Normal University, Beijing 100875, China
| | - Dongtao Wei
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Department of Psychology, Southwest University, Chongqing 400715, China
| | - Jiangzhou Sun
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Department of Psychology, Southwest University, Chongqing 400715, China
| | - Yu Li
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Department of Psychology, Southwest University, Chongqing 400715, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Department of Psychology, Southwest University, Chongqing 400715, China.
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175
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Li F, Xu YM, Zhu JH, Lu J, Zhong BL. Pain of methadone-maintained heroin addicts: lonelier individuals feel more intense pain. Oncotarget 2017; 8:79948-79952. [PMID: 29108376 PMCID: PMC5668109 DOI: 10.18632/oncotarget.20387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 08/06/2017] [Indexed: 01/10/2023] Open
Abstract
Managing pain in patients with heroin addiction is challenging, because most pain medications are addictive. A promising way to relieve pain of heroin addicts is to identify and address modifiable psychosocial factors associated with pain. This study examined the association between loneliness and pain intensity in Chinese heroin addicts receiving methadone maintenance treatment (MMT). A consecutive sample of 603 heroin addicts were recruited from three MMT clinics in Wuhan, China. Loneliness was assessed with a single question, and socio-demographic and clinical data were collected with a standardized questionnaire. Pain intensity was assessed with the five-point Verbal Rating Scale. Multiple ordinary logistic regression was used to control for potential confounders that may bias the loneliness-pain relationship. There was a significant and positive correlation between pain intensity and loneliness scores among methadone-maintained heroin addicts (r = 0.453, P < 0.001). After controlling for potential socio-demographic and clinical confounders, an increase in the level of loneliness was significantly associated with an increase in pain intensity (OR = 1.22, P = 0.042). Loneliness is significantly associated with pain of methadone-maintained heroin addicts. Psychosocial interventions aimed at reducing loneliness might prevent or reduce pain of patients receiving MMT.
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Affiliation(s)
- Fu Li
- Affiliated Wuhan Mental Health Center (The Ninth Clinical School), Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yan-Min Xu
- Affiliated Wuhan Mental Health Center (The Ninth Clinical School), Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Jun-Hong Zhu
- Affiliated Wuhan Mental Health Center (The Ninth Clinical School), Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Jin Lu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Bao-Liang Zhong
- Affiliated Wuhan Mental Health Center (The Ninth Clinical School), Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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176
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Richard A, Rohrmann S, Vandeleur CL, Schmid M, Barth J, Eichholzer M. Loneliness is adversely associated with physical and mental health and lifestyle factors: Results from a Swiss national survey. PLoS One 2017; 12:e0181442. [PMID: 28715478 PMCID: PMC5513556 DOI: 10.1371/journal.pone.0181442] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/30/2017] [Indexed: 12/18/2022] Open
Abstract
Introduction Loneliness is a common, emotionally distressing experience and is associated with adverse physical and mental health and an unhealthy lifestyle. Nevertheless, little is known about the prevalence of loneliness in different age groups in Switzerland. Furthermore, the existing evidence about age and gender as potential effect modifiers of the associations between loneliness, physical and mental health and lifestyle characteristics warrants further investigation. Thus, the aim of the study was to examine the prevalence of loneliness among adults in Switzerland and to assess the associations of loneliness with several physical and mental health and behavioral factors, as well as to assess the modifying effect of sex and age. Methods Data from 20,007 participants of the cross-sectional population-based Swiss Health Survey 2012 (SHS) were analyzed. Logistic regression analyses were used to assess associations of loneliness with physical and mental health or lifestyle characteristics (e.g. diabetes, depression, physical activity). Wald tests were used to test for interactions. Results Loneliness was distributed in a slight U-shaped form from 15 to 75+ year olds, with 64.1% of participants who had never felt lonely. Lonely individuals were more often affected by physical and mental health problems, such as self-reported chronic diseases (Odds ratio [OR] 1.41, 95% confidence interval [CI] 1.30–1.54), high cholesterol levels (OR 1.31, 95% CI 1.18–1.45), diabetes (OR 1.40, 95% CI 1.16–1.67), moderate and high psychological distress (OR 3.74, 95% CI 3.37–4.16), depression (OR 2.78, 95% CI 2.22–3.48) and impaired self-perceived health (OR 1.94, 95% CI 1.74–2.16). Loneliness was significantly associated with most lifestyle factors (e.g. smoking; OR 1.13, 95% 1.05–1.23). Age, but not sex, moderated loneliness’ association with several variables. Conclusion Loneliness is associated with poorer physical and mental health and unhealthy lifestyle, modified by age, but not by sex. Our findings illustrate the importance of considering loneliness for physical and mental health and lifestyle factors, not only in older and younger, but also in middle-aged adults. Longitudinal studies are needed in Switzerland to elucidate the causal relationships of these associations.
