The Relationship Between Loneliness and Depressive Symptoms in Children and Adolescents: A Meta-Analysis

Factors associated with chronic depressive symptoms across adolescence and young adulthood: a UK birth cohort study

AIMS

Identifying children and/or adolescents who are at highest risk for developing chronic depression is of utmost importance, so that we can develop more effective and targeted interventions to attenuate the risk trajectory of depression. To address this, the objective of this study was to identify young people with persistent depressive symptoms across adolescence and young adulthood and examine the prospective associations between factors and persistent depressive symptoms in young people.

METHODS

We used data from 6711 participants in the Avon Longitudinal Study of Parents and Children. Depressive symptoms were assessed at 12.5, 13.5, 16, 17.5, 21 and 22 years with the Short Mood and Feelings Questionnaire, and we further examined the influence of multiple biological, psychological and social factors in explaining chronic depressive symptoms.

RESULTS

Using latent class growth analysis, we identified four trajectories of depressive symptoms: persistent high, persistent low, persistent moderate and increasing high. After applying several logistic regression models, we found that loneliness and feeling less connected at school were the most relevant factors for chronic course of depressive symptoms.

CONCLUSIONS

Our findings contribute with the identification of those children who are at highest risk for developing chronic depressive symptoms.

Association between support of basic psychological needs and stress response as mediated by motivation for solitude

This study examined the relationship between not self-determined / self-determined solitude and stress responses, as well as the effect of supporting / thwarting of basic psychological needs. The sample consisted of 606 Japanese people aged 20 years and older. We used a cross-sectional survey to measure their motivations for solitude, supporting / thwarting of basic psychological needs, and stress responses. Not self-determined solitude was negatively correlated with supporting of basic psychological needs and positively correlated with thwarting of basic psychological needs. In addition, a cutoff score of 16 for not self-determined solitude was found to be optimal for identifying individuals with a high stress response. Mediation analysis revealed that supporting / thwarting of basic psychological needs has direct effects on stress responses and indirect effects mediated by not self-determined solitude. These findings suggest that fostering environments that support basic psychological needs of autonomy, competence, and relatedness can alleviate not self-determined solitude and reduce stress responses.

Hypnosis with depressed children and teens: Building skills, creating connection

Depression in children and teens has been on the rise for several years. Recent increases in anxiety and loneliness, both contributors to the development of depression, are putting more young people at risk for chronic and comorbid mental health struggles. The use of hypnosis with depressed children offers the opportunity to target the identified skills depressed and anxious children need and is a modality clinicians should embrace. This article describes how to create hypnotic interventions focusing on improved emotional and cognitive management, better sleep, and the ability to make positive social connections. Such interventions serve to not only build the resources depressed children need for recovery, but also support a paradigm shift toward prevention in children and families.

Depressive symptoms and loneliness among early adolescents: a psychometric network analysis approach

BACKGROUND

Previous studies demonstrate a high prevalence of depression and loneliness among adolescents. Although they often co-occur, the relationship between symptoms of depression and loneliness remains poorly understood. This study investigates: (a) the symptoms of depression that are connected to loneliness; (b) the role played by loneliness in the network of depression symptoms; and (c) whether the method used to measure loneliness (single-item direct or multi-item indirect) affects the relationship of loneliness with depressive symptoms.

METHODS

Participants were 496 Polish adolescents (50.8% girls) aged 11 to 13, who completed: (a) the 10-item Major Depressive Disorder subscale of the Revised Child Anxiety and Depression Scale; (b) the 11-item De Jong Gierveld Loneliness Scale (indirect loneliness), and (c) a single direct question evaluating loneliness: 'I'm lonely'. Networks were estimated using a Gaussian Graphical Model.

RESULTS

Loneliness shows a direct relationship with three affective symptoms of depression: sadness, worthlessness, and anhedonia, which mediate relationships with somatic symptoms. In contrast to previous studies, loneliness has the lowest level of centrality among all elements of the network. The method used to assess loneliness did not significantly affect the connections between loneliness and depressive symptoms.

CONCLUSIONS

Loneliness and depression overlap since they are formed by the same cognitive biases and deficits in emotion regulation but differ in the level of generality. In loneliness, they have an interpersonal context, while symptoms of depression can be intrapersonal. This helps us to understand why cognitive interventions, as compared to those which are social, are more effective in reducing loneliness.

