Adolescent loneliness and psychiatric morbidity in Northern Ireland

Loneliness and suicide risks in the general population before and during first-year COVID-19 in Taiwan

PURPOSE

Loneliness is a critical issue affecting the general population. Current evidence from national surveys of loneliness is scarce. The study aimed to examine the impact of COVID-19 pandemic on the prevalence of loneliness and its associating suicide risks in Taiwan.

METHODS

Four annual telephone interview surveys were performed by the Taiwan Suicide Prevention Center in 2015-2017 and 2020 during COVID outbreak. Each year the sample was randomly selected by stratifying the general public in different geographical areas and fulfilled a questionnaire collecting information including loneliness, psychological distress, and suicide risk assessment. All the data were analyzed using SPSS25 analysis.

RESULTS

A total of 8460 participants were recruited. The average prevalence of loneliness was 12.6 %. Feelings of loneliness was significantly correlated with psychological distress and most risk factors relating to suicide. The odds of loneliness for lifetime suicidal ideation, lifetime suicide attempt, and future suicide intent were 4.9, 5.1, and 9.2, respectively. During the COVID-19 period, loneliness and suicidality demonstrated a noteworthy decline trend, whereas "no one trustworthy to talk to" was the only item that showed significant increase under the pandemic and also impacted on loneliness.

CONCLUSION

Nearly one in ten Taiwanese people felt lonely before and during COVID-19. Loneliness was closely linked with various suicide risk factors such as lifetime suicide ideation and attempt or future intention. Although psychological distress and suicide risk were not increased during COVID-19, maintaining trustful relationships to seek support appeared to be critical to prevent the risks of loneliness or suicide.

Adolescent mental well-being, religion and family activities: a cross-sectional study (Northern Ireland Schools and Wellbeing Study)

OBJECTIVES

In this study, we seek to explore the relationship between adolescent mental well-being, religion and family activities among a school-based adolescent sample from Northern Ireland.

SETTING

The Northern Ireland Schools and Wellbeing Study is a cross-sectional study (2014-2016) of pupils in Northern Ireland aged 13-18 years.

PARTICIPANTS

1618 adolescents from eight schools participated in this study.

OUTCOMES MEASURES

Our primary outcome measure was derived using the Warwick-Edinburgh Mental Wellbeing Scale. We used hierarchical linear regression to explore the independent effects of a range of personal/social factors, including religious affiliation, importance of religion and family activities.

RESULTS

In fully adjusted models, older adolescents and females reported lower mental well-being scores-for the year-on-year increase in age β=-0.45 (95% CI=-0.84, -0.06), and for females (compared with males) β=-5.25 (95% CI=-6.16, -4.33). More affluent adolescents reported better mental well-being. No significant differences in mental well-being scores across religious groups was found: compared with Catholics, Protestant adolescents recorded β=-0.83 (95% CI=-2.17, 0.51), other religious groups β=-2.44 (95% CI=-5.49, 0.62) and atheist adolescents β=-1.01 (95% CI=-2.60, 0.58). The importance of religion in the adolescents' lives was also tested: (compared with those for whom it was not important) those for whom it was very important had better mental well-being (β=1.63: 95% CI=0.32, 2.95). Higher levels of family activities were associated with higher mental well-being: each unit increase in family activity produced a 1.45% increase in the mental well-being score (β=0.78: 95% CI=0.67, 0.90).

CONCLUSIONS

This study indicates that non-religious adolescents may have lower mental well-being scores when compared with their more religious peers, irrespective of religious denomination. This may relate to both a sense of lack of firm identity and perceived marginalisation. Additionally, adolescents with poor family cohesion are more vulnerable to poor mental well-being.

Associations between transient and chronic loneliness, and depression, in the understanding society study

OBJECTIVES

Loneliness has a long-established link with depression; however, patterns of loneliness, specifically transient (short-term) and chronic loneliness (longer-term), have seldom been researched in terms of their associations with depression and psychiatric distress. We investigated whether chronic loneliness could predict higher levels of psychiatric distress and higher chance of depression diagnosis (via self-report) than transient and no loneliness.

