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Xiao Z, Robertson S, Long E, Flaig R, Kirby L, Romaniuk L, Murray A, Whalley H. Loneliness in the Digital World: protocol for a co-produced ecological momentary assessment study in adolescents. BMJ Open 2024; 14:e087374. [PMID: 38844398 PMCID: PMC11163606 DOI: 10.1136/bmjopen-2024-087374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/30/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION Loneliness has been identified as an important public health issue, peaking during adolescence. Previous research has suggested that social interaction is a key factor in loneliness, and positive social interaction can act as a protective factor against loneliness. However, it is unclear whether there are differing impacts of in-person and online social interaction on adolescents' loneliness and mental health. Ecological Momentary Assessment (EMA) designs are ideally suited for better understanding these associations. METHOD AND ANALYSIS In the 'Loneliness in the Digital World' study, we will use a co-developed EMA design to capture daily social interactions, loneliness and mental health such as positive and negative emotions, depression and anxiety in approximately 200 adolescents aged 12-15 years. We will combine this with comprehensive information gathered from online surveys. Analysing the data using techniques such as dynamic structural equation modelling, we will examine, among other research questions, the associations between online and in-person social interaction and feelings of loneliness. The results can help inform interventions to support adolescents with high levels of loneliness and poor mental health. ETHICS AND DISSEMINATION We received the ethics approval for the data collection from The Academic and Clinical Central Office for Research and Development, followed by the College of Medicine and Veterinary Medicine Ethics panel at University of Edinburgh, and finally reviewed by East of Scotland Research Ethics Service. The results will be disseminated through journal publications, conferences and seminar presentations and to relevant stakeholders such as teachers.
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Affiliation(s)
- Zhuoni Xiao
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Sarah Robertson
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Emily Long
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Robin Flaig
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
| | - Liz Kirby
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Liana Romaniuk
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Aja Murray
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Heather Whalley
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Eager S, Johnson S, Pitman A, Uribe M, Qualter P, Pearce E. Young people's views on the acceptability and feasibility of loneliness interventions for their age group. BMC Psychiatry 2024; 24:308. [PMID: 38654301 DOI: 10.1186/s12888-024-05751-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Loneliness is a frequently reported problem for young people aged 16 to 24 years old. A variety of interventions have been developed (but in most cases not extensively evaluated) to try and tackle loneliness in this age group. These include interpersonal, intrapersonal, and social approaches that vary in their content and mechanisms of action. The current study aimed to qualitatively examine young peoples' views on the acceptability and feasibility of different loneliness interventions. METHODS Young people from 16 to 24 years old living in the United Kingdom who self-identified as having experienced loneliness were recruited to participate in this study. We conducted semi-structured qualitative interviews to assess their views on the acceptability and feasibility of loneliness interventions for their age group. Interviews were analysed using inductive reflexive thematic analysis. RESULTS Our analysis of 23 individual interview transcripts identified six themes. These related to the appropriate stage for intervention and how different types of strategies may be best suited to particular contexts; the key facilitators and barriers to engaging young people in an intervention; considerations for optimising the delivery of an intervention; divergent views on technology use in strategies to manage loneliness; the scope of an intervention and whether it takes a targeted or general approach; and the idea of combining different options within an intervention to allow tailoring to individual preferences and nature of loneliness. CONCLUSIONS These findings demonstrate the need for continued development of individualised interventions designed to help manage loneliness in this age group. Future loneliness strategies should be co-produced with young people to ensure that they suit the varying needs of this population.
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Affiliation(s)
- Sharon Eager
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK.
| | - Sonia Johnson
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Alexandra Pitman
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Manuela Uribe
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK
| | - Pamela Qualter
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | - Eiluned Pearce
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK
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Shah HA, Househ M. Understanding Loneliness in Younger People: Review of the Opportunities and Challenges for Loneliness Interventions. Interact J Med Res 2023; 12:e45197. [PMID: 37917125 PMCID: PMC10654910 DOI: 10.2196/45197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/20/2023] [Accepted: 04/30/2023] [Indexed: 11/03/2023] Open
Abstract
Loneliness affects the quality of life of people all around the world. Loneliness is also shown to be directly associated with mental health issues and is often the cause of mental health problems. It is also shown to increase the risk of heart diseases and other physical illnesses. Loneliness is studied both from the social and medical sciences perspectives. There are also interventions on the basis of health informatics, information and communication technologies (ICTs), social media, and other technological solutions. In the literature, loneliness is studied from various angles and perspectives ranging from biological to socioeconomical and through anthropological understandings of technology. From the ICT and technological sides, there are multiple reviews studying the effectiveness of intervention strategies and solutions. However, there is a lack of a comprehensive review on loneliness that engulfs the psychological, social, and technological studies of loneliness. From the perspective of loneliness informatics (ie, the application of health informatics practices and tools), it is important to understand the psychological and biological basis of loneliness. When it comes to technological interventions to fight off loneliness, the majority of interventions focus on older people. While loneliness is highest among older people, theoretical and demographical studies of loneliness give a U-shaped distribution age-wise to loneliness; that is, younger people and older people are the demographics most affected by loneliness. But the strategies and interventions designed for older people cannot be directly applied to younger people. We present the dynamics of loneliness in younger people and also provide an overview of the technological interventions for loneliness in younger people. This paper presents an approach wherein the studies carried out from the perspectives of digital health and informatics are discussed in detail. A comprehensive overview of the understanding of loneliness and the study of the overall field of tools and strategies of loneliness informatics was carried out. The need to study loneliness in younger people is addressed and particular digital solutions and interventions developed for younger people are presented. This paper can be used to overcome the challenges of technological gaps in the studies and strategies developed for loneliness. The findings of this study show that the majority of interventions and reviews are focused on older people, with ICT-based and social media-based interventions showing promise for countering the effects of loneliness. There are new technologies, such as conversational agents and robots, which are tailored to the particular needs of younger people. This literature review suggests that the digital solutions developed to overcome loneliness can benefit people, and younger people in particular, more if they are made interactive in order to retain users.