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Affiliation(s)
- Aline Richard
- Epidemiology, Biostatistics and Prevention Institute, Division of Chronic Disease Epidemiology, University of Zurich, Hirschengraben 84, Zurich, Switzerland
| | - Sabine Rohrmann
- Epidemiology, Biostatistics and Prevention Institute, Division of Chronic Disease Epidemiology, University of Zurich, Hirschengraben 84, Zurich, Switzerland
- * E-mail:
| | - Caroline L. Vandeleur
- Centre for Research in Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, University Hospital of Lausanne, Site de Cery, Prilly, Switzerland
| | - Margareta Schmid
- Epidemiology, Biostatistics and Prevention Institute, Division of Chronic Disease Epidemiology, University of Zurich, Hirschengraben 84, Zurich, Switzerland
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital and University of Zurich, Sonneggstr. 6, Zurich, Switzerland
| | - Monika Eichholzer
- Epidemiology, Biostatistics and Prevention Institute, Division of Chronic Disease Epidemiology, University of Zurich, Hirschengraben 84, Zurich, Switzerland
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177
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Investigating insomnia as a cross-sectional and longitudinal predictor of loneliness: Findings from six samples. Psychiatry Res 2017; 253:116-128. [PMID: 28364589 PMCID: PMC5479064 DOI: 10.1016/j.psychres.2017.03.046] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 03/10/2017] [Accepted: 03/23/2017] [Indexed: 11/21/2022]
Abstract
Loneliness has been repeatedly associated with sleep problems; however, there is a dearth of research examining the prospective relationship between insomnia and loneliness, as well as this association controlling for other psychiatric symptoms. This study evaluated the cross-sectional and prospective relationship between insomnia and loneliness using six samples: 666 undergraduates; 2785 Army recruiters; 208 adults with a history of suicidality and/or depression; 343 adult psychiatric outpatients; 326 young adults at elevated suicide risk; and 183 undergraduates. A meta-analysis also was conducted to examine the magnitude of the relationship between insomnia and loneliness across the six studies. More severe insomnia symptoms were significantly associated with greater feelings of loneliness while accounting for some (e.g., anxiety, nightmares) but not all (i.e., depression) psychiatric covariates. Findings underscore the strength of the association between insomnia and loneliness and suggest that depression may account for this relationship. Additional studies are needed to further establish the temporal relationship between these variables, delineate the role of depression in the association between insomnia and loneliness, and test whether insomnia may confer unique risk for subsequent loneliness.
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178
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“On their own”: social isolation, loneliness and chronic musculoskeletal pain in older adults. QUALITY IN AGEING AND OLDER ADULTS 2017. [DOI: 10.1108/qaoa-03-2017-0010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to explore the concepts of social isolation and loneliness in relation to people with chronic musculoskeletal pain. Through these concepts, biological, psychological and social factors will be examined to consider how we can identify people at risk of social isolation and loneliness who have chronic musculoskeletal pain and then how health professionals may intervene to reduce their effects.
Design/methodology/approach
Conceptual paper.
Findings
Social isolation and loneliness are often evident in the situation of people with chronic musculoskeletal diseases. This may be bi-directional where pains may lead to social isolation and loneliness, but equally, social isolation and loneliness may exacerbate pain. Interventions to improve the symptoms of chronic musculoskeletal pain, and also approaches around social participation and engagement should be adopted in combination to ameliorate this potentially disabling scenario.
Originality/value
There remains limited evidence around the prevalence and management of social isolation and loneliness for people with chronic musculoskeletal pain. By raising awareness of social isolation and loneliness in this population, people with chronic musculoskeletal pain may be better supported to reduce the negative impact that social isolation and loneliness can have on their health and well-being.
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179
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Kirmayer LJ, Gomez-Carrillo A, Veissière S. Culture and depression in global mental health: An ecosocial approach to the phenomenology of psychiatric disorders. Soc Sci Med 2017; 183:163-168. [DOI: 10.1016/j.socscimed.2017.04.034] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 04/24/2017] [Indexed: 10/19/2022]
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180
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LeRoy AS, Murdock KW, Jaremka LM, Loya A, Fagundes CP. Loneliness predicts self-reported cold symptoms after a viral challenge. Health Psychol 2017; 36:512-520. [PMID: 28358524 PMCID: PMC5486976 DOI: 10.1037/hea0000467] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Loneliness is a well-established risk factor for poor physical health. Much less is known about how loneliness affects patient-reported outcomes (PROs), such as somatic symptoms, which are increasingly important for guiding symptom management and assessing quality of patient care. The current study investigates whether (a) loneliness and social isolation predict cold symptoms independent of each other, and (b) whether loneliness is a more robust risk factor than objective social isolation for experiencing cold symptoms. METHOD As part of a larger parent study, 213 healthy participants completed the Short Loneliness Scale (LON) and the Social Network Index (SNI) at baseline. They were given nasal drops containing rhinovirus 39 (RV39; i.e., a common cold virus), then quarantined for 5 days during which they reported on subjective cold symptoms in addition to being monitored for objective indicators of infection. Data from 160 of the participants (who were infected with the virus) were used in the present analyses. RESULTS A hierarchical multiple regression revealed that baseline loneliness predicted self-reported cold symptoms over time (assessed via area under the curve), over and above demographic variables, season of participation, and depressive affect. Interestingly, social network size and diversity did not predict cold symptoms. CONCLUSIONS These findings suggest that the perception of loneliness is more closely linked to self-reported illness symptoms than objectively measured social isolation. Assessing psychosocial factors such as loneliness when treating and evaluating the common cold could contribute to health care practitioners' understanding of their patients' experiences with acute illness. (PsycINFO Database Record
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Affiliation(s)
- Angie S. LeRoy
- Department of Psychology, University of Houston
- Department of Psychology, Rice University, Bioscience Research Collaborative
| | - Kyle W. Murdock
- Department of Psychology, Rice University, Bioscience Research Collaborative
| | - Lisa M. Jaremka
- Department of Psychological and Brain Sciences, University of Delaware
| | - Asad Loya
- Department of Psychology, Rice University, Bioscience Research Collaborative
- Department of Biology, Department of Mathematics, University of Houston
| | - Christopher P. Fagundes
- Department of Psychology, Rice University, Bioscience Research Collaborative
- Department of Symptom Research, The University of Texas MD Anderson CancerCenter
- Department of Psychiatry, Baylor College of Medicine
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Zhang D, Yang Y, Sun Y, Wu M, Xie H, Wang K, Zhang J, Jia J, Su Y. Characteristics of the Chinese rural elderly living in nursing homes who have suicidal ideation: A multiple regression model. Geriatr Nurs 2017; 38:423-430. [PMID: 28347559 DOI: 10.1016/j.gerinurse.2017.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Chinese rural elderly are at higher risk of committing suicide. However, little is known about the suicidal ideation (SI) of institutional elderly residents in rural China. METHODS 250 participants aged 60 or above living in Chinese rural nursing homes were recruited. Data were collected on subjects' SI, social-demographic characters, physical illness and psychological factors. Univariate comparisons and path analysis were conducted then. RESULTS 19.5% (40/205) of the participants reported a current SI. Hopelessness and depression had significant direct impacts on SI, and self-esteem and loneliness can impact SI through the mediating of depression and hopelessness. Visiting frequency of children, number of physical illnesses and social activities can also affect SI through the mediating of loneliness or self-esteem. CONCLUSION As the first study on path analysis of SI of rural institutional elderly, the findings are significant. All these factors in our model should be considered when interventions are being conducted.
