Battling the Modern Behavioral Epidemic of Loneliness: Suggestions for Research and Interventions

Psychometric properties of the variants of the Chinese UCLA Loneliness Scales and their associations with mental health in adolescents

Loneliness is a pervasive and distressing emotional experience that affects individuals of all ages and can have significant consequences for both physical and mental health. The UCLA Loneliness Scale (UCLA-LS) is widely used to assess the subjective feelings of loneliness, but concerns have been raised about its structure and applicability in diverse cultural contexts. This study analysed the reliability and validity of the five Chinese versions of the UCLA-LS in a representative sample of 2,643 adolescents and young adults with Chinese as their first language in Hong Kong. The results showed high internal consistency across all versions and content validity for most items. Factor analysis revealed a two-factor structure for the longer versions and a unidimensional structure for the shorter versions. However, the fit statistics suggested that the models did not meet good fit criteria, indicating item loading or model specification requires further review. The scales demonstrated strong associations with mental health conditions such as depression and anxiety, as well as psychosocial factors like hopelessness and aggression. Notably, the 8-item version's total scores were associated with mental health and psychological attributes comparable to those of the 20-item version, suggesting its potential suitability as a screening tool in population settings. Future research is needed to improve the generalisability of these scales to other Chinese populations, particularly for items with lower content validity.

Prospective Health Impacts of a Universal Basic Income: Evidence from Community Engagement in South Tyneside, United Kingdom

Studies have suggested that universal basic income (UBI) has the capacity to have substantial health benefits across the population at national level. Multiple impact pathways have recently been theorized and there are calls for trials to explore these pathways empirically. However, very limited research has taken place at local levels to explore potential context-specific effects, or how these effects could play out in economic, social, and behavioral changes. In order to examine these effects and to think through potential issues and unintended consequences, we brought together citizen engagement groups in Jarrow, South Tyneside, in the northeast of England to explore local people's expectations and positions on the development of UBI policies and pilots prior to their implementation. We found that people's expectations regarding the potential beneficial health impacts of UBI on their communities mapped strongly onto academically theorized impact pathways. They also extended understanding of these pathways in meaningful ways. Our findings add to the literature about UBI and health and provide important insights for the future development of empirical, health focused, UBI research.

All the king's men (and women): Fluoro-less leadless pacemaker implant in a severely obese patient

INTRODUCTION

Severe obesity presents significant challenges in imaging and delivery of therapy, including pacemaker implant.

METHODS AND RESULT

We present our experience implanting a leadless pacemaker (LP) in a severely obese man presenting with heart block. We describe our multidisciplinary approach using right internal jugular venous access and transesophageal imaging in lieu of fluoroscopy which failed to provide workable images in this instance.

CONCLUSION

Ultrasound guided LP placement may have wider application in the midst of an ongoing obesity epidemic where fluoroscopy imaging is both limited and unsafe.

A Tablet-Based Application to Enhance Social Connectedness for Individuals With a Cognitive Impairment: Results From the PRISM-CI Pilot Study

Social engagement is fundamental to successful aging and linked to better emotional, physical, and cognitive health. Maintaining social engagement is challenging for many older adults but especially for those with a cognitive impairment (CI). Information and communication technologies (ICT) can provide enhanced opportunities for social and cognitive engagement for older adults with a CI via increased information, education, and social connectivity access. This study used a pre-test post-test design to evaluate the feasibility, acceptability, and preliminary efficacy of the PRISM-CI software system, a tablet-based application designed to enhance access to resources, information, and social engagement, in 52 individuals with a CI between the ages of 65-88 years who had access to PRISM-CI for five months. Findings show that social isolation, loneliness, and depressive symptoms significantly decreased, and mobile device proficiency significantly increased, from baseline to follow-up. Results highlight ICTs potential to foster social engagement among older adults with a CI.

Trends in loneliness in 17 European countries between 2006 and 2015: A secondary analysis of data from the European Social Survey

The present study analysed changes in loneliness between 2006 and 2015 and associated factors using publicly available data (N = 128,718) from the European Social Survey from 17 countries. The study protocol was pre-registered on the Open Science Framework (https://osf.io/eq63j/). Loneliness-weighted prevalence (and mean) decreased from 30% to 27% over time. The decreasing trend was significant for both sexes. Young and old age groups reported a decline in loneliness over time while other age groups did not. Loneliness did not demonstrate a significant decline - but rather a stable trend - in persons with disability and first- and second-generation immigrants. Sociodemographic characteristics, social factors, well-being and psychological distress were associated with loneliness. These findings update those from previous studies indicating that loneliness trends and differences between European regions might be better explained by differences in psychological distress.

On social health: history, conceptualization, and population patterning

We propose a psychologically-informed concept of social health to join physical and mental components in a more comprehensive assessment of human health. Although there is an extensive literature on the importance of social relationships to health, a theoretical framework is needed to coalesce this work into a codified conceptualisation of social health, defined here as adequate quantity and quality of relationships in a particular context to meet an individual's need for meaningful human connection. Informing this novel conceptualisation, we outline eight key propositions to guide future research and theory on social health, including five propositions focused on the conceptualisation of social health and three focused on its population patterning. The former five propositions include that social health is an outcome in its own right, that health interventions can have divergent effects on social versus physical and mental aspects of health, that social health has independent effects on quality of life, that it is a dynamic and contextual construct, and that it is embedded and encoded in the human body (and mind). The utility of the social health concept is further revealed in its significance for understanding and addressing population health concerns, such as health inequalities experienced by marginalised groups.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Creating arts and crafting positively predicts subjective wellbeing

Introduction

This study explored whether engagement with Creating Arts and Crafting (CAC) predicted subjective wellbeing and loneliness, above and beyond known sociodemographic predictors.

Methods

Secondary data from 7,182 adults living in England from the Taking Part Survey (a 2019-2020 UK household survey of culture and sport participation) were analyzed. Hierarchical Linear regressions were used to explore the predictive effect of engagement with CAC on aspects of subjective wellbeing (anxiety, happiness, life satisfaction and a sense that life is worthwhile) and loneliness. Covariates included gender, Index of Multiple Deprivation (IMD), age group, health and employment status.

Results

Engaging in CAC significantly predicted increased life satisfaction, a sense that life is worthwhile and happiness, above and beyond known sociodemographic predictors.

Conclusion

Our study provides support for the wellbeing benefits of engagement with creating arts and crafting, and we suggest that this will be a useful tool at a public health level, noting that relative accessibility and affordability creating arts and crafting.

A typology of social network interactions in sub-Saharan Africa: Evidence from a rural population in Senegal

Social isolation/marginalization in sub-Saharan Africa is under-researched, despite increasing evidence of weakening traditional community-based social support. This paper aims to develop a typology of social networks capable of accounting for social marginalization in a rural community in Western Senegal and to describe the socio-demographic characteristics of network profiles. Building on prior qualitative work, we carry out a latent profile analysis using a unique and extensive social network data set, identifying four different network profiles: Locally integrated, Constrained relationships, Locally marginalized, and Local elites. This paper provides the first empirically supported classification of social integration and marginalization in social networks in rural sub-Saharan Africa. In doing so, it can serve as a reference for future research seeking to understand both the broader scope of social integration and marginalization and the consequences of differential access to social capital through social networks on access to health resources and well-being.

