Loneliness and associated factors among Brazilian adolescents: results of national adolescent school-based health survey 2015

Reliability and validity evaluation of the stigma of loneliness scale in Chinese college students

BACKGROUND

The stigma of loneliness exacerbates the negative effect of loneliness, reduces the willingness to seek help, damages interpersonal relationships, and threatens health status. However, there is currently no valid scale for measuring the stigma of loneliness in China. The study aims to translate the Stigma of Loneliness Scale (SLS) and evaluate the reliability and validity of the Chinese version.

METHODS

The investigation was conducted in two phases. In the first phase, the SLS was used to conduct a questionnaire survey on 657 college students aged 17 to 24; in the second phase, the SLS, the UCLA Loneliness Scale (ULS-8), the Distress Disclosure Index (DDI), the Revised Cheek and Buss Shyness Scale (RCBS), the Self-Concealment Scale (SCS), the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS), the Kessler Psychological Distress Scale (K10), and the Rosenberg Self-Esteem Scale (RSES) were used to conduct the questionnaire survey on 801 college and graduates students aged 18 to 39.

RESULTS

Two dimensions of Self-stigma of Loneliness and Public Stigma of Loneliness were extracted with a cumulative factor interpretation rate of 74.60% when conducting exploratory factor analysis on the first-stage data. The factor loading of each item ranged from 0.585 to 0.890, and the commonality ranged from 0.609 to 0.735. The confirmatory factor analysis and reliability and validity test were carried out on the data gathered in the second phase, indicating that the two-factor model fits well. In addition, the scores of SLS and all dimensions were significantly positively correlated with the total scores of ULS-8, RCBS, SCS, SIAS, SPS, and K10, and negatively correlated with those of DDI and RSES. The Cronbach's alpha coefficients for SLS and SSL and PSL dimensions were 0.957, 0.941, and 0.955. The cross-group invariance test found that the SLS was equivalent for males and females. Meanwhile, males scored significantly higher than females on both the total scores of SLS score and each dimension.

CONCLUSIONS

The Chinese version of SLS displayed satisfactory psychometric properties and can be a valid tool to assess the stigma of loneliness among Chinese young people.

Gender inequalities as contributors to dementia in Latin America and the Caribbean: what factors are missing from research?

The current knowledge of modifiable risk factors for dementia comes mainly from high-income countries. In Latin America and Caribbean countries, where the burden of gender and socioeconomic inequalities is greater than in high-income countries, the prevalence of dementia is also higher and disease onset is earlier, especially among women, even after adjustments for life expectancy. In this Personal View, we discuss socioeconomic modifiable risk factors for dementia established by previous studies and postulate further harmful and often hidden factors faced by women that might influence the gender-specific timing of onset and general prevalence of dementia. We emphasise some of the effects of gender roles, their direct and indirect effects on dementia, and how they disproportionately impact women. Finally, we highlight the importance of bringing hidden risk factors to open discussion to promote research with high-quality data and to encourage public policies to promote and preserve women's health.

A saúde mental dos adolescentes brasileiros

Objetivo: descrever as prevalências dos indicadores de saúde mental entre os escolares brasileiros. Método: estudo transversal com dados da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2019. Estimou-se as prevalências e intervalos de confiança de 95% (IC95%) dos indicadores de saúde mental dos adolescentes brasileiros de 13 a 17 anos, segundo idade, sexo, dependência administrativa da escola e Unidade da Federação. Resultados: dos 125.123 escolares de 13 a 17 anos investigados, 4,0% (IC95% 3,7-4,3) mencionaram que não tinham amigos próximos; 50,6% (IC95% 49,8-51,4) sentiram-se preocupados com as coisas comuns do dia a dia; 31,4% sentiram-se tristes na maioria das vezes ou sempre; 30,0% (IC95% 29,4 - 30,6) achavam que ninguém se preocupava com eles; 40,9% (IC95% 40,2 - 41,5) ficaram irritados, nervosos ou mal-humorados; 21,4% (IC95% 20,9 - 22,0) sentiam que a vida não vale a pena ser vivida; e 17,7% (IC95% 17,2 - 18,2) apresentou autoavaliação em saúde mental negativa. A maioria desses indicadores foram mais frequentes em escolares de 16 e 17 anos, no sexo feminino e em escolas públicas. Conclusão: evidenciou-se o aumento do sofrimento mental entre os adolescentes brasileiros pelos indicadores de saúde mental da PeNSE edição 2019. Os resultados revelaram relações de desigualdades estruturais de gênero e classe social. É necessário maior investimento em políticas públicas a fim de diminuir as consequências do sofrimento mental entre os adolescentes brasileiros.