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Twivy E, Kirkham M, Cooper M. The lived experience of adolescent depression: A systematic review and meta-aggregation. Clin Psychol Psychother 2023; 30:754-766. [PMID: 36700415 DOI: 10.1002/cpp.2834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/16/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND The under-detection of depression in adolescents suggests that a better understanding of its presentation may be needed. Conceptualizations of adolescent depression are largely the same as adult depression, with minimal consideration of developmental stage. Exploration of first-hand accounts could help to identify any unique features of adolescent depression. Therefore, this systematic review aimed to understand the lived experience of adolescents with depression to inform clinical practice. METHODS The review was registered with PROSPERO (CRD42020198141). Databases (PsychINFO, CINAL, MEDLINE and EMBASE) were searched in March 2022 to identify peer-reviewed qualitative studies on first-hand experiences of adolescent depression. The Joanna Briggs Institute's qualitative data extraction tool and checklist for qualitative research were used to obtain study data and assess methodological quality of included papers. Meta-aggregation was the method of synthesis, whereby extracted themes from the papers were grouped according to shared meanings. RESULTS Fifteen papers of mixed methodological quality were identified for inclusion from screening a total of 1,983 references. Studies were published between 2002 and 2021, spanned seven countries and included participants aged 11 to 22 years old. Aggregation of 56 themes resulted in 16 categories and 3 synthesized findings encompassing key aspects of adolescent depression: causes, symptoms and coping. Variability in adolescents' perspectives across these domains was evident. Some symptoms described, such as social disconnection and anger, are not listed in existing diagnostic criteria. CONCLUSIONS Subjective experiences of depression among adolescents vary and may not entirely match diagnostic criteria. Awareness of this when assessing for depression may improve detection and help to ensure adolescents feel understood.
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Affiliation(s)
- Eve Twivy
- Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Miriam Kirkham
- Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Myra Cooper
- Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
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Marquez J, Goodfellow C, Hardoon D, Inchley J, Leyland AH, Qualter P, Simpson SA, Long E. Loneliness in young people: a multilevel exploration of social ecological influences and geographic variation. J Public Health (Oxf) 2023; 45:109-117. [PMID: 34999845 PMCID: PMC10017088 DOI: 10.1093/pubmed/fdab402] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Loneliness is a growing public health concern, yet little is known about loneliness in young people. The current study aimed to identify social ecological factors related to loneliness and examine the extent to which geographic region may account for differences in loneliness. METHODS The data come from a cross-sectional sample of 6503 young people living in the UK. Loneliness was measured using the UCLA 3-item scale. Bivariate analyses were used to test associations between each predictor and loneliness. Multilevel models were used to identify key social ecological factors related to loneliness, and the extent to which loneliness may vary across geographic regions (local authority districts). RESULTS Sociodemographic, social, health and well-being, and community factors were found to be associated with loneliness. Geographic region was associated with 5-8% of the variation in loneliness. The effect of gender, sexual orientation and minority ethnic background on loneliness differed across regions. CONCLUSIONS This is the first study to highlight modifiable social and community factors related to youth loneliness, and individual vulnerabilities, such as poor mental well-being. Results related to geographic differences suggest that local-level initiatives may be most appropriate in tackling loneliness, rather than wider, less contextualized national efforts.
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Affiliation(s)
- J Marquez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - C Goodfellow
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - D Hardoon
- What Works Centre for Wellbeing, London SW1H 9EA, UK
| | - J Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - A H Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - P Qualter
- University of Manchester, Manchester Institute of Education, Manchester M13 9PL, UK
| | - S A Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - E Long
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
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Binte Mohammad Adib NA, Sabharwal JK. Experience of loneliness on well-being among young individuals: A systematic scoping review. CURRENT PSYCHOLOGY 2023:1-21. [PMID: 37359674 PMCID: PMC9982787 DOI: 10.1007/s12144-023-04445-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 03/06/2023]
Abstract
A systematic scoping review was conducted to explore the current evidence on the experience of loneliness influencing well-being among youths. The electronic databases Scopus, APA PsycINFO, Emerald Insight and One Search were used to identify relevant studies, followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. Reference lists of all shortlisted articles were searched for additional studies. 20 studies (quantitative, qualitative and mixed) published in the English language were identified for inclusion. Findings illustrate that the experience of loneliness is a complex, evolutionary process influenced by relational and environmental factors. Results from the studies identified factors that promote lower experience of loneliness and better well-being in future life stages. Future research can substantiate the issues related to young individuals being socially isolated from others for a prolonged duration.
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Affiliation(s)
| | - Jagdeep Kaur Sabharwal
- School of Social and Health Sciences, James Cook University, 149 Sims Drive, Singapore, 533884 Singapore
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Birken M, Chipp B, Shah P, Olive RR, Nyikavaranda P, Hardy J, Chhapia A, Barber N, Lee S, Pearce E, Lloyd-Evans B, Perkins R, McDaid D, Stefanidou T, Shafran R, Pitman A, Johnson S. Exploring the experiences of loneliness in adults with mental health problems: A participatory qualitative interview study. PLoS One 2023; 18:e0280946. [PMID: 36881570 PMCID: PMC9990944 DOI: 10.1371/journal.pone.0280946] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 01/11/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Loneliness is associated with many mental health conditions, as both a potential causal and an exacerbating factor. Richer evidence about how people with mental health problems experience loneliness, and about what makes it more or less severe, is needed to underpin research on strategies to help address loneliness. METHODS Our aim was to explore experiences of loneliness, as well as what helps address it, among a diverse sample of adults living with mental health problems in the UK. We recruited purposively via online networks and community organisations, with most interviews conducted during the COVID-19 pandemic. Qualitative semi-structured interviews were conducted with 59 consenting participants face-to-face, by video call or telephone. Researchers with relevant lived experience were involved at all stages, including design, data collection, analysis and writing up of results. FINDINGS Analysis led to identification of four overarching themes: 1. What the word "lonely" meant to participants, 2. Connections between loneliness and mental health, 3. Contributory factors to continuing loneliness, 4. Ways of reducing loneliness. Central aspects of loneliness were lack of meaningful connections with others and lack of a sense of belonging to valued groups and communities. Some drivers of loneliness, such as losses and transitions, were universal, but specific links were also made between living with mental health problems and being lonely. These included direct effects of mental health symptoms, the need to withdraw to cope with mental health problems, and impacts of stigma and poverty. CONCLUSIONS The multiplicity of contributors to loneliness that we identified, and of potential strategies for reducing it, suggest that a variety of approaches are relevant to reducing loneliness among people with mental health problems, including peer support and supported self-help, psychological and social interventions, and strategies to facilitate change at community and societal levels. The views and experiences of adults living with mental health problems are a rich source for understanding why loneliness is frequent in this context and what may address it. Co-produced approaches to developing and testing approaches to loneliness interventions can draw on this experiential knowledge.