The association between depression and the cortisol awakening response is moderated by loneliness in men from a non-clinical sample

Previous studies investigating cortisol levels in people with depression or depressive symptoms have provided mixed findings. It has been suggested that the difficulty to generalize findings across studies in this field might be related to interindividual variability in experiencing depressive symptoms in terms of clinical and social contexts. Therefore, in the present study we aimed to test the association of morning cortisol levels and depressive symptoms in a non-clinical sample of young men taking into consideration the level of perceived loneliness. We hypothesized that the level of loneliness might moderate the association between morning cortisol levels and depressive symptoms. A total of 102 participants (aged 29.9 ± 5.0 years) completed questionnaires measuring the levels of depressive and anxiety symptoms, perceived stress, and loneliness. Cortisol levels were determined in four morning samples of saliva. There were significant positive correlations of the cortisol awakening response (CAR) and the mean increase in cortisol levels during the measurement period (MnInc) with the levels of depressive symptoms and loneliness. Moreover, a significant association of the depressive symptoms by loneliness interaction with the CAR and the MnInc was found. Specifically, the correlation of depressive symptoms with the CAR and the MnInc appeared to be significant and negative at high levels of loneliness. No significant association between depressive symptoms and the CAR was observed in men with low levels of loneliness. There were no significant associations of depressive symptoms, loneliness and the depressive symptoms by loneliness interaction with cortisol levels at awakening. In conclusion, findings from the present study indicate the importance of social contexts in understanding the association between altered activity of the hypothalamic-pituitary-adrenal axis and depressive symptoms in men.

The robust reciprocal relationship between loneliness and depressive symptoms among the general population: Evidence from a quantitative analysis of 37 studies

BACKGROUND

Loneliness has long been associated with depressive symptoms, but there is no evidence on the question of "which comes first". To help us to answer this question, this study conducted a meta-analysis using a cross-lagged formula to examine the reciprocal relations between loneliness and depressive symptoms, as well as potential moderators.

METHODS

The meta-analytic dataset consisted of 37 studies with sample sizes ranging from 52 to 5991. Effect sizes (including autoregressive effects and lagged coefficients) were included. We computed weighted mean effect sizes for the correlation effect and cross-lagged effect between loneliness and depressive symptoms. We also performed a meta-regression to investigate potential moderators.

RESULTS

The results showed that loneliness and depressive symptoms reciprocally predicted each other over time with similar effect sizes. There was no moderation of our overall effect size in either direction by time interval between measurements, the proportion of female participants, mean age of the sample, or type of measurement.

LIMITATIONS

Caution should be taken in drawing final conclusions about the relative strength of reciprocal effects between loneliness and depressive symptoms due to the potential influence of varied research focus in the included studies, which could affect the effect size.

CONCLUSIONS

These findings advance the study of the relationship between loneliness and depressive symptoms by providing evidence that the link between them is symmetrically reciprocal and robust, which may help clinicians to develop effective intervention methods.

What Do We Know About Depression Among Youth and How Can We Make Progress Toward Improved Understanding and Reducing Distress? A New Hope

This paper summarizes many findings about depression among children and adolescents. Depression is prevalent, highly distressing, and exerts considerable burden worldwide. Rates surge from childhood through young adulthood and have increased over the last decade. Many risk factors have been identified, and evidence-based interventions exist targeting mostly individual-level changes via psychological or pharmacological means. At the same time, the field appears stuck and has not achieved considerable progress in advancing scientific understanding of depression's features or delivering interventions to meet the challenge of youth depression's high and growing prevalence. This paper adopts several positions to address these challenges and move the field forward. First, we emphasize reinvigoration of construct validation approaches that may better characterize youth depression's phenomenological features and inform more valid and reliable assessments that can enhance scientific understanding and improve interventions for youth depression. To this end, history and philosophical principles affecting depression's conceptualization and measurement are considered. Second, we suggest expanding the range and targets of treatments and prevention efforts beyond current practice guidelines for evidence-based interventions. This broader suite of interventions includes structural- and system-level change focused at community and societal levels (e.g., evidence-based economic anti-poverty interventions) and personalized interventions with sufficient evidence base. We propose that by focusing on the FORCE (Fundamentals, Openness, Relationships, Constructs, Evidence), youth depression research can provide new hope.

Negative Life Events on Depression of Vocational Undergraduates in the Partial Least Squares Structural Equation Modeling Approach Perspective: A Mediated Moderation Model

BACKGROUND

Following China's strategy of developing applied and compound social talents, vocational undergraduates are surging rapidly, and it is essential to understand the causes of their depression to effectively prevent and intervene in schools.

OBJECTIVE

We aimed to investigate the relationship between negative life events (NLEs) and depression among vocational undergraduates in China, along with the mediating role of loneliness and the moderating role of socioeconomic status (SES).

METHODS

A convenience sample survey was conducted at a vocational education university (N = 1487), and analyzed using partial least squares structural equation modeling.