Association between loneliness and mental health among nurses: a cross-sectional research in China

This study explored the association between loneliness and mental health among nurses in China during the COVID-19 pandemic. This cross-sectional study was conducted from March to April 2022. We enrolled 2,811 nurses from a tertiary hospital in China. Demographic characteristics, lifestyle factors, work-related factors, and psychological characteristics were collected from participants via a self-reported questionnaire. Loneliness was measured with the three-item short form of the Revised UCLA Loneliness Scale, and the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scale were used to measure mental health. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were determined using binary logistic regression. Among participants in this study, 12.0% (337) experienced loneliness, and 7.8% (219) and 6.7% (189) reported depression and anxiety, respectively. The loneliness scores were categorized into three levels (3, 4-6, and 7-9). For depression, compared with the lowest reference, the ORs and 95% CI across the tertile were 1.31 (0.69-1.84) and 2.53 (1.11-5.76) after adjustment, respectively, and the P-value for trend was 0.045. For anxiety, compared with the lowest reference, the ORs and 95%CI across the tertile were 1.84 (1.28-2.63) and 2.52 (1.57-4.10) after adjustment, respectively; the P-value for trend was 0.004. This study showed that loneliness was significantly associated with poor mental health among nurses during the COVID-19 pandemic. These findings suggested that medical establishments should offer interventions for nurses to prevent mental health problems by targeting this modifiable risk factor.

Addressing adolescent social and emotional concerns: Insights from loneliness, burnout, and preferred conversation topics in Asian and UK contexts post-pandemic

This study investigated relationships between social and emotional concerns, loneliness, and school burnout, as these factors are associated with adaptive functioning during adolescence residence in Asia (i.e., China, Hong Kong) and the UK. Analysis of data from 2849 participants illuminated compelling insights. The participants reported a high level of loneliness, notably among girls in the UK. The research generated 11 preferred conversation topics (i.e., future and aspirations, anything, learning, nothing, mental health, personal interests, health, relationships, psychosocial issues, social issues, feelings). Among them, future and aspirations lead the way, aligning with developmental needs. A desire for mental health discussions coexisted with heightened loneliness and burnout among participants who pursued such conversations. The low achievers tended to talk about mental health issues or have nothing to say. High achievers were drawn to social issues, emphasizing their distinct socio-emotional needs. Forging a connection between personal interests and mitigated school burnout underscores the potential for individual passions to harmonize with educational experience. These findings underscore the exigency for bespoke interventions addressing the evolving emotional terrain of adolescents, especially in the pandemic's aftermath. The study's implications underscore the importance of empathetic listening and proactive engagement between adolescents and supportive adults. This research enriches the comprehension of pandemic-induced adolescent experiences and suggests avenues for future investigations into long-term emotional well-being. CLASSIFICATION CODE: 2800 (Developmental Psychology).

Separating the Effects of Transitions Into and Out of Social Isolation and Loneliness on Cognitive Function in Later Life

OBJECTIVES

This study investigates the effects of social isolation and loneliness on cognitive function, distinguishing between the effects of transitioning into and out of these states.

METHODS

This study analyzed data from 6,663 adults aged 65 or older collected over the course of 7 waves (12 years) of the Korean Longitudinal Study of Aging from 2006 to 2018. A novel asymmetric fixed effects model was utilized to separately estimate the effects of transitions into and out of social isolation or loneliness.

RESULTS

The association of transitions into social isolation due to a lack of informal social contact or loneliness with cognitive function (b = -1.387, p < .001 and b = -0.601, p < .001, respectively) was stronger than the association of transitions out of these states (b = 0.345, p < .05 and b = 0.353, p < .001, respectively). The magnitude of the negative and positive coefficients was statistically different (F-statistic = 45.29, p < .001 and F-statistic = 5.12, p < .05, respectively). In contrast, no such asymmetric effects were observed for social isolation due to a lack of formal activity (F-statistic = 0.06, p = .800).

DISCUSSION

The detrimental effects of transitioning into social isolation due to a lack of informal social contact (but not formal activity) or loneliness on cognitive function outweigh the beneficial effects of transitioning out of these states. Preventing the onset of social disconnection should be prioritized as an intervention to improve the cognitive function of older adults.

Objective monitoring of loneliness levels using smart devices: A multi-device approach for mental health applications

Loneliness is linked to wide ranging physical and mental health problems, including increased rates of mortality. Understanding how loneliness manifests is important for targeted public health treatment and intervention. With advances in mobile sending and wearable technologies, it is possible to collect data on human phenomena in a continuous and uninterrupted way. In doing so, such approaches can be used to monitor physiological and behavioral aspects relevant to an individual's loneliness. In this study, we proposed a method for continuous detection of loneliness using fully objective data from smart devices and passive mobile sensing. We also investigated whether physiological and behavioral features differed in their importance in predicting loneliness across individuals. Finally, we examined how informative data from each device is for loneliness detection tasks. We assessed subjective feelings of loneliness while monitoring behavioral and physiological patterns in 30 college students over a 2-month period. We used smartphones to monitor behavioral patterns (e.g., location changes, type of notifications, in-coming and out-going calls/text messages) and smart watches and rings to monitor physiology and sleep patterns (e.g., heart-rate, heart-rate variability, sleep duration). Participants reported their loneliness feeling multiple times a day through a questionnaire app on their phone. Using the data collected from their devices, we trained a random forest machine learning based model to detect loneliness levels. We found support for loneliness prediction using a multi-device and fully-objective approach. Furthermore, behavioral data collected by smartphones generally were the most important features across all participants. The study provides promising results for using objective data to monitor mental health indicators, which could provide a continuous and uninterrupted source of information in mental healthcare applications.

Moderators of Loneliness Trajectories in People with Systemic Sclerosis During the COVID-19 Pandemic: A SPIN COVID-19 Cohort Longitudinal Study

BACKGROUND

Many individuals with systemic sclerosis (SSc) are at heightened risk for COVID-19 related morbidity and isolation due to interstitial lung disease, frailty, and immunosuppressant use. Minimal research has explored loneliness predictors in individuals with chronic illnesses during COVID-19. This study evaluated moderators of loneliness trajectories in individuals with SSc during COVID-19.

METHODS

Longitudinal data were analyzed across 30 timepoints from April 2020 to May 2022 from 775 adults in the Scleroderma Patient-centered Intervention Network (SPIN) COVID-19 Cohort. Hierarchical linear modeling evaluated cross-level moderators of loneliness trajectories, including marital status, baseline number of household members, number of virtual or telephone one-on-one or virtual group conversations, number of hours spent enjoying in-person household conversations or activities, and satisfaction with quality of in-person household conversations (all in the past week). Level-1 moderation analyses assessed effects of conversation, activity, and satisfaction means and slopes over time.

RESULTS

Baseline values were not statistically significant moderators of loneliness trajectories. Higher mean (averaged over time) virtual or telephone one-on-one and in-person household conversations, in-person household activity, and in-person household conversation satisfaction were associated with lower loneliness trajectories (ps < .05). The relationship between in-person household conversation satisfaction and loneliness trajectory was statistically significantly but minimally attenuated over time (p < .001).