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Affiliation(s)
- Mary Birken
- Division of Psychiatry, University College London, London, United Kingdom
- * E-mail:
| | - Beverley Chipp
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Prisha Shah
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Rachel Rowan Olive
- NIHR Mental Health Policy Research Unit COVID-19 Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Patrick Nyikavaranda
- NIHR Mental Health Policy Research Unit COVID-19 Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Jackie Hardy
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Anjie Chhapia
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Nick Barber
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Stephen Lee
- The Loneliness and Social Isolation in Mental Health Research Network Co-Production Group, Division of Psychiatry, University College London, London, United Kingdom
| | - Eiluned Pearce
- Division of Psychiatry, University College London, London, United Kingdom
| | | | - Rosie Perkins
- Centre for Performance Science, Royal College of Music, London, United Kingdom
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | | | - Roz Shafran
- Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Alexandra Pitman
- Division of Psychiatry, University College London, London, United Kingdom
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
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Contribution of perceived loneliness to suicidal thoughts among French university students during the COVID-19 pandemic. Sci Rep 2022; 12:16833. [PMID: 36207381 PMCID: PMC9540057 DOI: 10.1038/s41598-022-21288-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/26/2022] [Indexed: 11/08/2022] Open
Abstract
Restrictive measures during the COVID-19 epidemic have led to increased levels of loneliness, especially among university students, although the influence on suicidal thoughts remains unclear. In this cross-sectional study of 1913 French university students, those with the highest level of loneliness had a fourfold increased risk of suicidal thoughts. Perceived loneliness should be incorporated into suicide risk assessment, and assistance in coping with loneliness should be considered as a means of reducing suicidal risk in vulnerable groups, like university students.
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The Relationship Between Loneliness and Depressive Symptoms in Children and Adolescents: A Meta-Analysis. BEHAVIOUR CHANGE 2022. [DOI: 10.1017/bec.2022.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Abstract
Objective: To provide a quantitative assessment of the literature examining the cross-sectional association between loneliness and depressive symptoms in children and adolescents. Method: A total of 44 studies from 35 articles (n = 27, 214; mean age 13.63 years; 51% female) met inclusion criteria. Results: A medium, positive correlation between loneliness and depressive symptoms in children and adolescents was found (r = .48). Age and gender did not moderate the relationship between loneliness and depressive symptoms. Conclusion: Loneliness may be a particular risk factor for depression. These results have implications for COVID-19 disease containment measures.
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Chiao C, Lin KC, Chyu L. Perceived Peer Relationships in Adolescence and Loneliness in Emerging Adulthood and Workplace Contexts. Front Psychol 2022; 13:794826. [PMID: 35756205 PMCID: PMC9226895 DOI: 10.3389/fpsyg.2022.794826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/19/2022] [Indexed: 12/02/2022] Open
Abstract
Background A common life-course hypothesis is that negative early-life experiences contribute to poor health in later-life. However, little is known about perceived peer relationships during adolescence and the feeling of loneliness in emerging adulthood. This study explores the perception of adolescent peer relationships in a school context and its association with loneliness in adulthood and in workplace contexts. Methods This study used data from a cohort sample of 2,520 adolescents from the Taiwan Youth Project (N = 2,520), consisting of eleven waves of data collected from 2000 to 2017. Major measures included the Loneliness Scale (6-item de Jong Gierveld short scale) and perceived peer relationships (classroom cohesion and perceived popularity among classmates) in middle school. Multivariate multinomial logistic regressions were used to estimate the associations of perceived peer relationships during adolescence and workplace characteristics with loneliness in adulthood. Results Positive perceived peer relationships in adolescence were significantly related to decreased risk of serious social loneliness [Relative risk ratios (RRR) 0.70, 95% CI: 0.58–0.85] and severe social/emotional loneliness (RRR = 0.76, 95% CI: 0.63–0.91) in adulthood. Workplace satisfaction was a protective factor of severe social/emotional loneliness in employed adults. Conclusion Adolescents who perceived peer relationships in middle school as positive were less likely to report social and emotional loneliness during adulthood. Satisfaction in the workplace characteristics was also associated with lower risk of loneliness in adulthood. Theoretical and policy implications are discussed.
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Affiliation(s)
- Chi Chiao
- College of Medicine, Institute of Health and Welfare Policy, Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kuan-Chen Lin
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Laura Chyu
- Master of Public Health Program, School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, United States
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Eating Disorders and Intimate Partner Violence: The Influence of Fear of Loneliness and Social Withdrawal. Nutrients 2022; 14:nu14132611. [PMID: 35807792 PMCID: PMC9268080 DOI: 10.3390/nu14132611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 02/04/2023] Open
Abstract
Eating disorders are vulnerability factors that increase the likelihood of intimate partner violence. However, the mechanisms underlying this relationship are unclear. Although eating disorders have been associated with increased perception and fear of loneliness, they have also been associated with increased social withdrawal resulting from decreased enjoyment of social situations and poorer social functioning. The purpose of the present study was to examine the mediating role of fear of loneliness in the relationship between the behavioural characteristics of eating disorders and intimate partner violence, as well as to explore the moderating role of social withdrawal in the relationship between fear of loneliness and intimate partner violence. The sample comprised 683 participants (78% female and 22% male) with a mean age of 21.14 years (SD = 2.72). The psychometric scales used were Eating Disorders Inventory (EDI 2), Emotional Dependency Questionnaire (EDQ), Coping Strategies Inventory (CSI) and the Violence Received, Exercised and Perceived in Youth and Adolescent Dating Relationships Scale (VREPS). The hypothesised model was tested by path analysis using maximum likelihood. The path analysis of the hypothesised model showed that inefficacy, fear of maturity, and impulsivity were the behavioural characteristics of eating disorders predominantly related to fear of loneliness. Fear of loneliness had no direct significant effect on any of the received violence variables. However, interaction effects indicated that there was a moderately significant effect of fear of loneliness on physical, psychological, and social violence received as a function of levels of social withdrawal. These findings show the need to take into account and work on fear of loneliness and social withdrawal among individuals with an eating disorder to decrease the likelihood of establishing violent intimate partner relationships. Improving interpersonal functioning and social support is key to recovery from eating disorders.