METHODS

We used data from 18,999 participants in Waves 9 and 10 of the Understanding Society survey: a nationally representative study of adults in the United Kingdom. The study used a between-subjects, cross-sectional, design, where participants' scores on loneliness measures across two time points were combined to form patterns of loneliness, and participants were compared on their levels of psychiatric distress and depression diagnoses across the three loneliness groups: chronic loneliness (lonely at both time points), transient loneliness (lonely at one time point) and no loneliness.

RESULTS

Regression analyses revealed that patterns of loneliness predicted both the likelihood of participants reporting a history of depression diagnosis and participants' levels of psychiatric distress. The chronic loneliness group had the highest likelihood of self-reported depression diagnosis and had the highest levels of psychiatric distress, compared to both the transient and no loneliness groups. Transient loneliness, in turn, predicted higher likelihood of reporting a history of depression diagnosis and higher levels of psychiatric distress than the no loneliness group.

CONCLUSIONS

The study replicates and extends prior findings, suggesting that prolonged loneliness even over the course of one year is a risk factor for poorer mental health.

Perceived poverty, perceived income adequacy and loneliness in Israeli young adults: Are social capital and neighbourhood capital resilience factors?

Loneliness is a severe risk factor that has been linked to diminished health outcomes and low quality of life across ages. Young adults have been identified as a high-risk group for experiencing loneliness, but only a few studies have explored the economic and social determinants of loneliness in this age group. Taking a social inequality approach to health, with loneliness as a focus, this study examined: (a) the associations between the following factors - subjective social status (SSS) indicators (perceived poverty and perceived income adequacy), offline and online social capital, and neighbourhood capital - and loneliness; and (2) whether social and neighbourhood capital were moderators in the association between SSS and loneliness. Cross-sectional data for individuals aged 20-29 were taken from the 2017 Israeli Social Survey (N = 1,508). Employing multinomial logit models, we found that perceived poverty was a strong predictor of loneliness. Greater social and neighbourhood capital decreased loneliness, whereas a higher use of online social networks increased loneliness. Neighbourhood capital and perceived trust were moderators, whereas trust was a resilience factor, neighbourhood capital strengthened the negative effect of perceived poverty on loneliness. To reduce the prevalence of loneliness in young adults, policymakers should examine various means of enhancing social and neighbourhood capital along with moderating the use of online social networks. However, they should be aware that interventions of this kind can do little to buffer the strong effect of perceived poverty on loneliness, as in most cases the effect of perceived poverty on the probability of loneliness is not ameliorated by improved social or neighbourhood resources.

Feasibility and preliminary efficacy of a school-based health and well-being program for adolescent girls

BACKGROUND

The primary aim of this pilot study was to evaluate the feasibility and preliminary efficacy of a school-based health and well-being program (Health and Well-being for Girls: HWBG) on adolescent girls' well-being, mindfulness, screen-time, and physical activity.

METHOD

The HWBG program was evaluated using a group randomized controlled trial (RCT) in one secondary school. A convenience sample of female students in Grade 8 (mean age 14 ± 0.5 years) was recruited for the study (n=4 classes; 89 girls). The 20-week multi-component HWBG program, guided by Self-Determination Theory and Acceptance and Commitment Therapy, was designed and delivered by a member of the research team. Randomization occurred prior to baseline assessments at the class level (n=4 classes) into dose-matched treatment conditions (i.e., two classes received the HWBG intervention and two classes received an alternate elective course as a wait-list control group). Process evaluation measures of recruitment, retention, adherence, and satisfaction were used to determine program feasibility. This study was designed to assess feasibility (primary outcome) and preliminary efficacy (secondary outcomes), rather than effectiveness. Preliminary efficacy of HWBG for improving mental and social health, screen-time, and physical activity were measured and analyzed using linear mixed-models.

RESULTS

"The health and well-being program" targeting adolescent girls was found to be feasible for implementation as an elective course in a secondary school setting. Participants in the HWBG program reported high levels of satisfaction, the majority of lessons (45 out of 50), were implemented as planned and adherence to the planned HWBG program content was very high. Medium positive effects on mental health (d=0.45) and social health (d=0.50) were observed. Small effects were observed for physical activity, and no significant intervention effects were found for levels of recreational screen time. Participant ratings showed high levels of perceived benefit and enjoyment as indicated in the evaluation data (mean rating of 4.44 out of a possible 5.0) when asked whether the program was enjoyable.