Prevalence and factors associated with loneliness among Indonesian female adolescents: a cross-sectional study

Background

Loneliness, or the perception of social disconnectedness, is a public health concern and is reported to be a frequent experience during adolescence (10–19 years). This study investigates the prevalence of loneliness and associated health-risk behaviors among Indonesian female adolescents.

Methods

This was a cross-sectional study, data for which were extracted from the WHO’s Global School-based Student Health Survey (GSHS), which uses a globally standardized cross-sectional methodology to provide accurate data on behaviors and protective factors among students. Data from 4993 female students aged 13–17 years old from 74 schools were extracted from the 2015 survey in Indonesia and analyzed. Loneliness was used as a single measure, as happens in other studies using GSHS data. Descriptive analysis was done for age, socioemotional issues, health-risk behaviors, and contextual factors. This was followed by multiple logistic regression analysis to identify loneliness-associated factors.

Results

Approximately 6.5% of Indonesian female adolescents experience loneliness most of the time or always. Adolescents experiencing loneliness had a higher rate of sleep disturbance (37.6%), suicide ideation (21%), suicide plan (20.8%), smoking behavior (15%), and alcohol use (15.7%) than the general population. Multiple regression analysis confirms that adolescents who have no close friends, have been bullied during the past month, experience sleep disturbance, have had suicide ideation and suicide plans, are always feeling hungry, are exposed to passive smoking, and are engaged in a sedentary lifestyle are at a higher likelihood of suffering from loneliness (p < 0.05). On the other hand, having kind and helpful classmates served as a useful protection against loneliness (p < 0.05).

Conclusions

The rate of loneliness in Indonesian female adolescents is relatively lower than previously reported elsewhere. Several health-risk behaviors and contextual factors are associated with loneliness. It is important to gain insight into the exact interplay between factors and loneliness since that could inform future intervention development and lead to better well-being among female adolescents.

The prevalence of loneliness across 113 countries: systematic review and meta-analysis

OBJECTIVES

To identify data availability, gaps, and patterns for population level prevalence of loneliness globally, to summarise prevalence estimates within World Health Organization regions when feasible through meta-analysis, and to examine temporal trends of loneliness in countries where data exist.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Embase, Medline, PsycINFO, and Scopus for peer reviewed literature, and Google Scholar and Open Grey for grey literature, supplemented by backward reference searching (to 1 September 2021) ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Observational studies based on nationally representative samples (n≥292), validated instruments, and prevalence data for 2000-19. Two researchers independently extracted data and assessed the risk of bias using the Joanna Briggs Institute checklist. Random effects meta-analysis was conducted in the subset of studies with relatively homogeneous research methods by measurement instrument, age group, and WHO region.

RESULTS

Prevalence data were available for 113 countries or territories, according to official WHO nomenclature for regions, from 57 studies. Data were available for adolescents (12-17 years) in 77 countries or territories, young adults (18-29 years) in 30 countries, middle aged adults (30-59 years) in 32 countries, and older adults (≥60 years) in 40 countries. Data for all age groups except adolescents were lacking outside of Europe. Overall, 212 estimates for 106 countries from 24 studies were included in meta-analyses. The pooled prevalence of loneliness for adolescents ranged from 9.2% (95% confidence interval 6.8% to 12.4%) in South-East Asia to 14.4% (12.2% to 17.1%) in the Eastern Mediterranean region. For adults, meta-analysis was conducted for the European region only, and a consistent geographical pattern was shown for all adult age groups. The lowest prevalence of loneliness was consistently observed in northern European countries (2.9%, 1.8% to 4.5% for young adults; 2.7%, 2.4% to 3.0% for middle aged adults; and 5.2%, 4.2% to 6.5% for older adults) and the highest in eastern European countries (7.5%, 5.9% to 9.4% for young adults; 9.6%, 7.7% to 12.0% for middle aged adults; and 21.3%, 18.7% to 24.2% for older adults).

CONCLUSION

Problematic levels of loneliness are experienced by a substantial proportion of the population in many countries. The substantial difference in data coverage between high income countries (particularly Europe) and low and middle income countries raised an important equity issue. Evidence on the temporal trends of loneliness is insufficient. The findings of this meta-analysis are limited by data scarcity and methodological heterogeneity. Loneliness should be incorporated into general health surveillance with broader geographical and age coverage, using standardised and validated measurement tools.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42019131448.