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Affiliation(s)
- Dan Zhang
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Yang Yang
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Yaoyao Sun
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Menglian Wu
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Hui Xie
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Kefang Wang
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Jie Zhang
- School of Public Health, Shandong University, Jinan, 250012, Shandong, China; Department of Sociology, State University of New York Buffalo State, Buffalo, NY, 14222, USA
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, 250012, Shandong, China
| | - Yonggang Su
- School of Foreign Languages and Literature, Shandong University, Jinan, 250100, Shandong, China; School of Nursing, Shandong University, Jinan, 250012, Shandong, China.
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183
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Adams RN, Mosher CE, Rand KL, Hirsh AT, Monahan PO, Abonour R, Kroenke K. The Cancer Loneliness Scale and Cancer-related Negative Social Expectations Scale: development and validation. Qual Life Res 2017; 26:1901-1913. [PMID: 28236266 DOI: 10.1007/s11136-017-1518-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE Loneliness is a known risk factor for poor mental and physical health outcomes and quality of life in the general population, and preliminary research suggests that loneliness is linked to poorer health outcomes in cancer patients as well. Various aspects of the cancer experience contribute to patients feeling alone and misunderstood. Furthermore, loneliness theory suggests that negative social expectations, which may specifically relate to the cancer experience, precipitate and sustain loneliness. Cancer-specific tools are needed to assess key constructs of this theory. In the current study, we developed and tested measures of (1) loneliness attributed to cancer (i.e., cancer-related loneliness) and (2) negative social expectations related to cancer. METHODS First, we developed the items for the measures based on theory, prior research, and expert feedback. Next, we assessed the measures' psychometric properties (i.e., internal consistency and construct validity) in a diverse sample of cancer patients. RESULTS The final products included a 7-item unidimensional Cancer Loneliness Scale and a 5-item unidimensional Cancer-related Negative Social Expectations Scale. Evidence of excellent reliability and validity was found for both measures. CONCLUSIONS The resulting measures have both clinical and research utility.
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Affiliation(s)
- Rebecca N Adams
- Department of Pediatrics, Stanford University School of Medicine, 780 Welch Road, MC 5776, Palo Alto, CA, 94304, USA.
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
| | - Patrick O Monahan
- Department of Biostatistics, Indiana University School of Medicine and School of Public Health, 410 W. Tenth St., Suite 3000, Indianapolis, IN, 46202, USA
| | - Rafat Abonour
- Department of Medicine, Indiana University School of Medicine, 535 Barnhill Drive, Indiana Cancer Pavilion, Suite 446, Indianapolis, IN, 46202, USA
| | - Kurt Kroenke
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA.,VA HSR&D Center for Health Information and Communication, Indianapolis, IN, 46202, USA.,Regenstrief Institute, Inc. (RF), 1101 West Tenth Street, RF 221, Indianapolis, IN, 46202, USA
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Adams RN, Mosher CE, Abonour R, Robertson MJ, Champion VL, Kroenke K. Cognitive and Situational Precipitants of Loneliness Among Patients With Cancer: A Qualitative Analysis. Oncol Nurs Forum 2017; 43:156-63. [PMID: 26906127 DOI: 10.1188/16.onf.156-163] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE/OBJECTIVES To identify situations and thoughts that may precipitate or protect against loneliness experienced by patients with cancer.
RESEARCH APPROACH Qualitative.
SETTING The hematology/oncology clinic at the Indiana University Melvin and Bren Simon Cancer Center, an outpatient oncology center in Indianapolis.
PARTICIPANTS Purposive sample of 15 patients undergoing treatment for multiple myeloma or non-Hodgkin lymphoma.
METHODOLOGIC APPROACH Individual, semistructured qualitative interviews were conducted. Theoretical thematic analysis was used to analyze interview data.
FINDINGS Factors that appeared to precipitate loneliness included several situations (e.g., physical isolation, social constraints such as criticism) and thoughts (e.g., unmet expectations for visits or questions about health, belief that others do not understand their cancer experience). Several situations (e.g., social support, normal routine) and thoughts (e.g., beliefs that time alone is desirable and that others' discomfort with cancer-related discussions is normative) appeared to protect against loneliness. Certain social situations were loneliness-inducing for some patients and not for others, suggesting that patients' thoughts about their situations, rather than the situations themselves, have the greatest impact on their loneliness.
CONCLUSIONS The current study fills gaps in loneliness theory by identifying cancer-related situations and thoughts that patients associate with their loneliness. Consistent with theory, patients reported feeling lonely when they had negative thoughts about their social situations.
INTERPRETATION Findings inform nursing assessment and intervention strategies to incorporate into care plans. For instance, when conducting assessments, nurses should be more attentive to patients' satisfaction with their social environment than actual characteristics of the environment. Normalizing patients' experiences and encouraging positive thoughts about others' behavior may reduce patients' loneliness.