CONCLUSION

The study provides preliminary support for HWBG as a potentially feasible and enjoyable program suitable for use with adolescent girls in the secondary school setting. Potential of the study for facilitating improvements in pro-social and psychological well-being is also supported.

TRIAL REGISTRATION

ACTRN12617000157370 . The trial was registered with the Australian New Zealand Clinical Trials Registry.

Loneliness is associated with poor mental health, social-environmental factors, and health risk behaviours among national samples of in-school adolescents in four Caribbean countries

The goal of the study was to estimate associations of loneliness with poor mental health, social-environmental and health risk behaviour indicators among adolescents in the Caribbean. Cross-sectional national 'Global School-Based Student Health Survey (GSHS)' data of four Caribbean countries (N = 9,143 adolescents) in 2016-2017 were analysed. In adjusted logistic regression analysis, loneliness was significantly positively associated with all five poor mental health outcomes (having no close friends, anxiety-induced sleep disturbance, suicidal ideation, suicide plan and suicide attempt). Regarding social-environmental outcomes, loneliness was significantly positively associated with bullying victimization, having been physically attacked, involvement in fighting, frequent experiences of hunger and passive smoking (in particular among boys). In terms of health risk behaviour outcomes, loneliness significantly increased the odds for current tobacco use, ever drunk, trouble from alcohol use, ever amphetamine use, multiple sexual partners, leisure-time sedentary behaviour, injury and frequent soft drink consumption. In addition, among boys, loneliness increased the likelihood for current cannabis use. Loneliness is associated with poorer mental health, social-environmental risk factors and health risk behaviours. Results show the importance of taking loneliness into account in a number of mental, social, and physical health factors.

Loneliness and Depression among Polish High-School Students

Introduction: Having impaired relations and limited interpersonal contact is associated with a sense of loneliness, and can result in a number of mental disorders, including the development of depression. Approximately one in five adolescents in the world suffers from depression, and first episodes of such are occurring at increasingly young ages. Due to a lack of appropriate support from parents, teachers and the healthcare system, the young person feels alone when dealing with their problem. Aims: The aims of this study are to determine the prevalence of anxiety, depression, aggression and sense of loneliness among high school students, and to analyze a correlation between loneliness and depression. Materials and methods: The study was conducted on 300 high school students in Poland. The study material was collected using the Hospital Anxiety and Depression Scale (HADS-M) and De Jong Gierveld Loneliness Scale (DJGLS). Results: A feeling of loneliness correlated significantly with depressive disorders (p < 0.005), with the strongest effect between the total HADS-M score and the total loneliness scale score (r = 0.61). The overall presence of disorders as per HADS-M was found to be 23%, and borderline conditions were found in 19.3%. In 24% of the students, disorders were revealed on the anxiety subscale and in 46.3% on the aggression subscale. On DJGLS, a very severe sense of loneliness was observed in 6.67% of the subjects, and in 42.3% of them, a moderate feeling of loneliness was indicated. On the social loneliness subscale, a severe sense of loneliness was found in 22.7%, while on the emotional loneliness subscale, it was found in 16.7% of the subjects. Conclusions: In this study, a quarter of the student participants experienced anxiety and depression disorders. Students showing higher levels of anxiety, depression, and aggression also showed enhanced loneliness. Girls showed higher levels of anxiety, depression and aggression, as well as emotional loneliness.

Entanglements of loneliness and mental ill health among young adult women

PURPOSE

If a person experiences both loneliness and mental ill health, it may have severe effects on a person's wellbeing and functioning. This study explored the ways in which loneliness may be entangled with mental ill health and the factors that contribute to the development of such entanglements.

METHODS

The study participants were women from the Northern Finland Birth Cohort 1986 study, who, in 2001-2002, responded to the survey about being very lonely at the age of 15-16. Women (n = 17) were interviewed again at age 27-28 with semi-structured interviews. Data was analysed with thematic analysis.