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Wu G, Wang S, Wang T, Han J, Yu A, Feng C, Wang Y, Liu S. Neurological and Psychological Characteristics of Young Nitrous Oxide Abusers and Its Underlying Causes During the COVID-19 Lockdown. Front Public Health 2022; 10:854977. [PMID: 35719623 PMCID: PMC9201030 DOI: 10.3389/fpubh.2022.854977] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background The COVID-19 pandemic has a serious impact on the mental health of the public due to its economic and social impact. And psychological effects have led to drug and alcohol abuse. After the city lifted the lockdown, we consecutively encountered several young nitrous oxide abusers admitted to hospital for neurological treatment. Purpose To inform physician decisions and social intervention, this observational study aimed at investigating the neurological and psychological characteristics of nitrous oxide abusers and its underlying causes during the COVID-19 lockdown. Methods The nitrous oxide abusers who sought neurological treatment at our hospital between May 2020 and June 2020 were enrolled. Clinical data including socio-demographic, physical examination, laboratory examination, electromyography and neuroimaging were collected. Their motivations for inhaling nitrous oxide, knowledge about the nitrous oxide abuse and the accompanying of family were investigated face to face. Psychological status was assessed by the Symptom Checklist 90 (SCL-90) psychological evaluation. Results Six nitrous oxide abusers were enrolled and the age was 22 ± 4.3. Clinical presentations included varying degrees of limb numbness and an ataxic gait. Laboratory examination revealed that all the patients did not have pernicious anemia, 4 patients had decreased vitamin B12 while 3 patients exhibited elevated homocysteine levels. MR of the spinal cord revealed that 4 patients had abnormal signals in the cervical spinal cord of high symmetry with splayed or inverted V sign after T2WI. Electromyogram (EMG) test showed 5 patients had peripheral nerve damage. The SCL-90 psychological evaluation results indicated that all patients had severe anxiety, depression and psychosis and they had severer psychological problems than ordinary citizens. Their motives for inhaling nitrous oxide are to relieve boredom, curiosity and buddy pressure. Their family spent <1 day per week to stay with them during city lockdown. Conclusion The enrolled patients caused by abuse of nitrous oxide presented with symptoms of subacute combined with spinal degeneration. They had more serious psychological problems related to the COVID-19 pandemic. These cases make us value the psychological problems of young people under the outbreak and take multi-layered measures from families, schools (companies), hospitals, and governments to address it.
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Affiliation(s)
- Gang Wu
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.,Department of Neurology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Shanshan Wang
- Department of Neurology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Tingling Wang
- Department of Neurology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Jiali Han
- Department of Neurology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Anna Yu
- Department of Mental Health, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Changqiang Feng
- Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Yajing Wang
- Department of Neurology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Suzhi Liu
- Department of Neurology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
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Hards E, Loades ME, Higson-Sweeney N, Shafran R, Serafimova T, Brigden A, Reynolds S, Crawley E, Chatburn E, Linney C, McManus M, Borwick C. Loneliness and mental health in children and adolescents with pre-existing mental health problems: A rapid systematic review. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:313-334. [PMID: 34529837 DOI: 10.1111/bjc.12331] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 07/12/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Periods of social isolation are associated with loneliness in children and young people, and loneliness is associated with poor mental and physical health. Children and young people with pre-existing mental health difficulties may be prone to loneliness. Containment of COVID-19 has necessitated widespread social isolation, with unprecedented school closures and restrictions imposed on social interactions. This rapid review aimed to establish what is known about the relationship between loneliness and mental health problems in children and young people with pre-existing mental health problems. METHODS We sought to identify all primary research that examined the cross-sectional and longitudinal associations between loneliness/perceived social isolation and mental health in children and young people with pre-existing mental health problems. We also aimed to identify effective interventions that reduce the adverse impact of loneliness. A rapid systematic search was conducted using MEDLINE, PsycINFO, and Web of Science. RESULTS Of 4,531 papers screened, 15 included children and young people with pre-existing mental health conditions. These 15 studies included 1,536 children and young people aged between 6 and 23 years with social phobia, anxiety and/or depression, and neurodevelopmental disorders. Loneliness was associated with anxiety and depression both cross-sectionally and prospectively in children and young people with mental health problems and neurodevelopmental conditions. We found preliminary evidence that psychological treatments can help to reduce feelings of loneliness in this population. CONCLUSIONS Loneliness is associated with depression and anxiety in children and young people with pre-existing mental health conditions, and this relationship may be bidirectional. Existing interventions to address loneliness and/or mental health difficulties in other contexts may be applied to this population, although they may need adaptation and testing in younger children and adolescents. PRACTITIONER POINTS Loneliness is common in children and young people, and during periods of enforced social isolation such as during COVID-19, children and young people report high levels of loneliness (or increased rates of loneliness). The review showed that loneliness is associated, both cross-sectionally and prospectively, in children and young people with mental health problems and also in children and young people with neurodevelopmental conditions, such as autism spectrum disorder. Thus, loneliness is a possible risk factor of which mental health providers should be aware. Maintaining social contact both by direct and by indirect means, especially through the Internet, could be important in mitigating loneliness. Interventions to address loneliness should be further developed and tested to help children and young people with pre-existing mental health problems who are lonely by preventing exacerbation of their mental health difficulties, in particular anxiety and depression.