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Affiliation(s)
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University in Indianapolis
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185
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Hilberink SR, van der Slot WMA, Klem M. Health and participation problems in older adults with long-term disability. Disabil Health J 2016; 10:361-366. [PMID: 28025088 DOI: 10.1016/j.dhjo.2016.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 11/29/2016] [Accepted: 12/13/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND More attention and understanding of the health and participation problems of adults with early and later onset disabilities in the Netherlands is needed. OBJECTIVE To explore health/participation problems and unmet needs in adults aged ≥40 years with long-term disabilities and their relationship with the time of onset. METHODS Participants were recruited in the Netherlands through newsletters and social media to participate in a web-based questionnaire. The questionnaire assessed background characteristics, (change in) health/participation problems, and unmet needs. Spearman's rho was used to examine the relationships with time of onset. RESULTS Of the 163 survey respondents, 42% acquired their disability before age 25 years and reported fatigue (77%), walking problems (66%), and pain (59%). In 21% of the respondents with early-onset disability fatigue, pain and depressive feelings co-occurred. Early-onset disability correlated with joint deformities, pain and anxiety. Participation problems included loss of income and fewer social activities. Early-onset correlated with the need for more information about diagnosis and prognosis. CONCLUSIONS People aged over 40 years with long-term disability have significant and increasing health and participation problems. Adults with early-onset disability are more likely to have health or participation problems than adults with late-onset disability. Early identification is needed for preventive care and access to specialized services that focus on improving and maintaining physical symptoms, energy management, and participation.
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Affiliation(s)
- Sander R Hilberink
- BOSK, Association of Physically Disabled Persons, Utrecht, The Netherlands.
| | - Wilma M A van der Slot
- Rijndam Rehabilitation Institute, Rotterdam, The Netherlands; Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Martijn Klem
- BOSK, Association of Physically Disabled Persons, Utrecht, The Netherlands
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186
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Donovan NJ, Okereke OI, Vannini P, Amariglio RE, Rentz DM, Marshall GA, Johnson KA, Sperling RA. Association of Higher Cortical Amyloid Burden With Loneliness in Cognitively Normal Older Adults. JAMA Psychiatry 2016; 73:1230-1237. [PMID: 27806159 PMCID: PMC5257284 DOI: 10.1001/jamapsychiatry.2016.2657] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Emotional and behavioral symptoms in cognitively normal older people may be direct manifestations of Alzheimer disease (AD) pathophysiology at the preclinical stage, prior to the onset of mild cognitive impairment. Loneliness is a perceived state of social and emotional isolation that has been associated with cognitive and functional decline and an increased risk of incident AD dementia. We hypothesized that loneliness might occur in association with elevated cortical amyloid burden, an in vivo research biomarker of AD. OBJECTIVE To determine whether cortical amyloid burden is associated with greater loneliness in cognitively normal older adults. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional analyses using data from the Harvard Aging Brain Study of 79 cognitively normal, community-dwelling participants. A continuous, aggregate measure of cortical amyloid burden, determined by Pittsburgh Compound B-positron emission tomography (PiB-PET), was examined in association with loneliness in linear regression models adjusting for age, sex, apolipoprotein E ε4 (APOEε4), socioeconomic status, depression, anxiety, and social network (without and with the interaction of amyloid and APOEε4). We also quantified the association of high amyloid burden (amyloid-positive group) to loneliness (lonely group) using logistic regression, controlling for the same covariates, with the amyloid-positive group and the lonely group, each composing 32% of the sample (n = 25). MAIN OUTCOMES AND MEASURES Loneliness, as determined by the 3-item UCLA Loneliness Scale (possible range, 3-12, with higher score indicating greater loneliness). RESULTS The 79 participants included 43 women and 36 men with a mean (SD) age of 76.4 (6.2) years. Mean (SD) cortical amyloid burden via PiB-PET was 1.230 (0.209), and the mean (SD) UCLA-3 loneliness score was 5.3 (1.8). Twenty-two (28%) had positive APOEε4 carrier status, and 25 (32%) were in the amyloid-positive group with cortical PiB distribution volume ratio greater than 1.2. Controlling for age, sex, APOEε4, socioeconomic status, depression, anxiety, and social network, we found that higher amyloid burden was significantly associated with greater loneliness: compared with individuals in the amyloid-negative group, those in the amyloid-positive group were 7.5-fold (95% CI, 1.7-fold to 34.0-fold) more likely to be classified as lonely than nonlonely (β = 3.3, partial r = 0.4, P = .002). Furthermore, the association of high amyloid burden and loneliness was stronger in APOEε4 carriers than in noncarriers. CONCLUSIONS AND RELEVANCE We report a novel association of loneliness with cortical amyloid burden in cognitively normal older adults, suggesting that loneliness is a neuropsychiatric symptom relevant to preclinical AD. This work will inform new research into the neural underpinnings and disease mechanisms involved in loneliness and may enhance early detection and intervention research in AD.