RESULTS

Loneliness and mental ill health formed four types of entanglements: Entanglement 1 (E1): "Loneliness periodically evoked depressive feelings"; E2: "Loneliness and depressive feelings formed an ongoing spiral"; E3: "Loneliness and diagnosed depression/serious emotional disturbance formed periodic spirals;" and E4: "Serious emotional disturbance/mental illness and loneliness formed an ongoing, difficult spiral." Social adversities like unsafe family environment, lack of close friends, and school violence contributed to the development of Entanglements 1-3. In Entanglement 4, serious mental health disorder caused loneliness.

CONCLUSIONS

Loneliness was centrally linked to mental health issues in the present study and should be taken into consideration when providing mental health prevention and treatment.

Unemployment and Psychological Distress among Young People during the COVID-19 Pandemic: Psychological Resources and Risk Factors

In the wake of COVID-19, unemployment and its potential deleterious consequences have attracted renewed interest. We examined (1) the association between unemployment, occurring upon the coronavirus outbreak, and psychological distress among Israeli young people (20–35-years-old); (2) the associations between various psychological resources/risk factors and psychological distress; and (3) whether these resources and risk factors were moderators in the unemployment-psychological distress link. A real-time survey based on snowball sampling was conducted during the month of April 2020 (N = 390). We employed hierarchical linear models to explore associations between unemployment, psychological resources, risk factors, and psychological distress. Unemployment was independently associated with greater psychological distress. Perceived trust, optimism, and sense of mastery decreased psychological distress, whereas financial strain and loneliness during the crisis increased this distress. The effect of unemployment on psychological distress did not depend on participants’ resource and risk factor levels. Policymakers must develop and extend health initiatives aimed at alleviating the mental health consequences of COVID-19-related unemployment and promote labor market interventions to help young job seekers integrate into employment. These measures, which are in line with the UN sustainable development goals, should be seen as an important route to promote public health.

Quality not quantity: loneliness subtypes, psychological trauma, and mental health in the US adult population

PURPOSE

Loneliness is a recognised public-health concern that is traditionally regarded as a unidimensional construct. Theories of loneliness predict the existence of subtypes of loneliness. In this study, latent class analysis (LCA) was used to test for the presence of loneliness subtypes and to examine their association with multiple mental health variables.

METHODS

A nationally representative sample of US adults (N = 1839) completed the De Jong Gierveld Loneliness Scale, along with self-report measures of childhood and adulthood trauma, psychological wellbeing, major depression, and generalized anxiety.

RESULTS

When treated as a unidimensional construct, 17.1% of US adults aged 18-70 were classified as lonely. However, the LCA results identified four loneliness classes which varied quantitatively and qualitatively: 'low' (52.8%), 'social' (8.2%), 'emotional' (26.6%), and 'social and emotional' (12.4%) loneliness. The 'social and emotional' class were characterised by the highest levels of psychological distress, followed by the 'emotional' class. The 'social' loneliness class had similar mental health scores as the 'low' loneliness class. Childhood and adulthood trauma were independently related to the most distressed loneliness classes.

CONCLUSIONS

Current findings provide support for the presence of subtypes of loneliness and show that they have unique associations with mental health status. Recognition of these subtypes of loneliness revealed that the number of US adults aged 18-70 experiencing loneliness was twice as high as what was estimated when loneliness was conceptualized as a unidimensional construct. The perceived quality, not the quantity, of interpersonal connections was associated with poor mental health.

Psychometric properties of the short-form UCLA Loneliness Scale (ULS-8) among Chinese adolescents

Loneliness is prevalent and severe among adolescents, indicating the need for a reliable, valid, and concise instrument for detecting adolescent loneliness. This study aims to examine the psychometric properties of the Chinese version of the short-form UCLA Loneliness Scale (ULS-8) among Chinese adolescents.Computer-assisted self-interviewing was used to complete the questionnaire among 3480 junior or senior high school students aged 10 to 19 years. Construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). To test the concurrent validity and convergent validity of the scale, a single loneliness item and variables such as depression, suicidal ideation, and quality of interpersonal relationships were used. For reliability, Cronbach alpha and test-retest correlation were computed.Construct validity and internal consistency showed that the ULS-6, which excluded 2 reverse-scored items from the ULS-8, had stronger psychometric properties than the ULS-8. The convergent validity and concurrent validity were also supported by the study results. The overall Cronbach α of the ULS-6 was 0.878 and the test-retest reliability coefficient was 0.663.The ULS-6 showed satisfactory reliability and validity in this study, suggesting that this instrument can be used in the measurement of loneliness among Chinese adolescents.