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Affiliation(s)
- Emily Hards
- Department of Psychology, University of Bath, UK
| | - Maria Elizabeth Loades
- Department of Psychology, University of Bath, UK
- Centre for Academic Child Health, University of Bristol, UK
| | | | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, London, UK
| | | | | | - Shirley Reynolds
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Esther Crawley
- Centre for Academic Child Health, University of Bristol, UK
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Kobos E, Knoff B, Dziedzic B, Maciąg R, Idzik A. Loneliness and mental well-being in the Polish population during the COVID-19 pandemic: a cross-sectional study. BMJ Open 2022; 12:e056368. [PMID: 35105595 PMCID: PMC8808318 DOI: 10.1136/bmjopen-2021-056368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE There is a growing concern that the restrictions imposed due to the COVID-19 pandemic could lead to increased loneliness and mental disorders, which are considered a major public health problem. The aim of the study was to assess loneliness, anxiety, depression and irritability in the Polish population during the COVID-19 pandemic. DESIGN A cross-sectional study. The study participants completed an online questionnaire using the computer-assisted web interview technique. Data were collected using Revised UCLA Loneliness Scale and Hospital Anxiety and Depression Scale. SETTING Poland. PARTICIPANTS This study was conducted between 6 October and 12 October 2020, in a representative sample of 890 Polish residents. PRIMARY OUTCOME MEASURES Self-reported loneliness; sociodemographic and COVID-19 pandemic factors associated with loneliness, anxiety, depression and irritability. RESULTS The analyses showed a moderately high degree of loneliness in 22%, symptoms of anxiety in 27%, depression in 14% and irritability in 33% of the respondents. The increasing severity of anxiety, depression and irritation in the study group was accompanied by higher loneliness. Generally, younger people, both tested positive for SARS-CoV-2 and those who experienced home quarantine, scored higher in both scales. CONCLUSIONS It is necessary to identify those most vulnerable to loneliness, anxiety and depression during a crisis to assess health needs and proactively allocate resources during and after the pandemic. Loneliness, anxiety, depression and irritability are important factors to consider in a population of younger, disadvantaged people, who tested positive for SARS-CoV-2, people who were quarantined at home, and people who believe that their physical and mental health is worse than in the pre-pandemic period. It is important to cater for the mental health of individuals during the COVID-19 pandemic and to promote psychological interventions to improve mental well-being in potentially vulnerable social groups.
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Affiliation(s)
- Ewa Kobos
- Department of Development of Nursing, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
- Medical University of Warsaw, Warsaw, Poland
| | | | | | | | - Anna Idzik
- Medical University of Warsaw, Warsaw, Poland
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15
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Processes and structures in intergenerational programs: a comparison across different types of programs. Int Psychogeriatr 2021; 33:1297-1308. [PMID: 34365993 DOI: 10.1017/s1041610221000922] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Given the widely acknowledged benefits of intergenerational programs (IGPs), we compared processes and structures across different IGP types and explored potential areas for improvement. DESIGN Thirteen IGPs were classified into three types: arts, learning, and assistance programs. Data were collected through direct structured interviews and analyzed quantitatively and qualitatively. SETTING Participants were recruited from community-based IGPs in the greater Tel Aviv area of Israel. PARTICIPANTS Eighty-four older participants (OPs), 97 younger participants (YPs), and 21 organizers were interviewed. MEASUREMENTS Questions included participant demographics as well as closed- and open-ended questions regarding processes based on the Impact of Intergenerational Programs Questionnaire (IIPQ). ANALYSIS Responses to closed-ended questions were compared among IGP types and age groups using two-way ANOVAs for ordinal data, and chi-squares for nominal data. Responses to open-ended questions by OP, YP, and program organizers about potential areas for improvement were analyzed using thematic analysis. RESULTS Processes in need of improvement were preparation and guidance, length of program participation, and monitoring of activities, which differed across IGP types and age groups. These processes were related to broader structural problems such as lack of resources, organizers' poor employment conditions, and inadequate public services for older persons in Israel. CONCLUSIONS Our study highlights the complex relationships between IGP types, processes, and structures. IGP processes and goals can be hindered by structural variables such as insufficient funding, infrastructure, and public services for older adults.
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Musetti A, Grazia V, Manari T, Terrone G, Corsano P. Linking childhood emotional neglect to adolescents' parent-related loneliness: Self-other differentiation and emotional detachment from parents as mediators. CHILD ABUSE & NEGLECT 2021; 122:105338. [PMID: 34560397 DOI: 10.1016/j.chiabu.2021.105338] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 08/26/2021] [Accepted: 09/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The detrimental role of childhood emotional neglect (CEN) on long-term affective and social development has received increasing attention in the literature. Individuals who were emotionally neglected during their childhood are more prone to feeling isolated and excluded by their parent during adolescence. However, little is known about the mediating processes underlying this association. OBJECTIVE This study investigated whether self-other differentiation (SOD) and emotional detachment from parents mediate the link between CEN and parent-related loneliness. METHOD AND PARTICIPANTS A sample of 535 high school students aged 13-18 years (63.6% female; Mage = 16.21; SD = 1.40) completed questionnaires regarding demographics, CEN, SOD, emotional detachment, and parent-related loneliness. RESULTS After controlling for demographic covariates, structural equation modeling (SEM) showed that (a) CEN was positively associated with parent-related loneliness (β = 0.64, p < .001), (b) SOD did not mediate the relationship between CEN and parent-related loneliness (β = -0.01, p = .142), (c) emotional detachment partially mediated the relationship between CEN and parent-related loneliness (β = 0.16, p < .001), and (d) SOD and emotional detachment partially and sequentially mediated the link between CEN and parent-related loneliness, albeit with a small effect size (β = 0.02, p = .027). CONCLUSIONS The findings underscore the significance of the link between CEN and parent-related loneliness in adolescence. Moreover, our results suggest that some adolescents with a history of CEN have difficulties in establishing clear boundaries between "self" and "other" and tend to engage in emotionally detached relationships with their parents, which may lead them to feel more parent-related loneliness. Clinical implications and directions for future research are discussed.
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Affiliation(s)
- Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy.
| | - Valentina Grazia
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
| | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
| | - Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, Via Cracovia 50, 00133 Rome, Italy
| | - Paola Corsano
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
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17
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Osborn T, Weatherburn P, French RS. Interventions to address loneliness and social isolation in young people: A systematic review of the evidence on acceptability and effectiveness. J Adolesc 2021; 93:53-79. [PMID: 34662802 DOI: 10.1016/j.adolescence.2021.09.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/07/2021] [Accepted: 09/21/2021] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Loneliness is prevalent and associated with negative health outcomes in young people. Our understanding of how it can be best addressed is limited. This systematic review aims to assess the acceptability and effectiveness of interventions to reduce and prevent loneliness and social isolation in young people. METHODS Six bibliographic databases were searched; references of included studies were screened for relevant literature. A pre-defined framework was used for data extraction. Quality appraisal was performed using the Mixed Method Appraisal Tool. Data were synthesised narratively. RESULTS 9,358 unique references were identified; 28 publications from 16 interventions met the inclusion criteria. The majority of interventions were high intensity, individual or small group interventions, often targeted at specific 'at risk' populations. While 14 interventions were associated with a statistically significant reduction in loneliness or social isolation, the heterogeneous measures of loneliness, small sample sizes, short periods of follow-up and high attrition rates limit evidence on effectiveness. Interventions implemented in more general populations of young people appeared more acceptable than those in specific 'at risk' populations. CONCLUSION High intensity interventions are unlikely to be feasible at a population level. Further work is required to develop and evaluate theoretically-informed loneliness interventions for young people that reach wider audiences.