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Affiliation(s)
- Nancy J. Donovan
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts2Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts3Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts4Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Olivia I. Okereke
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Patrizia Vannini
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts2Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rebecca E. Amariglio
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts2Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts5Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Dorene M. Rentz
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts2Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts3Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts5Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Gad A. Marshall
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts2Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts5Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Keith A. Johnson
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts2Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts5Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston6Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Reisa A. Sperling
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts2Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts5Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
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187
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Robinson-Whelen S, Taylor HB, Feltz M, Whelen M. Loneliness Among People With Spinal Cord Injury: Exploring the Psychometric Properties of the 3-Item Loneliness Scale. Arch Phys Med Rehabil 2016; 97:1728-34. [DOI: 10.1016/j.apmr.2016.04.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 04/08/2016] [Accepted: 04/12/2016] [Indexed: 02/06/2023]
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188
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Concerns about Breast Cancer, Pain, and Fatigue in Non-Metastatic Breast Cancer Patients Undergoing Primary Treatment. Healthcare (Basel) 2016; 4:healthcare4030062. [PMID: 27571115 PMCID: PMC5041063 DOI: 10.3390/healthcare4030062] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/21/2016] [Accepted: 08/22/2016] [Indexed: 01/21/2023] Open
Abstract
Women diagnosed with breast cancer often endorse psychosocial concerns prior to treatment, which may influence symptom experiences. Among these, low perceived social support relates to elevated fatigue. Those with low social support perceptions may also experience a greater sense of rejection. We sought to determine if social rejection concerns post-surgery predict fatigue interference 12 months later in women with non-metastatic breast cancer. Depressive symptoms and pain severity after completion of adjuvant therapy (six months post-surgery) were examined as potential mediators. Women (N = 240) with non-metastatic breast cancer were recruited 2–10 weeks post-surgery. Multiple regression analyses examined relationships among variables adjusting for relevant covariates. Greater rejection concerns at study entry predicted greater fatigue interference 12 months later (p < 0.01). Pain severity after adjuvant therapy partially mediated the relationship between social rejection concerns and fatigue interference, with significant indirect (β = 0.06, 95% CI (0.009, 0.176)) and direct effects (β = 0.18, SE = 0.07, t(146) = 2.78, p < 0.01, 95% CI (0.053, 0.311)). Therefore, pain levels post-treatment may affect how concerns of social rejection relate to subsequent fatigue interference. Interventions targeting fears of social rejection and interpersonal skills early in treatment may reduce physical symptom burden during treatment and into survivorship.
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189
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Theeke LA, Mallow JA, Moore J, McBurney A, Rellick S, VanGilder R. Effectiveness of LISTEN on loneliness, neuroimmunological stress response, psychosocial functioning, quality of life, and physical health measures of chronic illness. Int J Nurs Sci 2016; 3:242-251. [PMID: 29082303 PMCID: PMC5656260 DOI: 10.1016/j.ijnss.2016.08.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objectives Loneliness is a biopsychosocial determinant of health and contributes to physical and psychological chronic illnesses, functional decline, and mortality in older adults. This paper presents the results of the first randomized trial of LISTEN, which is a new cognitive behavioral intervention for loneliness, on loneliness, neuroimmunological stress response, psychosocial functioning, quality of life, and measures of physical health. Methods The effectiveness of LISTEN was evaluated in a sample population comprising 27 lonely, chronically ill, older adults living in Appalachia. Participants were randomized into LISTEN or educational attention control groups. Outcome measures included salivary cortisol and DHEA, interleukin-6, interleukin-2, depressive symptoms, loneliness, perceived social support, functional ability, quality of life, fasting glucose, blood pressure, and body mass index. Results At 12 weeks after the last intervention session, participants of the LISTEN group reported reduced loneliness (p = 0.03), enhanced overall social support (p = 0.05), and decreased systolic blood pressure (p = 0.02). The attention control group reported decreased functional ability (p = 0.10) and reduced quality of life (p = 0.13). Conclusions LISTEN can effectively diminish loneliness and decrease the systolic blood pressure in community-dwelling, chronically ill, older adults. Results indicate that this population, if left with untreated loneliness, may experience functional impairment over a period as short as 4 months. Further studies on LISTEN are needed with larger samples, in varied populations, and over longer periods of time to assess the long-term effects of diminishing loneliness in multiple chronic conditions.
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Affiliation(s)
- Laurie A Theeke
- Department of Adult Health, School of Nursing, West Virginia University, Morgantown, WV, USA
| | - Jennifer A Mallow
- Department of Adult Health, School of Nursing, West Virginia University, Morgantown, WV, USA
| | - Julia Moore
- Department of Adult Health, School of Nursing, West Virginia University, Morgantown, WV, USA
| | - Ann McBurney
- Department of Adult Health, School of Nursing, West Virginia University, Morgantown, WV, USA
| | - Stephanie Rellick
- Department of Physiology, West Virginia University, Morgantown, WV, USA
| | - Reyna VanGilder
- School of Pharmacy, West Virginia University, Morgantown, WV, USA
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190
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Happell B, Wilson K, Platania-Phung C, Stanton R. Physical health nurse consultant role to improve physical health in mental health services: A carer's perspective. Int J Ment Health Nurs 2016; 25:243-50. [PMID: 26876094 DOI: 10.1111/inm.12208] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 12/16/2015] [Accepted: 12/21/2015] [Indexed: 01/02/2023]
Abstract
The physical health of people diagnosed with a mental illness is significantly poorer in comparison with the general population. Awareness of this health disparity is increasing; however, strategies to address the problem are limited. Carers play an important role in the physical health care of people with mental illness, particularly in facilitating navigation of and advocating in the health care system. A specialist physical health nurse consultant position has been suggested as a way to address the physical health care disparity and limited research available suggests that positive outcomes are possible. In the present study, a qualitative exploratory research project was undertaken, involving in-depth interviews with people identifying as mental health carers. Two focus groups and one individual interview were conducted involving a total of 13 carers. The resulting data were analyzed thematically. Views and opinions about the proposed physical health nurse consultant (PHNC) position were sought during these interviews and are reported in this paper. Two main sub-themes were evident relating to characteristics of this role: reliability and consistency; and communication and support. Essentially carers expressed a need for support for themselves and consumers in addressing physical health concerns. Successful implementation of this position would require a consistent and reliable approach. Carers are significant stakeholders in the physical health of consumers of mental health services and their active involvement in identifying and tailoring services, including development of the physical health nurse consultant must be seen as a priority.