CONCLUSIONS

For people with SSc, higher mean conversation, activity, and satisfaction variables were associated with lower levels of loneliness during the pandemic, but changes in these social variables were generally not predictive of changes in loneliness.

Oxytocin-Augmented Modular-Based Group Intervention for Loneliness: A Proof-Of-Concept Randomized Controlled Trial

INTRODUCTION

Loneliness poses a significant health problem and existing psychological interventions have shown only limited positive effects on loneliness. Based on preliminary evidence for impaired oxytocin signaling in trait-like loneliness, the current proof-of-concept study used a randomized, double-blind, placebo-controlled design to probe intranasal oxytocin (OT) as an adjunct to a short-term modular-based group intervention for individuals suffering from high trait-like loneliness (HL, UCLA Loneliness Scale ≥55).

METHODS

Seventy-eight healthy HL adults (56 women) received five weekly group psychotherapy sessions. HL participants received OT or placebo before the intervention sessions. Primary outcomes were trait-like loneliness measured at baseline, after the intervention, and again at two follow-up time points (3 weeks and 3 months), and, assessed at each session, state loneliness (visual analog scale), perceived stress (Perceived Stress Scale, PSS-10), quality of life (World Health Organization Five Well-Being Index, WHO-5), and the therapeutic relationship (Group Questionnaire, GQ-D).

RESULTS

The psychological intervention was associated with significantly reduced perceived stress and improved trait-like loneliness across treatment groups, which was still evident at the 3-month follow-up. OT had no significant effect on trait-like loneliness, quality of life, or perceived stress. However, compared to placebo, OT significantly facilitated the decrease in state loneliness within sessions and significantly improved positive bonding between the group members.

CONCLUSION

Despite significantly improved trait-like loneliness after the intervention, OT did not significantly augment this effect. Further studies are needed to determine optimal intervention designs to translate the observed acute effects of OT into long-term benefits.

To reappraise or not to reappraise? Emotion regulation strategies moderate the association of loneliness during COVID-19 with depression and anxiety

BACKGROUND

The COVID-19 pandemic resulted in heightened feelings of loneliness due to lockouts and social restrictions.

OBJECTIVE

In the present study, we examined the association of loneliness during the pandemic with anxiety and depression, while exploring the moderating role of the tendency to use two emotion-regulation strategies (expressive suppression, cognitive reappraisal).

DESIGN

We chose to examine these associations in a sample of older adults, because they faced higher risk for loneliness and health problems during the COVID-19 pandemic.

METHODS

Specifically, 174 Israeli veterans and ex-prisoners of wars from the 1973 Yom Kippur war (mean age = 69) completed self-report scales tapping loneliness, depression, anxiety, and emotion regulation strategies at the beginning of the COVID-19 outbreak (April-May 2020).

RESULTS

Findings revealed a stronger association between loneliness and depression among participants who had a greater tendency of using suppression. The tendency to use suppression did not significantly moderate the link between loneliness and anxiety. Additionally, a weaker association between loneliness and depression was found among participants who has a greater tendency of using reappraisal. However, these participants showed a stronger association between loneliness and anxiety.

CONCLUSIONS

These findings highlight the complexity of reappraisal and adds to the growing body of work on emotion regulation.

Loneliness in the Daily Lives of People With Mood and Psychotic Disorders

BACKGROUND AND HYPOTHESIS

Loneliness, the subjective experience of feeling alone, is associated with physical and psychological impairments. While there is an extensive literature linking loneliness to psychopathology, limited work has examined loneliness in daily life in those with serious mental illness. We hypothesized that trait and momentary loneliness would be transdiagnostic and relate to symptoms and measures of daily functioning.

STUDY DESIGN

The current study utilized ecological momentary assessment and passive sensing to examine loneliness in those with schizophrenia (N = 59), bipolar disorder (N = 61), unipolar depression (N = 60), remitted unipolar depression (N = 51), and nonclinical comparisons (N = 82) to examine relationships of both trait and momentary loneliness to symptoms and social functioning in daily life.

STUDY RESULTS

Findings suggest that both trait and momentary loneliness are higher in those with psychopathology (F(4,284) = 28.00, P < .001, ηp2 = 0.27), and that loneliness significantly relates to social functioning beyond negative symptoms and depression (β = -0.44, t = 6.40, P < .001). Furthermore, passive sensing measures showed that greater movement (β = -0.56, t = -3.29, P = .02) and phone calls (β = -0.22, t = 12.79, P = .04), but not text messaging, were specifically related to decreased loneliness in daily life. Individuals higher in trait loneliness show stronger relationships between momentary loneliness and social context and emotions in everyday life.

CONCLUSIONS

These findings provide further evidence pointing to the importance of loneliness transdiagnostically and its strong relation to social functioning. Furthermore, we show that passive sensing technology can be used to measure behaviors related to loneliness in daily life that may point to potential treatment implications or early detection markers of loneliness.

Reducing Loneliness through the Power of Practicing Together: A Randomized Controlled Trial of Online Dyadic Socio-Emotional vs. Mindfulness-Based Training

Loneliness has become a pressing topic, especially among young adults and during the COVID-19 pandemic. In a randomized controlled trial with 253 healthy adults, we evaluated the differential efficacy of two 10-week app-delivered mental training programs: one based on classic mindfulness and one on an innovative partner-based socio-emotional practice (Affect Dyad). We show that the partner-based training resulted in greater reductions in loneliness than the mindfulness-based training. This effect was shown on three measures of loneliness: general loneliness assessed with the 20-item UCLA Loneliness Scale, state loneliness queried over an 8-day ecological momentary assessment in participants' daily lives, and loneliness ratings required before and after daily practice. Our study provides evidence for the higher efficacy of a mental training approach based on a 12 min practice conducted with a partner in reducing loneliness and provides a novel, scalable online approach to reduce the increasing problem of loneliness in society.

A Holistic Approach to Early Relational Health: Cultivating Culture, Diversity, and Equity

Early Relational Health (ERH) is the foundation for infant and child emotional and social wellbeing. ERH is a quality of relationships co-created by infants, caregivers, and other members of their families and communities from pregnancy through childhood. Relationships themselves are not ERH; rather, ERH can be a feature of relationships. Those that are characterized by positive, shared emotionality become contexts within which members co-develop mutual capacities that enable them to prevail and flourish. This essay offers a synthesis of current knowledge about ERH in the US and begins to integrate Indigenous and non-Indigenous research and knowledge about ERH in the hope that readers will embrace "Etuaptmumk"-"Two-Eyed Seeing". The authors maintain that systems of care for infants, families, and their communities must first and foremost attend to revitalization, cultural context, diversity, equity, and inclusion. Authors discuss key concepts in ERH; Indigenous and non-Indigenous research that inform ERH; structural and systemic factors in the US that affect ERH ecosystems; the critical intersections of culture, diversity, equity; the broader concept of village support for fostering ERH; and efforts to revitalize ERH discourse, practices, and policies. The authors advocate for a holistic approach to ERH and suggest future directions for research and advocacy.