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Affiliation(s)
- Tom Osborn
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK; Division of Psychology and Language Sciences, Faculty of Brain Sciences, UCL, 26 Bedford Way, London, WC1H 0AP, UK.
| | - Peter Weatherburn
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Rebecca S French
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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18
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Zhang H, Yang J, Li Y, Ren G, Mu L, Cai Y, Luo Q, Zhou Y. The Patterns and Predictors of Loneliness for the Chinese Medical Students Since Post-Lockdown to New Normal With COVID-19. Front Public Health 2021; 9:679178. [PMID: 34277545 PMCID: PMC8281249 DOI: 10.3389/fpubh.2021.679178] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/12/2021] [Indexed: 01/19/2023] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19)-related quarantine has had unique psychological challenges for medical students, particularly loneliness. In this study, we demonstrated the patterns and predictors of loneliness in medical students since post-lockdown to new normal with COVID-19. Methods: A convenience sampling method was used in this study. Face-to-face online questionnaires of UCLA Loneliness Scale and psychological characteristics scales were completed by 1,478 participants. Latent profile analysis and multinominal logistic regressions were performed. Results: Three latent profile models were identified in this study: low loneliness (52.3%), interpersonal sensitivity loneliness (3.5%), and high loneliness (44.1%). Sophomore (Est = 1.937; p < 0.05) and junior students (Est = 2.939; p < 0.05), neuroticism (Est = 2.475; p < 0.05), high arousal symptoms (Est = 2.618; p < 0.01), and the quality of support from friends (Est = 2.264; p < 0.05) were the risk factors for high loneliness profile. In addition, sophomore (Est = 2.065; p < 0.05) and junior students (Est = 2.702; p < 0.01), openness (Est = 2.303; p < 0.05), and conscientiousness personality (Est = −2.348; p < 0.05) were the predictors of an interpersonal sensitive loneliness profile. Good peer relationship (Est = −2.266; p < 0.05) and other support (Est = −2.247; p < 0.05) were protective factors for low loneliness profile. Limitations: Participants were selected from one medical university; the generalizability is limited. Conclusions: Timely loneliness-focused interventions should be targeted on the different profiles and predictors of loneliness in medical students.
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Affiliation(s)
- Hui Zhang
- School of Nursing, Harbin Medical University, Harbin, China
| | - Jun Yang
- School of Nursing, Harbin Medical University, Harbin, China
| | - Yuxin Li
- School of Nursing, Harbin Medical University, Harbin, China
| | - Gaoyue Ren
- School of Nursing, Harbin Medical University, Harbin, China
| | - Lina Mu
- School of Nursing, Harbin Medical University, Harbin, China
| | - Yunjiang Cai
- School of Nursing, Harbin Medical University, Harbin, China
| | - Qiusha Luo
- School of Nursing, Harbin Medical University, Harbin, China
| | - Yuqiu Zhou
- School of Nursing, Harbin Medical University, Harbin, China
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19
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Armitage R, Nellums LB. COVID-19, physical distancing, and young adults living alone. Perspect Public Health 2021; 141:131-132. [PMID: 34015995 DOI: 10.1177/1757913920975810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- R Armitage
- Division of Epidemiology & Public Health, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
| | - L B Nellums
- Division of Epidemiology & Public Health, University of Nottingham, Nottingham City Hospital, Nottingham, UK
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20
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Adamczyk K, Barr AB, Segrin C. Relationship status and mental and physical health among Polish and American young adults: The role of relationship satisfaction and satisfaction with relationship status. Appl Psychol Health Well Being 2021; 13:620-652. [DOI: 10.1111/aphw.12248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/07/2020] [Accepted: 11/05/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Katarzyna Adamczyk
- Faculty of Psychology and Cognitive Science Adam Mickiewicz University Poznań Poland
| | - Ashley B. Barr
- Department of Sociology State University of New York Buffalo NY USA
| | - Chris Segrin
- Department of Communication University of Arizona Tucson AZ USA
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21
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Perceived Health Problems of Young Single-Person Households in Housing Poverty Living in Seoul, South Korea: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031067. [PMID: 33530303 PMCID: PMC7908181 DOI: 10.3390/ijerph18031067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 12/03/2022]
Abstract
There is an increased prevalence of housing poverty among urban young adults; however, research on housing poverty and health is lacking. This study examined the effects of housing poverty on the health concepts of young people living alone. In-depth interviews were conducted with 20 single-person households, with individuals aged 19–39 years, living in Seoul, the demographic group with the highest housing poverty rate in South Korea. Data were analyzed using the constant comparison method. Based on the health concepts of the respondents, housing poverty negatively affected health in terms of “the occurrence and continuation of anxiety,” “the increase and continuation of lethargy,” “the difficulty in managing daily life and taking care of health,” “the lack of a dependable support person,” and “the difficulty in preventing and treating disease.” The majority of young people experienced difficulties responding to their situations, and their housing poverty was hard to overcome. This study suggests the need to expand healthy housing policies, strengthen housing safety nets, and enhance access to public resources needed for a healthy living.
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Affiliation(s)
- Hirofumi Morishita
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.