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Affiliation(s)
- Brenda Happell
- Synergy, Nursing and Midwifery Research Centre, University of Canberra, Faculty of Health, and ACT Health, Woden, Australian Capital Territory, Australia
| | - Karen Wilson
- Synergy, Nursing and Midwifery Research Centre, University of Canberra, Faculty of Health, and ACT Health, Woden, Australian Capital Territory, Australia
| | - Chris Platania-Phung
- Synergy, Nursing and Midwifery Research Centre, University of Canberra, Faculty of Health, and ACT Health, Woden, Australian Capital Territory, Australia
| | - Robert Stanton
- Central Queensland University, School of Medical and Applied Sciences, Rockhampton, Queensland, Australia
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191
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Hawkley LC, Capitanio JP. Perceived social isolation, evolutionary fitness and health outcomes: a lifespan approach. Philos Trans R Soc Lond B Biol Sci 2016; 370:rstb.2014.0114. [PMID: 25870400 DOI: 10.1098/rstb.2014.0114] [Citation(s) in RCA: 192] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Sociality permeates each of the fundamental motives of human existence and plays a critical role in evolutionary fitness across the lifespan. Evidence for this thesis draws from research linking deficits in social relationship--as indexed by perceived social isolation (i.e. loneliness)--with adverse health and fitness consequences at each developmental stage of life. Outcomes include depression, poor sleep quality, impaired executive function, accelerated cognitive decline, unfavourable cardiovascular function, impaired immunity, altered hypothalamic pituitary-adrenocortical activity, a pro-inflammatory gene expression profile and earlier mortality. Gaps in this research are summarized with suggestions for future research. In addition, we argue that a better understanding of naturally occurring variation in loneliness, and its physiological and psychological underpinnings, in non-human species may be a valuable direction to better understand the persistence of a 'lonely' phenotype in social species, and its consequences for health and fitness.
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Affiliation(s)
- Louise C Hawkley
- Academic Research Centers, National Opinion Research Center at the University of Chicago, Chicago, IL 60637, USA
| | - John P Capitanio
- California National Primate Research Center, University of California, Davis, CA 95616, USA
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192
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Choi H, Irwin MR, Cho HJ. Impact of social isolation on behavioral health in elderly: Systematic review. World J Psychiatry 2015; 5:432-438. [PMID: 26740935 PMCID: PMC4694557 DOI: 10.5498/wjp.v5.i4.432] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/23/2015] [Accepted: 11/11/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To examine and compare the effects of subjective and objective social isolation on behavioral health in elderly adults.
METHODS: A systematic search of PubMed was performed for original research articles from peer-reviewed journals examining one of the following topics: “Social isolation and sleep disturbance”, “social isolation and depression”, or “social isolation and fatigue in older adults”. Studies were selected following the criteria established based on the aim of this review. Data were extracted from the articles by two independent reviewers. Due to the heterogeneity in study designs and outcome measures of the included studies, qualitative and narrative analyses were conducted.
RESULTS: The set criteria were used to select a total of 16 studies for the review. Of the 16, 13 were cross-sectional studies. The characteristics of study populations were identified as follows. A total of 12 studies randomly selected subjects irrespective of pre-existing health conditions. Consequently, an unspecified number of the study subjects had chronic diseases in the studies compared. In addition, cultural and ethnic backgrounds of studies in this review were diverse, and included subjects living in North America, South America, Asia, Europe, and Oceania. Both subjective and objective types of social isolation increased behavioral symptoms, such as sleep disturbance, depressive symptoms, and fatigue in older adults. Furthermore, a few recent studies reported stronger effects of subjective social isolation than objective social isolation on sleep disturbance and depressive symptoms.
CONCLUSION: Social isolation affects behavioral health in older adults. Compared to the objective social isolation, subjective social isolation contributes more significantly to sleep disturbance and depression.
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The Association Between Social Resources and Depressive Symptoms Among Chinese Migrants and Non-Migrants Living in Guangzhou, China. JOURNAL OF PACIFIC RIM PSYCHOLOGY 2015. [DOI: 10.1017/prp.2015.12] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background: Depression is a commonly studied mental disorder affecting Chinese internal (i.e., rural-to-urban) migrants. Social resources effectively reduce depression for many communities experiencing adversities. This study evaluated social-level risk factors for depression between internal migrant and non-migrant Chinese living in mainland China. Method: We conducted a random population-level survey among migrants and local residents living in Guangzhou, China. Data were collected using face-to-face interviews. We used items from the Social Support Rating Scale to measure social resource dimensions, including social network size, emotional support, structural social capital, and one (self-developed) item that measured belonging (an element of social cohesion). The Patient Health Questionnaire-9 measured depression. Correlation and regression analyses of the partial sample ( n = 678) were conducted to estimate the association between social resources and depression for migrants ( n = 383) and non-migrants ( n = 295). Results: Stratified regression analysis demonstrated that for migrants, greater belonging was associated with less depression, while age and larger friendship social network size was related to less depression among non-migrants. Conclusion: Differences emerged in our sample with regard to the types of social resources that are protective against depression between migrants and non-migrants. Interventions that provide opportunities for migrants to better integrate and feel welcomed into their new communities may reduce their depression symptoms.