Social isolation and loneliness with risk of cardiometabolic multimorbidity: A prospective cohort study from UK Biobank

The pandemic of the coronavirus disease 2019 resulted in an increased prevalence of social isolation and loneliness. Cox proportional hazards regression was used to test the association between social isolation/loneliness, multiple cardiometabolic diseases (CMDs) and cardiometabolic multimorbidity (CMM). In the multivariable adjusted models, compared with the least isolated, the most isolated had independently associated with CMD (HR 1.07, 95% CI 1.03 to 1.11) and CMM (HR 1.24, 95% CI 1.12 to 1.36) in stage I, and CMM in stage II (HR 1.14, 95% CI 1.05 to 1.23). Compared with those with the least loneliness, those who with most loneliness had about 20% increased risk of CMD and 29% increased risk of CMM in stage I. Those with the most loneliness were also significantly associated with increased CMM risk (HR 1.30, 95% CI 1.19 to 1.42) in stage II. This study revealed the associations of social isolation/loneliness with CMD and CMM.

Does urban greenness reduce loneliness and social isolation among Canadians? A cross-sectional study of middle-aged and older adults of the Canadian Longitudinal Study on Aging (CLSA)

OBJECTIVES

Urban greenness has been shown to confer many health benefits including reduced risks of chronic disease, depression, anxiety, and, in a limited number of studies, loneliness. In this first Canadian study on this topic, we investigated associations between residential surrounding greenness and loneliness and social isolation among older adults.

METHODS

This cross-sectional analysis of the Canadian Longitudinal Study on Aging included 26,811 urban participants between 45 and 86 years of age. The Normalized Difference Vegetation Index (NDVI), a measure of greenness, was assigned to participants' residential addresses using a buffer distance of 500 m. We evaluated associations between the NDVI and (i) self-reported loneliness using the Center for Epidemiological Studies Depression Scale, (ii) whether participants reported "feeling lonely living in the local area", and (iii) social isolation. Logistic regression models were used to characterize associations between greenness and loneliness/social isolation while adjusting for individual socio-economic and health behaviours.

RESULTS

Overall, 10.8% of participants perceived being lonely, while 6.5% reported "feeling lonely in their local area". Furthermore, 16.2% of participants were characterized as being socially isolated. In adjusted models, we observed no statistically significant difference (odds ratio (OR) = 0.99; 95% confidence interval (CI) 0.93-1.04) in self-reported loneliness in relation to an interquartile range (IQR) increase of NDVI (0.06). However, for the same change in greenness, there was a 15% (OR = 0.85; 95% CI 0.72-0.99) reduced risk for participants who strongly agreed with "feeling lonely living in the local area". For social isolation, for an IQR increase in the NDVI, we observed a 7% (OR = 0.93; 95% CI 0.88-0.97) reduction in prevalence.

CONCLUSION

Our findings suggest that urban greenness plays a role in reducing loneliness and social isolation among Canadian urbanites.

The missing hallmark of health: psychosocial adaptation

The eight biological hallmarks of health that we initially postulated (Cell. 2021 Jan 7;184(1):33-63) include features of spatial compartmentalization (integrity of barriers, containment of local perturbations), maintenance of homeostasis over time (recycling & turnover, integration of circuitries, rhythmic oscillations) and an array of adequate responses to stress (homeostatic resilience, hormetic regulation, repair & regeneration). These hallmarks affect all eight somatic strata of the human body (molecules, organelles, cells, supracellular units, organs, organ systems, systemic circuitries and meta-organism). Here we postulate that mental and socioeconomic factors must be added to this 8×8 matrix as an additional hallmark of health ("psychosocial adaptation") and as an additional stratum ("psychosocial interactions"), hence building a 9×9 matrix. Potentially, perturbation of each of the somatic hallmarks and strata affects psychosocial factors and vice versa. Finally, we discuss the (patho)physiological bases of these interactions and their implications for mental health improvement.

Social isolation, loneliness, and mental health among older adults during COVID-19: a scoping review

COVID-19 continues to have detrimental effects worldwide, especially on vulnerable populations. The burden of mental health concerns and psychological well-being resulting from social isolation and loneliness induced by COVID-19 are increasingly recognized in old age. The aim is to determine the extent of social isolation and loneliness among older adults, the methodologies used, the effect on mental health during COVID-19, and review intervention strategies and lifestyle changes to improve the current situation through the recommendations of the studies included. The articles published on PubMed, ProQuest, and Scopus databases from December 2019 to December 2021 with the following keywords ("Older Adults" "Social Isolation," "Loneliness," "Mental Health," "COVID-19") in English were included. Older adults have faced a serious burden of social isolation and adverse mental health effects during COVID-19. Anxiety, depression, stress, and insomnia are the major mental health concerns among older adults worldwide. It is suggested that spousal support and social networks, adaptive organizational change, and a responsive public sector are critical in reducing the obstacles to older adults. COVID-19 resilience among the aging population can be remarkable if adequately cared for with senior-friendly pandemic-related intervention strategies, policies and legislation.

The Role of Acceptance in Everyday Loneliness Among Adults with Serious Mental Illness

There is a high prevalence of loneliness among adults with serious mental illness (SMI) with most research focusing on stable contributing factors. This study sought to identify the role of dispositional loneliness and internalized stigma, as well as the momentary feelings of acceptance on experiential loneliness among adults with SMI. Data were collected using ecological momentary assessment via smart phones, and 89 adults with a SMI were included. Hierarchical linear modeling was used to identify the role of dispositional and experience factors in experiential loneliness. Findings indicated that (a) dispositional internalized stigma, (b) being at home, (c) being alone and, (d) a cross-level interaction between dispositional loneliness and feelings of acceptance best fit the data. The relationship of acceptance to experiential loneliness was strongest among the most lonely. Supporting people with SMI to develop social connections contributing to their relational value may enhance feelings of acceptance and reduce loneliness.

Identifying Unmet Social Needs in a Patient Living in Isolation: A Case Report

Loneliness and social isolation are common among older adults. To deliver high-quality care to older patients, healthcare professionals should know the social conditions of their patients. Addressing social determinants of health (SDH) in daily practice is beneficial to both patients and healthcare professionals. We illustrate a patient with congestive heart failure and cognitive decline whose social conditions improved through an SDH assessment. An SDH assessment has some potential advantages, which include facilitating a comprehensive understanding of patients' social conditions, visualizing how patients' social conditions have changed, deepening interprofessional collaboration, and ameliorating unnecessary negative emotions toward patients. This case report conveys two key messages. Firstly, healthcare professionals have the capability to evaluate patients' social backgrounds and enhance their health and social conditions through routine care. Secondly, the utilization of an SDH screening toolkit can support and enhance this initiative.

The contribution of objective and perceived crime to neighbourhood socio-inequity in loneliness

Loneliness tends to be more prevalent in socioeconomically disadvantaged neighbourhoods, yet few studies explore the environmental differences contributing to area-based inequity in loneliness. This study examined how perceived and objective crime contributed to differences in loneliness between advantaged and disadvantaged neighbourhoods. The study used cross-sectional data from 3749 individuals aged between 48 and 77 years, residing in 200 neighbourhoods in Brisbane, Australia. We found that participants in disadvantaged neighbourhoods reported higher levels of loneliness and perceived crime, and the most disadvantaged neighbourhoods also had highest prevalence of objective crime. However, while perceived and objective crime were positively correlated with loneliness, only perceived crime accounted for socio-economic inequity in loneliness. Consequently, perceived crime plays an important role in addressing loneliness in disadvantaged communities and requires equitable resourcing for multiple strategies that aim to decrease crime and increase perceived safety.