Gender dysphoria in adolescence: current perspectives

Increasing numbers of adolescents are seeking treatment at gender identity services in Western countries. An increasingly accepted treatment model that includes puberty suppression with gonadotropin-releasing hormone analogs starting during the early stages of puberty, cross-sex hormonal treatment starting at ~16 years of age and possibly surgical treatments in legal adulthood, is often indicated for adolescents with childhood gender dysphoria (GD) that intensifies during puberty. However, virtually nothing is known regarding adolescent-onset GD, its progression and factors that influence the completion of the developmental tasks of adolescence among young people with GD and/or transgender identity. Consolidation of identity development is a central developmental goal of adolescence, but we still do not know enough about how gender identity and gender variance actually evolve. Treatment-seeking adolescents with GD present with considerable psychiatric comorbidity. There is little research on how GD and/or transgender identity are associated with completion of developmental tasks of adolescence.

Loneliness is adversely associated with physical and mental health and lifestyle factors: Results from a Swiss national survey

Introduction

Loneliness is a common, emotionally distressing experience and is associated with adverse physical and mental health and an unhealthy lifestyle. Nevertheless, little is known about the prevalence of loneliness in different age groups in Switzerland. Furthermore, the existing evidence about age and gender as potential effect modifiers of the associations between loneliness, physical and mental health and lifestyle characteristics warrants further investigation. Thus, the aim of the study was to examine the prevalence of loneliness among adults in Switzerland and to assess the associations of loneliness with several physical and mental health and behavioral factors, as well as to assess the modifying effect of sex and age.

Methods

Data from 20,007 participants of the cross-sectional population-based Swiss Health Survey 2012 (SHS) were analyzed. Logistic regression analyses were used to assess associations of loneliness with physical and mental health or lifestyle characteristics (e.g. diabetes, depression, physical activity). Wald tests were used to test for interactions.

Results

Loneliness was distributed in a slight U-shaped form from 15 to 75+ year olds, with 64.1% of participants who had never felt lonely. Lonely individuals were more often affected by physical and mental health problems, such as self-reported chronic diseases (Odds ratio [OR] 1.41, 95% confidence interval [CI] 1.30–1.54), high cholesterol levels (OR 1.31, 95% CI 1.18–1.45), diabetes (OR 1.40, 95% CI 1.16–1.67), moderate and high psychological distress (OR 3.74, 95% CI 3.37–4.16), depression (OR 2.78, 95% CI 2.22–3.48) and impaired self-perceived health (OR 1.94, 95% CI 1.74–2.16). Loneliness was significantly associated with most lifestyle factors (e.g. smoking; OR 1.13, 95% 1.05–1.23). Age, but not sex, moderated loneliness’ association with several variables.

Conclusion

Loneliness is associated with poorer physical and mental health and unhealthy lifestyle, modified by age, but not by sex. Our findings illustrate the importance of considering loneliness for physical and mental health and lifestyle factors, not only in older and younger, but also in middle-aged adults. Longitudinal studies are needed in Switzerland to elucidate the causal relationships of these associations.

"Where are all the lonely people?" A population-based study of high-risk groups across the life span

BACKGROUND

Loneliness is a prevalent and urgent public health issue. Optimal planning of community approaches to loneliness requires a differentiated understanding of loneliness across the life span. We identified groups at high risk of loneliness by exploring the relationship between loneliness and socio-demographic and health-related factors across multiple age groups.

METHODS

This was a combined population-based questionnaire survey and register data study based on a representative sample, including 33,285 Danish individuals aged 16-102 years. Loneliness was measured using the Three-Item Loneliness Scale.