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194
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Wolf LD, Davis MC, Yeung EW, Tennen HA. The within-day relation between lonely episodes and subsequent clinical pain in individuals with fibromyalgia: Mediating role of pain cognitions. J Psychosom Res 2015; 79:202-6. [PMID: 25637526 PMCID: PMC4496321 DOI: 10.1016/j.jpsychores.2014.12.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 12/29/2014] [Accepted: 12/31/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This daily diary study of individuals with fibromyalgia (FM) examined whether morning increases in loneliness relate to worsened evening bodily pain through afternoon negative pain cognitions. METHODS 220 participants with FM completed electronic diaries 4 times a day for 21days to assess loneliness, negative pain cognitions, bodily pain, and social enjoyment. Multilevel structural equation modeling was used to examine within-person relations of morning increases in loneliness, afternoon negative pain cognitions, and evening pain, controlling for morning pain. RESULTS On mornings when individuals experienced higher than their usual levels of loneliness, they experienced higher levels of afternoon maladaptive pain cognitions, which in turn predicted increases in evening pain above the level of morning pain. Afternoon maladaptive pain cognitions fully mediated the relations between morning loneliness and evening pain. CONCLUSIONS Lonely episodes are associated with subsequent increases in negative patterns of thinking about pain, which in turn predict subsequent increases in bodily pain within a day. Because pain cognitions mediate the loneliness-pain link, FM interventions may benefit from addressing individuals' vulnerability to maladaptive cognitions following lonely episodes.
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Affiliation(s)
| | | | | | - Howard A Tennen
- University of Connecticut Health Center, Department of Community Medicine and Health Care, United States
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195
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Aarts S, Peek STM, Wouters EJM. The relation between social network site usage and loneliness and mental health in community-dwelling older adults. Int J Geriatr Psychiatry 2015; 30:942-9. [PMID: 25503540 DOI: 10.1002/gps.4241] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 10/31/2014] [Accepted: 11/04/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Loneliness is expected to become an even bigger social problem in the upcoming decades, because of the growing number of older adults. It has been argued that the use of social network sites can aid in decreasing loneliness and improving mental health. The purpose of this study was to examine whether and how social network sites usage is related to loneliness and mental health in community-dwelling older adults. METHOD The study population included community-dwelling older adults aged 60 and over residing in the Netherlands (n = 626) collected through the LISS panel (www.lissdata.nl). Univariate and multivariate linear regression analyses, adjusted for potentially important confounders, were conducted in order to investigate the relation between social network sites usage and (emotional and social) loneliness and mental health. RESULTS More than half of the individuals (56.2%) reported to use social network sites at least several times per week. Social network sites usage appeared unrelated to loneliness in general, and to emotional and social loneliness in particular. Social network sites usage also appeared unrelated to mental health. Several significant associations between related factors and the outcomes at hand were detected. CONCLUSION In this sample, which was representative for the Dutch population, social network sites usage was unrelated to loneliness and/or mental health. The results indicate that a simple association between social network site usage and loneliness and mental health as such, cannot automatically be assumed in community-dwelling older adults.
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Affiliation(s)
- S Aarts
- Fontys University of Applied Sciences, School for Allied Health Professions, Chair of Health Innovations and Technology, Eindhoven, Netherlands
| | - S T M Peek
- Fontys University of Applied Sciences, School for Allied Health Professions, Chair of Health Innovations and Technology, Eindhoven, Netherlands.,Tilburg University, School of Social and Behavioral Sciences, Department of Tranzo, Netherlands
| | - E J M Wouters
- Fontys University of Applied Sciences, School for Allied Health Professions, Chair of Health Innovations and Technology, Eindhoven, Netherlands
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196
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Sharp L, O'Leary E, Kinnear H, Gavin A, Drummond FJ. Cancer-related symptoms predict psychological wellbeing among prostate cancer survivors: results from the PiCTure study. Psychooncology 2015; 25:282-91. [DOI: 10.1002/pon.3909] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 06/16/2014] [Accepted: 06/16/2014] [Indexed: 12/22/2022]
Affiliation(s)
- Linda Sharp
- National Cancer Registry Ireland; Cork Ireland
| | | | - Heather Kinnear
- Northern Ireland Cancer Registry; Queen's University Belfast; Belfast Northern Ireland United Kingdom
| | - Anna Gavin
- Northern Ireland Cancer Registry; Queen's University Belfast; Belfast Northern Ireland United Kingdom
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197
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Deckx L, van den Akker M, van Driel M, Bulens P, van Abbema D, Tjan-Heijnen V, Kenis C, de Jonge ET, Houben B, Buntinx F. Loneliness in patients with cancer: the first year after cancer diagnosis. Psychooncology 2015; 24:1521-8. [PMID: 25914244 DOI: 10.1002/pon.3818] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 03/02/2015] [Accepted: 03/14/2015] [Indexed: 01/22/2023]
Abstract
OBJECTIVES We studied the frequency and evolution of social and emotional loneliness in older cancer patients in comparison with younger cancer patients and older people without cancer. We evaluated if changes in common cancer-related and ageing-related problems such as fatigue, cognitive functioning and functional status contributed to the occurrence of loneliness. METHODS This study was part of the KLIMOP study (Dutch acronym for project on older cancer patients in Belgium and the Netherlands) and included older (≥70 years) and younger cancer patients (50-69 years) and older people without cancer. Data were collected at baseline and 1-year follow-up. Loneliness was measured with the loneliness scale of De Jong-Gierveld. The relationship between loneliness after 1 year and changes in fatigue, cognitive functioning and functional status was tested in multivariate logistic regression analyses. RESULTS Data were available for 475 participants. At baseline, older cancer patients were less lonely compared with older people without cancer. After 1 year, the frequency of emotional loneliness had significantly increased for older cancer patients (26-42%, p < 0.001) and had reached levels of older people without cancer. Emotional loneliness also increased for younger cancer patients (25-34%, p = 0.02), but not for older people without cancer (40-38%, p = 0.69). Frequency of social loneliness did not change significantly. People who were persistently fatigued and people who became or were persistently impaired on cognitive functioning were at increased risk of becoming lonely. CONCLUSION Loneliness, in particular emotional loneliness, is a common problem in cancer patients, and its frequency changes considerably over time.