Can Resilience Buffer the Effects of Loneliness on Mental Distress Among Working-Age Adults in the United States During the COVID-19 Pandemic? A Latent Moderated Structural Modeling Analysis

BACKGROUND

The profound health consequences of loneliness are well-established. However, less is known about the protective factors which may alleviate the effects of loneliness on mental health especially among working-age adults amidst the COVID-19 pandemic. We draw on the social ecology of resilience and examine whether resilience factors can buffer the effects of loneliness on mental distress.

METHODS

Data came from the National Well-being Survey-a national study of a demographically representative sample of U.S. working-age adults (N = 4014). We used (a) structural equation models with latent variables to examine the main effects of loneliness, psychological resilience, and perceived social support on mental distress, and (b) latent moderated structural equations to estimate the latent interaction effects.

RESULTS

Results revealed that (a) loneliness was positively associated with mental distress and psychological resilience was negatively related to mental distress, and (b) psychological resilience and perceived social support moderated the strength of the relationship between loneliness and mental distress.

CONCLUSIONS

Our study highlights the importance of psychological resilience and perceived social support as two protective factors in the relationship between loneliness and mental distress. Given that loneliness significantly predicts worse mental and physical health and higher mortality, identifying protective factors that might disrupt these connections is vital. As such, public health efforts to strengthen and expand familial and community social support networks and foster psychological resilience are urgently needed to support mental health among working-age adults during additional waves of the pandemic or future similar stressors.

The development of depressive symptoms in older adults from a network perspective in the English Longitudinal Study of Ageing

An increased understanding of the interrelations between depressive symptoms among older populations could help improve interventions. However, studies often use sum scores to understand depression in older populations, neglecting important symptom dynamics that can be elucidated in evolving depressive symptom networks. We computed Cross-Lagged Panel Network Models (CLPN) of depression symptoms in 11,391 adults from the English Longitudinal Study of Ageing. Adults aged 50 and above (mean age 65) were followed over 16 years throughout this nine-wave representative population study. Using the eight-item Center for Epidemiological Studies Depression Scale, we computed eight CLPNs covering each consecutive wave. Across waves, networks were consistent with respect to the strength of lagged associations (edge weights) and the degree of interrelationships among symptoms (centrality indices). Everything was an effort and could not get going displayed the strongest reciprocal cross-lagged associations across waves. These two symptoms and loneliness were core symptoms as reflected in strong incoming and outgoing connections. Feeling depressed was strongly predicted by other symptoms only (incoming but not strong outgoing connections were observed) and thus was not related to new symptom onset. Restless sleep had outgoing connections only and thus was a precursor to other depression symptoms. Being happy and enjoying life were the least central symptoms. This research underscores the relevance of somatic symptoms in evolving depression networks among older populations. Findings suggest the central symptoms from the present study (everything was an effort, could not get going, loneliness) may be potential key intervention targets to mitigate depression in older adults.

Loneliness Is Associated With Lower Self- and Clinician-Rated Levels of Personality Functioning

Personality disorders (PDs) are associated with interpersonal dysfunction, loneliness, and reduced social embeddedness. This study investigates loneliness and social network size in association with self- and clinician-rated personality functioning regarding the DSM-5's Alternative Model for Personality Disorders (AMPD). Eighty psychiatric inpatients including participants with and without PDs completed the Semi-structured Interview for Personality Functioning, the Level of Personality Functioning Scale - Brief Form, the UCLA Loneliness Scale, and the Social Network Index. Patients with PDs reported more loneliness and personality dysfunctioning than patients without PDs. Social network size did not differ between patient groups and showed lower correlations with personality functioning compared to loneliness. Loneliness was further associated with deficits in personality functioning. Deficits in distinct AMPD domains and loneliness may constitute transdiagnostically relevant factors that are related and mutually reinforcing. This could be important for identifying patients beyond PD diagnoses who are at risk of poor psychosocial functioning and require tailored psychotherapy.

angptl4 gene expression as a marker of adaptive homeostatic response to social isolation across the lifespan in zebrafish

Social isolation has detrimental health effects, but the underlying mechanisms are unclear. Here, we investigated the impact of 2 weeks of isolation on behavior and gene expression in the central nervous system at different life stages of zebrafish. Results showed that socially deprived young adult zebrafish experienced increased anxiety, accompanied by changes in gene expression. Most gene expression patterns returned to normal within 24 hours of reintroduction to a social environment, except angptl4, which was upregulated after reintroduction, suggesting an adaptive mechanism. Similarly, aging zebrafish displayed heightened anxiety and increased central nervous system expression of angptl4 during isolation, but effects were reversed upon reintroduction to a social group. The findings imply that angptl4 plays a homeostatic role in response to social isolation, which varies across the lifespan. The study emphasizes the importance of social interactions for psychological well-being and highlights the negative consequences of isolation, especially in older individuals. Further research may unravel how social isolation affects angptl4 expression and its developmental and aging effects.

Evaluation of Measurement Properties and Differential Item Functioning in the English and French Versions of the University of California, Los Angeles, Loneliness Scale-6: A Scleroderma Patient-Centered Intervention Network (SPIN) Study

OBJECTIVE

Loneliness has been associated with poorer health-related quality of life but has not been studied in patients with systemic sclerosis (SSc). The current study was undertaken to examine and compare the psychometric properties of the English and French versions of the University of California, Los Angeles, Loneliness Scale-6 (ULS-6) in patients with SSc during the COVID-19 pandemic.

METHODS

This study used baseline cross-sectional data from 775 adults enrolled in the Scleroderma Patient-Centered Intervention Network (SPIN) COVID-19 Cohort. Reliability and validity of ULS-6 scores overall and between languages were evaluated using confirmatory factor analysis (CFA), differential item functioning (DIF) through the multiple-indicator multiple-cause (MIMIC) model, omega/alpha calculation, and correlations of hypothesized convergent relationships.

RESULTS

CFA for the total sample supported the single-factor structure (comparative fit index [CFI] 0.96, standardized root mean residual [SRMR] 0.03), and all standardized factor loadings for items were large (0.60-0.86). The overall MIMIC model with language as a covariate fit well (CFI 0.94, SRMR 0.04, root mean square error of approximation 0.11). Statistically significant DIF was found for 3 items across language (βitem2  = 0.14, P < 0.001; βitem4  = -0.07, P = 0.01; βitem6  = 0.13, P < 0.001), but these small differences were without practical measurement implications. Analyses demonstrated high internal consistency with no language-based convergent validity differences.

CONCLUSION

Analyses demonstrated evidence of acceptable reliability and validity of ULS-6 scores in English- and French-speaking adults with SSc. DIF analysis supported use of the ULS-6 to examine comparative experiences of loneliness without adjusting for language.

Combined effects of loneliness and inflammation on depression in people with HIV

OBJECTIVE

Loneliness is prevalent in people with HIV (PWH) and associated with adverse health-related consequences, including depression. Chronic inflammation has been linked to depression in PWH, though its association with loneliness is less well established. Simultaneous examination of inflammation, loneliness and depression is needed to clarify these relationships. This study investigated the relationship between loneliness and inflammation, and the effects of loneliness and inflammation on depression in PWH.