RESULTS

The relation between loneliness and age took a shallow U-shaped distribution. Ethnic minority status, receiving disability pensions or being unemployed, living alone, prolonged mental disorder, and psychiatric treatment were strongly associated with severe loneliness. Socio-demographic and health-related factors were associated with an increased risk of severe loneliness in specific age groups. Being female, having a low educational level and living in a deprived area were only associated with loneliness in adolescence/emerging adulthood. Receiving disability pensions and living alone (i.e., divorced), on the other hand, were strongly associated with loneliness in early and middle adulthood and young-old age.

CONCLUSION

Ethnic minority status, living alone, and prolonged mental disorder may well be key factors in determining the generic level of loneliness in a given population. Other conditions are associated with an increased risk of severe loneliness in specific age groups and may moderate the age-loneliness relation. These findings may help to identify populations within communities at risk of loneliness and thereby support the implementation of policies and public health interventions across the life span.

Problem solving, loneliness, depression levels and associated factors in high school adolescents

Objectives:

To determine problem solving, loneliness, depression levels and associated factors in high school adolescents.

Methods:

This cross-sectional study was conducted in a city west of Turkey (Bursa) in a public high school and the population was 774 and the sampling was 394 students. Students to be included in the study were selected using the multiple sampling method. A personal Information Form with 23 questions, Problem Solving Inventory (PSI), Loneliness Scale (UCLA), Beck Depression Inventory (BDI) were used as data collection tools in the study. Basic statistical analyses, t-test, Kruskall Wallis-H, One Way Anova and Pearson Correlation test were used to evaluate the data. Necessary permissions were obtained from the relevant institution, students, parents and the ethical committee.

Results:

The study found significant differences between “problem solving level” and family type, health assessment, life quality and mothers’, fathers’ siblings’ closeness level; between “loneliness level” and gender, family income, health assessment, life quality and mothers’, fathers’, siblings’ closeness level; between “depression level” and life quality, family income, fathers’ closeness level.

Conclusion:

Unfavorable socio-economic and cultural conditions can have an effect on the problem solving, loneliness and depression levels of adolescents. Providing structured education to adolescents at risk under school mental health nursing practices is recommended.

Loneliness and its association with psychological and somatic health problems among Czech, Russian and U.S. adolescents

BACKGROUND

Loneliness is common in adolescence and has been linked to various negative outcomes. Until now, however, there has been little cross-country research on this phenomenon. The aim of the present study was to examine which factors are associated with adolescent loneliness in three countries that differ historically and culturally-the Czech Republic, Russia and the United States, and to determine whether adolescent loneliness is associated with poorer psychological and somatic health.

METHODS

Data from a school survey, the Social and Health Assessment (SAHA), were used to examine these relations among 2205 Czech, 1995 Russian, and 2050 U.S. male and female adolescents aged 13 to 15 years old. Logistic regression analysis was performed to examine if specific demographic, parenting, personal or school-based factors were linked to feeling lonely and whether lonely adolescents were more likely to report psychological (depression and anxiety) or somatic symptoms (e.g. headaches, pain).

RESULTS

Inconsistent parenting, shyness, and peer victimisation were associated with higher odds for loneliness in at least 4 of the 6 country- and sex-wise subgroups (i.e. Czech, Russian, U.S. boys and girls). Parental warmth was a protective factor against feeling lonely among Czech and U.S. girls. Adolescents who were lonely had higher odds for reporting headaches, anxiety and depressive symptoms across all subgroups. Loneliness was associated with other somatic symptoms in at least half of the adolescent subgroups.

CONCLUSION

Loneliness is associated with worse adolescent health across countries. The finding that variables from different domains are important for loneliness highlights the necessity of interventions in different settings in order to reduce loneliness and its detrimental effects on adolescent health.

Resilience factors may moderate the associations between pubertal timing, body mass and emotional symptoms in adolescence

AIM

The effects of resilience factors on associations between emotional symptoms and perceived pubertal timing or body mass in adolescence are unknown, and this study examined the moderating effects of social competence, family cohesion and loneliness.

METHODS

Data were drawn from the Young-HUNT 3 study, including a self-report questionnaire and clinical measurements of weight and height from 7639 adolescents aged 13-18 years. Emotional symptoms were assessed by a five-item version of the Hopkins Symptom Checklist. Associations between pubertal timing or body mass and emotional symptoms were assessed by linear regression models. Interactions with social competence, family cohesion and loneliness were explored.