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Affiliation(s)
- Laura Deckx
- Department of General Practice, KU Leuven, Leuven, Belgium
| | - Marjan van den Akker
- Department of General Practice, KU Leuven, Leuven, Belgium.,Department of Family Medicine, School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Mieke van Driel
- Discipline of General Practice, School of Medicine, The University of Queensland, Brisbane, Australia
| | - Paul Bulens
- Limburgs Oncologisch Centrum, Hasselt, Belgium
| | - Doris van Abbema
- Department of Medical Oncology, School GROW, Maastricht University, Maastricht, the Netherlands
| | - Vivianne Tjan-Heijnen
- Department of Medical Oncology, School GROW, Maastricht University, Maastricht, the Netherlands
| | - Cindy Kenis
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Eric T de Jonge
- Department of Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Bert Houben
- Department of Abdominal and Oncological Surgery, Jessa Hospital, Hasselt, Belgium
| | - Frank Buntinx
- Department of General Practice, KU Leuven, Leuven, Belgium.,Department of Family Medicine, School CAPHRI, Maastricht University, Maastricht, The Netherlands
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198
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Jaremka LM, Fagundes CP, Peng J, Belury MA, Andridge RR, Malarkey WB, Kiecolt-Glaser JK. Loneliness predicts postprandial ghrelin and hunger in women. Horm Behav 2015; 70:57-63. [PMID: 25725426 PMCID: PMC4409518 DOI: 10.1016/j.yhbeh.2015.01.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 01/21/2015] [Accepted: 01/28/2015] [Indexed: 01/17/2023]
Abstract
Loneliness is strongly linked to poor health. Recent research suggests that appetite dysregulation provides one potential pathway through which loneliness and other forms of social disconnection influence health. Obesity may alter the link between loneliness and appetite-relevant hormones, one unexplored possibility. We examined the relationships between loneliness and both postmeal ghrelin and hunger, and tested whether these links differed for people with a higher versus lower body mass index (BMI; kg/m(2)). During this double-blind randomized crossover study, women (N=42) ate a high saturated fat meal at the beginning of one full-day visit and a high oleic sunflower oil meal at the beginning of the other. Loneliness was assessed once with a commonly used loneliness questionnaire. Ghrelin was sampled before the meal and postmeal at 2 and 7h. Self-reported hunger was measured before the meal, immediately postmeal, and then 2, 4, and 7h later. Lonelier women had larger postprandial ghrelin and hunger increases compared with less lonely women, but only among participants with a lower BMI. Loneliness and postprandial ghrelin and hunger were unrelated among participants with a higher BMI. These effects were consistent across both meals. These data suggest that ghrelin, an important appetite-regulation hormone, and hunger may link loneliness to weight gain and its corresponding negative health effects among non-obese people.
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Affiliation(s)
- Lisa M Jaremka
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA.
| | - Christopher P Fagundes
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Juan Peng
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA; College of Public Health, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Martha A Belury
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Rebecca R Andridge
- College of Public Health, The Ohio State University College of Medicine, Columbus, OH, USA
| | - William B Malarkey
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA; Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA; Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Psychiatry, The Ohio State University College of Medicine, Columbus, OH, USA
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199
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Psychological Adjustment in Breast Cancer Survivors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 862:231-42. [DOI: 10.1007/978-3-319-16366-6_15] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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200
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Jaremka LM, Derry HM, Bornstein R, Prakash RS, Peng J, Belury MA, Andridge RR, Malarkey WB, Kiecolt-Glaser JK. Omega-3 supplementation and loneliness-related memory problems: secondary analyses of a randomized controlled trial. Psychosom Med 2014; 76:650-8. [PMID: 25264972 PMCID: PMC4288961 DOI: 10.1097/psy.0000000000000104] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Loneliness enhances risk for episodic memory declines over time. Omega-3 supplementation can improve cognitive function for people experiencing mild cognitive difficulties. Accordingly, we explored whether omega-3 supplementation would attenuate loneliness-related episodic memory problems. METHODS Participants (n = 138) from a parent randomized controlled trial were randomized to the placebo, 1.25 grams/d of omega-3, or 2.50 grams/d of omega-3 conditions for a 4-month period. They completed a baseline loneliness questionnaire and a battery of cognitive tests both at baseline and at the end of the randomized controlled trial. RESULTS After adjustment for baseline verbal episodic memory scores, lonelier people within the placebo condition had poorer verbal episodic memory postsupplementation, as measured by immediate (b = -0.28, t (117) = -2.62, p = .010) and long-delay (b = -0.06, t (116) = -2.07, p = .040) free recall, than their less lonely counterparts. This effect was not observed in the 1.25- and 2.50-grams/d supplementation groups (all p values > .10). The plasma omega-6:omega-3 ratio data mirrored these results. There were no loneliness-related effects of omega-3 supplementation on short-delay recall or the other cognitive tests (all p values > .32). CONCLUSION These results suggest that omega-3 supplementation attenuates loneliness-related verbal episodic memory declines over time and support the use of exploring novel interventions for treating episodic memory problems among lonely people. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00385723.
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Affiliation(s)
- Lisa M. Jaremka
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
| | - Heather M. Derry
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
- Department of Psychology, The Ohio State University
| | - Robert Bornstein
- Department of Psychiatry, The Ohio State University College of Medicine
| | | | - Juan Peng
- College of Public Health, The Ohio State University College of Medicine
| | | | | | - William B. Malarkey
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
- Department of Internal Medicine, The Ohio State University College of Medicine
- Comprehensive Cancer Center, The Ohio State University College of Medicine
| | - Janice K. Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
- Department of Psychiatry, The Ohio State University College of Medicine
- Comprehensive Cancer Center, The Ohio State University College of Medicine
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