RESULTS

Findings showed that NLEs directly predicted depression (β = 0.399, 95% CI [0.339, 0.452], p < 0.001) among vocational undergraduates. Furthermore, this relationship was partially mediated by loneliness (β = 0.182, 95% CI [0.145, 221], p < 0.001); SES moderated the link between NLEs and depression (β = 0.051, 95% CI [0.004, 092], p < 0.05), but not between NLEs and loneliness (p > 0.05).

CONCLUSIONS

The current study highlights the impact of NLEs on depression among vocational undergraduates, indicating the importance of addressing NLEs and consequent feelings of loneliness to promote mental health. In addition, the moderating role of SES underscores the necessity of targeted interventions to mitigate the impact of NLEs on depression. The present study contributes to our understanding of the unique characteristics of depression in vocational undergraduates and has practical implications for psychological support services. Moreover, it probably has broader implications for addressing mental health challenges in global education settings for vocational undergraduates.

Adolescent Loneliness and Negative Affect during the COVID-19 Pandemic: The Role of Extraversion and Neuroticism

The COVID-19 pandemic had varied but significant effects on the lives of adolescents. This study aimed to examine the effects of extraversion and neuroticism on changes in loneliness and negative affect among adolescents during the pandemic. Longitudinal data were collected in three waves from 673 German adolescents and young adults (Mage = 16.8 years, SDage = 0.91; female = 59%), affected by local lockdowns. The data collection was one time before (T1) and two times during the pandemic (T2, T3). Change score models were used to assess the relationship between loneliness and negative affect with consideration of extraversion and neuroticism. Results showed that pre-pandemic loneliness was predictive of changes in negative affect during the pandemic, with higher loneliness predicting increases in negative affect. Negative affect did not predict later loneliness. Extraverts showed an increase in negative affect over time, particularly between pre-pandemic measurement and the first phase of the pandemic. Higher neuroticism appeared to have increased vulnerability for negative affect during the pandemic, as a rise in negative affect were found among these adolescents throughout the course of the pandemic. In conclusion, the study highlights the significant impact of the COVID-19 pandemic on the mental health of adolescents and suggests that managing the pandemic during this specific developmental period is a challenge.

The Resilience of South African School Teachers in the Time of COVID-19: Coping with Risk of Infection, Loneliness, and Anxiety

The COVID-19 pandemic precipitated an overall increase in the global prevalence of mental health disorders and psychological distress. However, against this backdrop, there was also evidence of adaptation and coping, which suggested the influence of protective factors. The current study aims to extend previous research on the role of protective factors by investigating the health-sustaining and mediating roles of resilience in the relationship between perceived vulnerability to disease, loneliness, and anxiety. Participants consisted of a convenience sample of schoolteachers (N = 355) who completed the Perceived Vulnerability to Disease Questionnaire, the short form of the Connor-Davidson Resilience Scale, the University of California, Los Angeles Loneliness Scale, and the trait scale of the Spielberger State-Trait Anxiety Scale, through an online link created with Google Forms. The results of path analysis indicated significant negative associations between resilience and both loneliness and anxiety. These results indicate the health-sustaining role of resilience. In addition, resilience mediated the relationships between germ aversion and perceived infectability, on the one hand, and loneliness and anxiety, on the other hand. The findings confirm that resilience can play a substantial role in counteracting the negative impact of the pandemic on mental health.

Loneliness and Well-Being in Children and Adolescents during the COVID-19 Pandemic: A Systematic Review

Concerns have been raised about the loneliness and well-being of children and adolescents during the COVID-19 pandemic. The extent to which the ongoing pandemic has impacted loneliness and the association between loneliness and well-being is unclear. Therefore, a systematic review of empirical studies on the COVID-19 pandemic was conducted to examine the (1) prevalence of loneliness in children and adolescents, (2) associations between loneliness and indicators of well-being, and (3) moderators of these associations. Five databases (MEDLINE, Embase, PsycInfo, Web of Science, ERIC) were searched from 1 January 2020 to 28 June 2022 and 41 studies met our inclusion criteria (cross-sectional: n = 30; longitudinal: n = 11; registered on PROSPERO: CRD42022337252). Cross-sectional prevalence rates of pandemic loneliness varied, with some finding that over half of children and adolescents experienced at least moderate levels of loneliness. Longitudinal results reflected significant mean increases in loneliness compared to pre-pandemic levels. Cross-sectional results indicated that higher levels of loneliness were significantly associated with poorer well-being, including higher depression symptoms, anxiety symptoms, gaming addiction, and sleep problems. Longitudinal associations between loneliness and well-being were more complex than cross-sectional associations, varying by assessment timing and factors in the statistical analyses. There was limited diversity in study designs and samples, preventing a thorough examination of moderating characteristics. Findings highlight a broader challenge with child and adolescent well-being that predates the pandemic and the need for future research to examine underrepresented populations across multiple timepoints.