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23
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A prefrontal-paraventricular thalamus circuit requires juvenile social experience to regulate adult sociability in mice. Nat Neurosci 2020; 23:1240-1252. [PMID: 32868932 PMCID: PMC7898783 DOI: 10.1038/s41593-020-0695-6] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/20/2020] [Indexed: 11/12/2022]
Abstract
Juvenile social isolation reduces sociability in adulthood, but the neural circuit mechanisms are poorly understood. We found that, in male mice, 2 weeks of social isolation immediately following weaning leads to a failure to activate medial prefrontal cortex (mPFC) neurons projecting to the posterior paraventricular thalamus (pPVT) during social exposure in adulthood. Chemogenetic or optogenetic suppression of mPFC->pPVT activity in adulthood was sufficient to induce sociability deficits without affecting anxiety-related behaviors or preference toward rewarding food. Juvenile isolation led to both reduced excitability of mPFC->pPVT neurons and increased inhibitory input drive from low-threshold spiking somatostatin interneurons in adulthood, suggesting a circuit mechanism underlying sociability deficits. Chemogenetic or optogenetic stimulation of mPFC->pPVT neurons in adulthood could rescue the sociability deficits caused by juvenile isolation. Our study identifies a pair of specific mPFC excitatory and inhibitory neuron populations required for sociability that are profoundly affected by juvenile social experience.
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24
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Achterbergh L, Pitman A, Birken M, Pearce E, Sno H, Johnson S. The experience of loneliness among young people with depression: a qualitative meta-synthesis of the literature. BMC Psychiatry 2020; 20:415. [PMID: 32831064 PMCID: PMC7444250 DOI: 10.1186/s12888-020-02818-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/12/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Young people have a higher prevalence of loneliness than other age groups, and they are also at risk of depression. Quantitative studies describe a bidirectional association between loneliness and depression, but there is limited understanding of how these influence each other. Little is known about the experience of loneliness among young people with depression. Qualitative approaches may help understand the relationship between loneliness and depression among young people, and how to intervene to improve outcomes. We aimed to conduct a meta-synthesis to understand the complex inter-relationship between loneliness and depression among young depressed people by synthesising evidence from a systematic review of qualitative studies. METHODS We conducted a meta-synthesis of qualitative studies capturing experiences of loneliness among young people with depression. We systematically searched six electronic databases for selected search terms, critically appraised eligible studies, and analysed the data from included studies using the approach of thematic synthesis. We used feedback from an inter-disciplinary research workshop to improve reflexivity. RESULTS Our inclusion criteria identified fourteen studies. Our analysis identified four themes: (1) social withdrawal due to poor mental health, (2) non-disclosure of depression contributing to social distance, (3) the desire to connect, and (4) paradoxes of loneliness and depression. These themes illustrated a range of pathways between depression and loneliness, and a sense of how these might be mutually reinforcing. Our findings suggest that where depressed individuals engage in certain behaviours (withdrawing; not confiding) for a range of reasons, this can lead to feelings of loneliness, an awareness of which worsens their mood, thus perpetuating their depression. CONCLUSIONS Young people with depression experience loneliness as an insurmountable distance between themselves and others. Our findings identified non-disclosure of depression, and the debilitating nature of the depressive symptomatology, as factors perpetuating a vicious cycle of loneliness and depression. They suggest that approaches to tackling the problem might include helping young people communicate about their depression to trusted friends and educating their social networks in how to support them. The wider research literature suggests that cognitive interventions may have a role in shifting maladaptive cognitions about their social world.
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Affiliation(s)
- Louis Achterbergh
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK. .,Amsterdam UMC, location AMC (University of Amsterdam), Meibergdreef 9, 1105, Amsterdam, AZ, Netherlands.
| | - Alexandra Pitman
- grid.83440.3b0000000121901201UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK ,grid.439468.4Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE UK
| | - Mary Birken
- grid.83440.3b0000000121901201UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Eiluned Pearce
- grid.83440.3b0000000121901201UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Herman Sno
- grid.7177.60000000084992262Amsterdam UMC, location AMC (University of Amsterdam), Meibergdreef 9, 1105 Amsterdam, AZ Netherlands
| | - Sonia Johnson
- grid.83440.3b0000000121901201UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK ,grid.439468.4Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE UK
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Adverse adolescence experiences, feeling lonely across life stages and loneliness in adulthood. Int J Clin Health Psychol 2020; 20:243-252. [PMID: 32994797 PMCID: PMC7501448 DOI: 10.1016/j.ijchp.2020.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/23/2020] [Indexed: 11/23/2022] Open
Abstract
Loneliness is a mental health issue emerging over the life course. This study examines the latent structure of adult loneliness in a non-Western society and its association with adverse adolescence experiences (AAEs) as well as feeling lonely during middle school, high school, and college. Method: A cohort sample living in Northern Taiwan (N = 2,289) was analyzed from adolescence to adulthood. The de Jong Gierveld Loneliness Scale operationalized loneliness by a three-cluster model to present the latent structure of loneliness: emotional, serious emotional, and severe emotional/social loners. AAEs (e.g., abuse, neglect, and dysfunctional family) were measured by seven items. Multivariate multinomial logistic regression models were used to explore the longitudinal effects of AAEs and feeling lonely reported during middle school, high school, and college on adult loneliness. Results: AAEs and feeling lonely during adolescence were significantly associated with serious emotional loneliness and severe emotional/social loneliness during adulthood, even after adjusting for the individual’s characteristics. Attendance at a 4-year college was associated with decreased odds of serious emotional loneliness and severe emotional/social loneliness. Conclusions: Adults with AAEs and feelings of loneliness over life stages are more likely to report loneliness in the emotional and social domains.
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Pitman AL, King MB, Marston L, Osborn DPJ. The association of loneliness after sudden bereavement with risk of suicide attempt: a nationwide survey of bereaved adults. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1081-1092. [PMID: 32683472 PMCID: PMC7395013 DOI: 10.1007/s00127-020-01921-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 07/08/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE We aimed to test the hypothesis that among people who experience sudden bereavement, loneliness is associated with post-bereavement suicide attempt and post-bereavement suicidal ideation, even when adjusting for network size. METHODS We analysed cross-sectional data collected in the 2010 UCL Bereavement Study, to identify 3193 respondents who had experienced sudden bereavement. We used multivariable logistic regression to test for an association between loneliness (using a newly-developed eight-item loneliness measure) and post-bereavement suicide attempt and suicidal ideation, adjusting for socio-demographic factors, pre-bereavement depression and self-harm, and network size. RESULTS Among bereaved adults, loneliness was significantly associated with probability of post-bereavement suicide attempt (AOR 1.19; 95% CI 1.14-1.25) and of post-bereavement suicidal ideation (AOR 1.24; 95% CI 1.20-1.28), with estimates unchanged by adding perceived stigma of the bereavement to adjusted models. There was no association between suicide bereavement and loneliness (adjusted coefficient 0.22; 95% CI - 0.12 to 0.45; p = 0.063). The association of loneliness and suicide attempt risk was similar whether participants were bereaved by suicide or not. CONCLUSIONS People who report feeling lonely after sudden bereavement are more likely to make a suicide attempt after their loss, even when taking into account their network size and the perceived stigma of the sudden bereavement. There is no evidence that the effects of loneliness on suicidality are specific to suicide bereavement. This work identifies loneliness as a potential target for suicide prevention interventions among bereaved people. It also fuels interest in longitudinal research investigating loneliness as a putative mediator of suicide risk.