METHODS

82 PWH who were on suppressive ART (mean age [SD] = 53.2 [9.0]) completed the UCLA Loneliness Scale-Version 3 and the Center for Epidemiologic Studies Depression Scale as part of a comprehensive evaluation. Biomarkers of systemic inflammation (CRP, IL-6, CCL2/MCP-1, sCD14) and coagulation (D-dimer) were measured in blood using commercial immunoassays.

RESULTS

Multivariable linear regression analyses revealed that higher D-dimer, CCL2/MCP-1, and sCD14 were significant predictors of loneliness (ps < .05) while accounting for relevant covariates. Stepwise multiple linear regression models that included loneliness, biomarkers, and their interactions as predictors of depressive symptoms revealed significant main effects of loneliness and CCL2/MCP-1 levels (ps < .05), and a significant loneliness by D-dimer interaction (p < .05) whereby higher D-dimer was associated with increased depressive symptoms only at higher levels of loneliness.

CONCLUSIONS

Increased coagulation activity is associated with loneliness, and in the context of loneliness, may increase risk for depression. Increased inflammation was associated with depression suggesting potentially dissociable underlying biological processes. To the extent that these processes are modifiable, such findings could have important implications in the treatment of loneliness and depression in PWH.

Frailty after COVID-19: The wave after?

The COVID-19 pandemic poses an ongoing public health challenge, with a focus on older adults. Given the large number of older persons who have recovered from COVID-19 and reports of long-lasting sequelae, there is reasonable concern that the COVID-19 pandemic may lead to a long-term deterioration in the health of older adults, i.e., a potential "wave of frailty." Therefore, it is critical to better understand the circumstances surrounding the development of frailty as a result of COVID-19, as well as the underlying mechanisms and factors contributing to this development. We conducted a narrative review of the most relevant articles published on the association between COVID-19 and frailty through January 2023. Although few studies to date have addressed the effects of COVID-19 on the onset and progression of frailty, the available data suggest that there is indeed an increase in frailty in the elderly as a result of COVID-19. Regarding the underlying mechanisms, a multicausal genesis can be assumed, involving both direct viral effects and indirect effects, particularly from the imposed lockdowns with devastating consequences for the elderly: decreased physical activity, altered diet, sarcopenia, fatigue, social isolation, neurological problems, inflammation, and cardiovascular morbidity are among the possible mediators. Since the COVID-19 pandemic is leading to an increase in frailty in the elderly, there is an urgent need to raise awareness of this still little-known problem of potentially great public health importance and to find appropriate prevention and treatment measures.

Loneliness at the age of COVID-19

Loneliness has been a major concern for philosophers, poets and psychologists for centuries. In the past several decades, it has concerned clinicians and public health practitioners as well. The research on loneliness is urgent for several reasons. First, loneliness has been and still is extremely ubiquitous, potentially affecting people across multiple demographics and geographical areas. Second, it is philosophically intriguing, and its analysis delves into different branches of philosophy including phenomenology, existentialism, philosophy of mind, etc. Third, empirical research has shown that loneliness is a significant health risk factor. Loneliness may thus be defined as a (negative) social determinant of health.Having that said, COVID-19 has demonstrated how little we as members of humanity have been prepared to face the loneliness resulting from the global response to the virus. As people worldwide are literally dying from loneliness, we still do not know what makes one feel lonely while making another feel being in solitude, or how is it that one feels lonely in the heart of London.In this essay, I first review loneliness in general and specifically in the context of COVID-19. I then argue that loneliness should be understood as a social determinant of health. Lastly, I argue that individuals have a right not to be lonely. Such right stems in turn from the right to healthcare or even a right to health.

Assessment of an Epidemic Urgency: Psychometric Evidence for the UCLA Loneliness Scale

Background

In modern industrialized countries, loneliness has been declared an epidemic. The present paper aimed to replicate previous findings about the dimensionality of the UCLA Loneliness Scale-3 version (LS-3) in a sample of Italian adults using Exploratory Structural Equation Modeling (ESEM).

Methods

In Study 1, 1676 participants (M_age= 31.15; SD = 11.89) completed the LS-3. The three-factor ESEM model was performed to replicate the previous Italian version, and a Confirmatory Factor Analysis compared the three- and ten-item short versions. In Studies 2, 3, and 4, we administered measures of anxiety, depression, stress, internet addiction, self-esteem, and social interaction anxiety to 3513 participants (M_age= 30.81; SD = 11.77) to assess the convergent and discriminant validity of LS-3.

Results

The ESEM 3-factor model was replicated using a Target rotation (X² = 847.597; df = 133; CFI = 0.942; TLI = 0.917; RMSEA = 0.062), whereas the already-known LS-3 short version raised psychometric concerns. Positive relationships with anxiety, depression, stress, internet addiction, and social interaction anxiety, as well as negative association with self-esteem were found.

Conclusion

In conclusion, our findings support the use of the LS-3 in the Italian sample and discourage the administration of the current short forms. The implications for research and clinical practice have been discussed.

The neurocognitive impact of loneliness and social networks on social adaptation

Social adaptation arises from the interaction between the individual and the social environment. However, little empirical evidence exists regarding the relationship between social contact and social adaptation. We propose that loneliness and social networks are key factors explaining social adaptation. Sixty-four healthy subjects with no history of psychiatric conditions participated in this study. All participants completed self-report questionnaires about loneliness, social network, and social adaptation. On a separate day, subjects underwent a resting state fMRI recording session. A hierarchical regression model on self-report data revealed that loneliness and social network were negatively and positively associated with social adaptation. Functional connectivity (FC) analysis showed that loneliness was associated with decreased FC between the fronto-amygdalar and fronto-parietal regions. In contrast, the social network was positively associated with FC between the fronto-temporo-parietal network. Finally, an integrative path model examined the combined effects of behavioral and brain predictors of social adaptation. The model revealed that social networks mediated the effects of loneliness on social adaptation. Further, loneliness-related abnormal brain FC (previously shown to be associated with difficulties in cognitive control, emotion regulation, and sociocognitive processes) emerged as the strongest predictor of poor social adaptation. Findings offer insights into the brain indicators of social adaptation and highlight the role of social networks as a buffer against the maladaptive effects of loneliness. These findings can inform interventions aimed at minimizing loneliness and promoting social adaptation and are especially relevant due to the high prevalence of loneliness around the globe. These findings also serve the study of social adaptation since they provide potential neurocognitive factors that could influence social adaptation.

Growth of preference for solitude in urban and rural Chinese adolescents

Introduction

As individuals enter adolescence, their preference for solitude (PFS) increases with age, which may be a result of balancing the need for social affiliation and the need for autonomy and independence. These needs are shaped by the social-cultural contexts, and thus the growth rate of PFS may differ across social-cultural contexts.This study examined to what extent the developmental trajectory of PFS differed between urban and rural Chinese adolescents.

Methods

Adolescents in urban (n = 326,168 boys, Mage =12.00 years, SD = 0.61) and rural (n = 449, 198 boys, Mage =11.82 years, SD = 0.58) regions in China reported their PFS and shyness each year from Grade 6 to Grade 8. Longitudinal measurement invariance of PFS was established between the urban and rural samples. Location and gender differences in the intercept and the slope of PFS were examined using a latent growth model, while controlling for shyness at each time point.