RESULTS

A U-shaped relationship was found for both perceived pubertal timing and for perceived body mass and emotional symptoms. For girls, early perceived pubertal timing was more strongly associated with emotional symptoms among those who often felt lonely. For boys, late perceived pubertal timing and feeling they were fat were more strongly associated with emotional symptoms in those with low scores for social competence or family cohesion.

CONCLUSION

Emotional symptoms were more strongly associated with perceived pubertal timing and body mass than actual measures and the associations were stronger for adolescents with low scores for resilience factors.

Two years of gender identity service for minors: overrepresentation of natal girls with severe problems in adolescent development

BACKGROUND

Increasing numbers of adolescents present in adolescent gender identity services, desiring sex reassignment (SR). The aim of this study is to describe the adolescent applicants for legal and medical sex reassignment during the first two years of adolescent gender identity team in Finland, in terms of sociodemographic, psychiatric and gender identity related factors and adolescent development.

METHODS

Structured quantitative retrospective chart review and qualitative analysis of case files of all adolescent SR applicants who entered the assessment by the end of 2013.

RESULTS

The number of referrals exceeded expectations in light of epidemiological knowledge. Natal girls were markedly overrepresented among applicants. Severe psychopathology preceding onset of gender dysphoria was common. Autism spectrum problems were very common.

CONCLUSION

The findings do not fit the commonly accepted image of a gender dysphoric minor. Treatment guidelines need to consider gender dysphoria in minors in the context of severe psychopathology and developmental difficulties.

Adolescent loneliness and psychiatric morbidity in the general population: Identifying "at risk" groups using latent class analysis

BACKGROUND

Previous research has shown that loneliness is strongly associated with both physical and psychological ill health, particularly among adolescents. Factor analytic research has also shown that loneliness is a multi-dimensional construct, characterized by e.g. feelings of isolation, and relational and collective connectedness. While factor analytic representations of the phenomenon effectively illustrate the structure and form of the loneliness construct, they may not adequately capture its expression in the population within, among and across individuals.

METHOD

The current study modelled the expression of loneliness among a population sample of Northern Irish adolescents using latent class analysis. Data from the Young Life and Times Survey (2011) was used to identify the fewest groups of adolescents in the population characterized by discrete and shared loneliness profiles based on their responses to the UCLA Loneliness Scale (UCLA-LS). Individual "at risk" status for psychiatric morbidity was then assessed on the basis of LCA-group membership.

RESULTS

Four groups of adolescents were identified: 1) high loneliness, characterized predominantly by feelings of isolation, 2) intermediate loneliness (two groups), and a baseline group with low levels of loneliness. While all groups were more likely to screen positive for psychiatric morbidity compared with the baseline group, notable risk, however, was attributable to specific isolation experiences or disconnectedness, that characterized both the profiles of the high loneliness group and the similar, but less severe, intermediate loneliness group.

CONCLUSIONS

Loneliness is distributed throughout the adolescent population; however, among a significant minority, loneliness is predominantly characterized by feelings of isolation and is strongly indicative of psychological ill health.

The latent structure of loneliness: testing competing factor models of the UCLA Loneliness Scale in a large adolescent sample

This study assessed the dimensional structure of the UCLA Loneliness Scale ([UCLA-LS], UCLA-3). Data from the Northern Ireland Young Life and Times Survey (2011), a survey of 1,434 16-year-olds, was used to examine the underlying factor structure of the scale. Confirmatory factor analysis was employed to compare alternative factor analytical models that can inform the scoring of the measure and determine the degree to which different factors provided unique predictive utility. Fit statistics indicated that the best fitting model comprised three correlated factors: Isolation, Related Connectedness, and Collective Connectedness. These findings were consistent with previous findings that identified the multidimensional nature of the UCLA-LS. The study also found evidence that the subscales were differentially associated with psychiatric morbidity as measured by the General Health Questionnaire (GHQ-12) and provides a more reliable and comprehensive framework to assess the clinical significance of loneliness.