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Affiliation(s)
- Alexandra L Pitman
- UCL Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 Saint Pancras Way, London, NW1 0PE, UK.
| | - Michael B King
- UCL Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Louise Marston
- UCL Research Department of Primary Care and Population Health, University College London, Gower St, London, WC1E 6BT, UK
| | - David P J Osborn
- UCL Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 Saint Pancras Way, London, NW1 0PE, UK
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Hickie IB, Davenport TA, Burns JM, Milton AC, Ospina-Pinillos L, Whittle L, Ricci CS, McLoughlin LT, Mendoza J, Cross SP, Piper SE, Iorfino F, LaMonica HM. Project Synergy: co-designing technology-enabled solutions for Australian mental health services reform. Med J Aust 2020; 211 Suppl 7:S3-S39. [PMID: 31587276 DOI: 10.5694/mja2.50349] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Project Synergy aims to test the potential of new and emerging technologies to enhance the quality of mental health care provided by traditional face-to-face services. Specifically, it seeks to ensure that consumers get the right care, first time (delivery of effective mental health care early in the course of illness). Using co-design with affected individuals, Project Synergy has built, implemented and evaluated an online platform to assist the assessment, feedback, management and monitoring of people with mental disorders. It also promotes the maintenance of wellbeing by collating health and social information from consumers, their supportive others and health professionals. This information is reported back openly to consumers and their service providers to promote genuine collaborative care. The online platform does not provide stand-alone medical or health advice, risk assessment, clinical diagnosis or treatment; instead, it supports users to decide what may be suitable care options. Using an iterative cycle of research and development, the first four studies of Project Synergy (2014-2016) involved the development of different types of online prototypes for young people (i) attending university; (ii) in three disadvantaged communities in New South Wales; (iii) at risk of suicide; and (iv) attending five headspace centres. These contributed valuable information concerning the co-design, build, user testing and evaluation of prototypes, as well as staff experiences during development and service quality improvements following implementation. Through ongoing research and development (2017-2020), these prototypes underpin one online platform that aims to support better multidimensional mental health outcomes for consumers; more efficient, effective and appropriate use of health professional knowledge and clinical skills; and quality improvements in mental health service delivery.
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Affiliation(s)
- Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW
| | | | - Jane M Burns
- Swinburne Research, Swinburne University of Technology, Melbourne, VIC
| | | | - Laura Ospina-Pinillos
- Brain and Mind Centre, University of Sydney, Sydney, NSW.,Department of Psychiatry and Mental Health, School of Medicine, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Lisa Whittle
- Brain and Mind Centre, University of Sydney, Sydney, NSW
| | | | - Larisa T McLoughlin
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Birtinya, QLD
| | - John Mendoza
- Brain and Mind Centre, University of Sydney, Sydney, NSW.,ConNetica, Caloundra, QLD
| | - Shane P Cross
- Brain and Mind Centre, University of Sydney, Sydney, NSW
| | - Sarah E Piper
- Brain and Mind Centre, University of Sydney, Sydney, NSW
| | - Frank Iorfino
- Brain and Mind Centre, University of Sydney, Sydney, NSW
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Chiao C, Chen YH, Yi CC. Loneliness in young adulthood: Its intersecting forms and its association with psychological well-being and family characteristics in Northern Taiwan. PLoS One 2019; 14:e0217777. [PMID: 31150498 PMCID: PMC6544274 DOI: 10.1371/journal.pone.0217777] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/19/2019] [Indexed: 01/06/2023] Open
Abstract
Objectives Most researchers have examined forms of loneliness as discrete and emotional distress. The approach proposed in this study captures the reality that many persons experience more than one dimension of loneliness—varying degrees coupled with their psychological well-being in a family context. This study explores the latent structure of loneliness during young adulthood and its association with psychological well-being, as well as how these are related to their family characteristics in adolescence. Methods Data are from 2,748 young people, a cohort sample from the Taiwan Youth Project (TYP). Loneliness was assessed by a 6-item de Jong-Gierveld short scale with emotional and social loneliness domains. We describe the clustering between loneliness domains and psychological well-being, namely depressive symptoms, self-esteem, suicidal thoughts, and alcohol use using latent class cluster analysis. In addition to incorporating the Taiwanese family context, multivariate multinomial logistic regression models included data on family cohesion and parental guan (parental control) in adolescence. This might be associated with choices in partnership and childbearing, and influence loneliness in young adulthood. Results Our results demonstrate a three-cluster model of loneliness involving emotional loners, serious emotional loners, and severe emotional/social loners. We also found that a feeling of serious emotional loneliness and severe emotional/social loneliness were significantly associated with psychological well-being, even adjusting for individual characteristics. Among young adults who had a partner, the married adults were significantly less likely to feel serious emotional loneliness than those who were living alone. Furthermore, young adults with stronger family cohesion during early adolescence were less likely to suffer from serious emotional loneliness (Relative risk ratios [RRR] 0.77, 95% CI 0.65–0.91) and severe emotional/social loneliness (RRR 0.54, 95% CI 0.34–0.85) in young adulthood. Discussion This measurement strategy provides a foundation for future research into how experts can address loneliness clusters in order to better understand psychological well-being during young adulthood and family context in adolescence. This is important because our results suggest that the various loneliness domains do not occur independently, but rather are embedded in patterns and are associated with family characteristics.
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Affiliation(s)
- Chi Chiao
- Institute of Health and Welfare Policy, Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei Taiwan
- * E-mail:
| | - Yu-Hua Chen
- Department of Bio-Industry Communication and Development, National Taiwan University, Taipei Taiwan
| | - Chin-Chun Yi
- Institute of Sociology, Academia Sinica, Taipei Taiwan
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