Results

The analyses revealed that adolescents in both urban and rural regions showed an increasing trajectory of PFS. Although urban and rural adolescents did not differ in the initial level of PFS at Grade 6, urban adolescents' PFS increased faster than that of the rural adolescents. The urban-rural difference in the slope of PFS remained significant after controlling for the associations between the intercept and the slope of PFS and shyness at each time point. In addition, in the rural region, boys showed a faster increase of PFS than girls, yet gender differences in the initial level of PFS and the developmental trajectory in the urban region were nonsignificant.

Discussion

The findings reveal a normative increasing trend of PFS during early adolescence and faster increase for urban than rural adolescents. To promote adolescents' psychological well-being, parents, teachers and practitioners need to help adolescents establish a good balance between social interaction and solitude. When deciding what is a good balance, it is important to consider the social-cultural context.

Association between COVID-19-related loneliness or worry and symptoms of anxiety and depression among first-year college students

OBJECTIVE

To examine the relationship between COVID-19-related distress and mental health among first-year college students.

PARTICIPANTS

Data for this longitudinal study (n = 727) were collected before the school year (August 2019), end of fall semester (December 2019), and soon after the university suspended in-person instruction (April 2020).

METHODS

We used multivariable log-linear and logistic regressions to examine continuous and dichotomous outcomes on the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale.

RESULTS

The most consistent predictor of during-pandemic mental health was feeling extremely isolated (versus not at all), which was associated with increased symptom severity of depression (proportional change[95% CI] = 2.43[1.87, 3.15]) and anxiety (2.02[1.50, 2.73]) and greater odds of new moderate depression (OR[95% CI] = 14.83[3.00, 73.41]) and anxiety (24.74[2.91, 210.00]). Greater COVID-19-related concern was also related to increased mental health symptoms.

CONCLUSIONS

Results highlight the need for mental health services during crises that lead to social isolation.

Natural environments, psychosocial health, and health behaviors in a crisis - A scoping review of the literature in the COVID-19 context

The COVID-19 outbreak led to major restrictions globally, affecting people's psychosocial health and their health behaviors. Thus, the purpose of this scoping review was to summarize the available research regarding nature and health in the COVID-19 context. Keywords relating to natural environments and COVID-19 were combined to conduct a systematic online search in six major databases. Eligibility criteria were a) published since 2020 with data collected in the COVID-19 context b) peer-reviewed, c) original empirical data collected on human participants, d) investigated the association between natural environments and psychosocial health or health behaviors, and e) English, German, or Scandinavian languages. Out of 9126 articles being screened, we identified 188 relevant articles, representing 187 distinct studies. Most research focused on adults in the general population and was predominantly conducted in the USA, Europe, and China. Overall, the findings indicate that nature may mitigate the impact of COVID-19 on psychological health and physical activity. Through a systematic thematic analysis of the extracted data, three primary themes were identified: 1) type of nature assessed, 2) psychosocial health and health behaviors investigated, and 3) heterogeneity in the nature-health relationship. Research gaps in the COVID-19 context were identified regarding I) nature characteristics that promote psychosocial health and health behaviors, II) investigations of digital and virtual nature, III) psychological constructs relating to mental health promotion, IV) health-promoting behaviors other than physical activity, V) underlying mechanisms regarding heterogeneity in the nature-health relationship based on human, nature, and geographic characteristics, and VI) research focusing on vulnerable groups. Overall, natural environments demonstrate considerable potential in buffering the impact of stressful events on a population level on mental health. However, future research is warranted to fill the mentioned research gaps and to examine the long-term effects of nature exposure during COVID-19.

Temporal dynamics in mental health symptoms and loneliness during the COVID-19 pandemic in a longitudinal probability sample: a network analysis

Figuring out which symptoms are central for symptom escalation during the COVID-19 pandemic is important for targeting prevention and intervention. Previous studies have contributed to the understanding of the course of psychological distress during the pandemic, but less is known about key symptoms of psychological distress over time. Going beyond a pathogenetic pathway perspective, we applied the network approach to psychopathology to examine how psychological distress unfolds in a period of maximum stress (pre-pandemic to pandemic onset) and a period of repeated stress (pandemic peak to pandemic peak). We conducted secondary data analyses with the Understanding Society data (N = 17,761), a longitudinal probability study in the UK with data before (2019), at the onset of (April 2020), and during the COVID-19 pandemic (November 2020 & January 2021). Using the General Health Questionnaire and one loneliness item, we computed three temporal cross-lagged panel network models to analyze psychological distress over time. Specifically, we computed (1) a pre-COVID to first incidence peak network, (2) a first incidence peak to second incidence peak network, and (3) a second incidence peak to third incidence peak network. All networks were highly consistent over time. Loneliness and thinking of self as worthless displayed a high influence on other symptoms. Feeling depressed and not overcoming difficulties had many incoming connections, thus constituting an end-product of symptom cascades. Our findings highlight the importance of loneliness and self-worth for psychological distress during COVID-19, which may have important implications in therapy and prevention. Prevention and intervention measures are discussed, as single session interventions are available that specifically target loneliness and worthlessness to alleviate mental health problems.

Talking to strangers: Intention, competence, and opportunity

Despite having more opportunities than ever to connect with strangers, and much to gain from doing so, people often refrain from talking with, and listening to, strangers. We propose a framework that classifies obstacles to connecting with strangers into three categories concerning intention (underestimating the benefits of conversations), competence (misunderstanding how to appear likeable and competent in conversation), and opportunity (being constrained in access to a diverse set of strangers). To promote conversations among strangers, interventions have attempted to calibrate people's expectations, improve their communication, and create more opportunities for strangers to connect. We identify the need to better understand how miscalibrated beliefs emerge and are sustained, what contextual factors impact conversation likelihood, and how conversations evolve as relationships develop.

Self-criticism and romantic relationship satisfaction as serial mediators of links between childhood psychological maltreatment and loneliness

BACKGROUND

Psychological maltreatment may be one of the causes of adults' loneliness despite having a partner. There are some links between psychological maltreatment, self-criticism, relationship satisfaction, and loneliness in the literature. But the nature of these links requires further explanation.

OBJECTIVE

The present study examined the serial mediation role of self-criticism and romantic relationship satisfaction on the pathway from childhood psychological maltreatment to loneliness, in a Turkish sample.

PARTICIPANTS AND SETTINGS

In total 403 individuals (Female = 294, Male = 109) participated from 53 different cities in Türkiye. Participants were either dating (65.8 %), had a fiancée (4 %), or were married (30.3 %).

METHOD

The data was collected using Psychological Maltreatment Questionnaire, UCLA Loneliness Scale, Self-criticism Rumination Scale, and the Relationship Assessment Scale.

RESULTS

Structural equation modeling results indicated that self-criticism and romantic relationship satisfaction fully mediated the impact of psychological maltreatment on loneliness. The model was a good fit [χ² (29, N = 403) = 63.846, p < .001; χ²/df = 2.20; SRMR = 0.061; RMSEA = 0.055; GFI = 0.969; CFI = 0.979; NFI = 0.963; IFI = 0.979].

CONCLUSIONS

Childhood experiences of psychological maltreatment can continue to haunt individuals, even as adults. Although being in a relationship can help individuals with their loneliness, psychologically maltreated adults may feel lonely in their relationships due to self-criticism and dissatisfaction. Interventions focused on childhood psychological maltreatment and self-criticism may help lonely adults. Along with this focus, relationship satisfaction can be addressed in family/couple counseling.

Social isolation through single housing negatively affects trabecular and cortical bone in adult male, but not female, C57BL/6J mice

Social isolation is a potent form of psychosocial stress and is a growing public health concern, particularly among older adults. Even prior to the onset of the COVID-19 pandemic, which has significantly increased the prevalence of isolation and loneliness, researchers have been concerned about a rising "epidemic" of loneliness. Isolation is associated with an increased risk for many physical and mental health disorders and increased overall mortality risk. In addition to social isolation, older adults are also at greater risk for osteoporosis and related fractures. While researchers have investigated the negative effects of other forms of psychosocial stress on bone, including depression and PTSD, the effects of social isolation on bone have not been thoroughly investigated. The aim of this study was to test the hypothesis that social isolation would lead to bone loss in male and female C57BL/6J mice. 16-week-old mice were randomized into social isolation (1 mouse/cage) or grouped housing (4 mice/cage) for four weeks. Social isolation significantly decreased trabecular (BV/TV, BMD, Tb. N., Tb. Th.) and cortical bone (Ct.Th., Ct.Ar., Ct.Ar./Tt.Ar., pMOI, Ct.Por.) parameters in male, but not female mice. Isolated male mice had signs of reduced bone remodeling represented by reduced osteoblast numbers, osteoblast-related gene expression and osteoclast-related gene expression. However, isolated females had increased bone resorption-related gene expression, without any change in bone mass. Overall, our data suggest that social isolation has negative effects on bone in male, but not female mice, although females showed suggestive effects on bone resorption. These results provide critical insight into the effects of isolation on bone and have key clinical implications as we grapple with the long-term health impacts of the rise in social isolation related to the COVID-19 pandemic.

Investigating the relationship between cross-national suicide rates and COVID-19 first and second waves spread across the world: An exploratory study

INTRODUCTION

COVID-19 spreads between people in close contact. Social isolation, which is linked with increased suicide risk, prevents COVID-19 from spreading. Suicide and COVID-19 may therefore represent two antagonistic phenomena. Specifically, we tested whether previous cross-national suicide rates inversely correlate with COVID-19 cases and deaths across countries.

MATERIAL AND METHODS

We ran unadjusted bivariate correlations between the most updated (2016) cross-national Age-Standardised suicide rates and COVID-19 cumulative cases and deaths (as of: 30/08/2020, 11/10/2020 and 30/05/2021) across countries; and we controlled for WHO Income group, WHO region, suicide data quality, and urbanicity.

RESULTS

Suicide rates negatively correlated with COVID-19 cumulative cases up to 30/08/2020 (r=-0.14, P=.064) and up to 11/10/2020 at an almost significant level (r=-0.149, P=.050) across 174 countries. As of 11/10/2020 this correlation became significant when controlling for WHO region (r=-0.17, P=.028), data quality (r=-0.181, P=.017) and urbanicity (r=-0.172, P=.039); and as of 30/08/2020 when adjusting for WHO region (r=-0.15, P=.047) and data quality a (r=-0.16, P=.036). No significant correlations between suicide rates and COVID-19 deaths were found.

CONCLUSIONS

There seems to be an inverse correlation between previous cross-national suicide rates and COVID-19 cumulative cases across countries. Suicide and COVID-19 appear to behave, to some degree, as antagonistic phenomena, which challenges their prevention.

Worse psychological traits associated with higher probability of emotional problems during the Omicron pandemic in Tianjin, China

Background and Objectives

Individuals with specific psychological weaknesses are prone to mental problems during the coronavirus pandemic. This self-rating study assessed the combined effects of infection-related stress, resilience, worry, and loneliness on the likelihood of depression and anxiety among infected and non-infected individuals during the Tianjin Pandemic in 2022.

Methods

Individuals infected with Omicron (n = 249) and health residents (n = 415) were recruited from two hospitals and communities in Tianjin. Each respondent completed the following on-site assessment: Self-developed Scale of Demographics, Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS), the Connor-Davidson Resilience Scale (CD-RISC), De Jong Gierveld Scale (DJGLS), and the Penn State Worry Questionnaire (PSWQ). The respondents were categorized into depression or non-depression group by SDS scores, and anxiety or non-anxiety group by SAS scores.

Results

The overall scores of CD-RISC, DJGJLS, and PSWQ were significantly different both between the depression group and non-depression groups and between the anxiety group and non-anxiety groups. The greater likelihood of depression was associated with lower overall scores of CD-RISC and higher scores of PSWQ; the greater likelihood of anxiety was associated with higher scores of PSWQ. The likelihood of depression was also positively associated with having infection-related stress and three demographics.

Conclusions

This on-site study demonstrates the importance of specific traits in a small-scale pandemic: the worse resilience and the greater worry propensity related to the higher probability of depression, and the greater propensity of worry related to the higher probability of anxiety. Moreover, those experiencing infection-related stress, being male, living alone, and being unemployed are more likely to have depressive problems.

Parental loneliness, parental stress and child mental health during the COVID-19 pandemic: Variations by cumulative socioeconomic risk

Background

The COVID-19 pandemic has raised concerns about parent and child mental health, especially within disadvantaged families. However, little is known about how parental stress and loneliness during the pandemic influenced their children and no studies have investigated if these associations could vary by socioeconomic status.

Methods

In July to September 2021, a large representative sample of parents (N = 4,524) in Québec (Canada) reported on aspects of their own mental health and that of their 9-10 year old child. Outcome variables were child externalizing and internalizing symptoms. Exposure variables were changes in parental loneliness and parental stress since the onset of the pandemic. The moderator variable was cumulative socioeconomic risk. Multiple linear regression analyses were executed and adjusted for confounding factors.

Results

Child internalizing symptoms were associated with higher levels of parental stress (β = 0.14, p<.001) and loneliness (β = 0.23, p<.001). Child externalizing symptoms were also associated with parental stress (β = 0.13, p<.001) and loneliness (β = 0.18, p<.001). Most of these associations were stronger within the most disadvantaged households.

Limitations

The cross-sectional design does not allow interpretations about causality.

Conclusions

Increases in parental stress and loneliness since the onset of the COVID-19 pandemic would be detrimental to parent and child mental health. As these issues were amplified within families experiencing more socioeconomic adversities, our results can inform public policy to support families in times of crisis and direct resources to those most in need.

Neighbourhood socio-economic disadvantage and loneliness: the contribution of green space quantity and quality

Disadvantaged areas experience higher levels of loneliness than advantaged areas, though studies rarely identify environmental determinants of neighbourhood inequity in loneliness. We studied the contribution of the quantity and quality of green space to neighbourhood inequity in loneliness in three buffer sizes (400 m, 800 m, 1600 m), using cross-sectional data from 3778 individuals aged 48-77 years old living in 200 neighbourhoods in Brisbane, Australia. Levels of loneliness were significantly higher in disadvantaged neighbourhoods, and these neighbourhoods had less green space and less access to quality green space. However, there was no evidence that neighbourhood disparities in green space contributed to the association between neighbourhood disadvantage and loneliness. Possible methodological and substantive reasons for this result are discussed.