The Level of Expectations Regarding Aging Among Older Adults: A Systematic Review and Meta-analysis

OBJECTIVE

To systematically review the level of expectations regarding aging (ERA) among older adults.

DESIGN

Systematic review and meta-analysis.

SETTING AND PARTICIPANTS

Adults aged 60 years and older in any setting.

METHODS

We searched 11 databases for cross-sectional studies that reported ERA scores among older adults using the ERA survey from inception to May 1, 2022, without language restrictions. Two researchers independently selected studies, extracted data, and assessed quality. The mean scores and standard deviations of the ERA survey and its subscales were pooled using the Stata software (version 17.0).

RESULTS

Twelve studies with 3664 participants were included in this study. The pooled mean scores of overall ERA were 37.85 (95% CI, 33.54-42.16). Specifically, the pooled scores for expectations regarding physical health, mental health, and cognitive function were 31.67 (95% CI, 27.42-35.92), 43.69 (95% CI, 38.99-48.39), and 33.28 (95% CI, 29.56-37.00), respectively. No statistically significant differences between groups were observed in any subgroup analysis.

CONCLUSIONS AND IMPLICATIONS

The level of ERA among older adults is relatively low, particularly concerning cognitive function and physical health dimensions. These findings may provide a valuable reference for public health professionals and policymakers to intervene and manage the health problems of older adults.

Disability-related inequalities in the prevalence of loneliness across the lifespan: trends from Australia, 2003 to 2020

BACKGROUND

Experiencing loneliness can be distressing and increasing evidence indicates that being lonely is associated with poor physical and mental health outcomes. Cross-sectional studies have demonstrated that people with disability have increased risk of experiencing loneliness compared to people without disability. However, we do not know if these inequalities have changed over time. This study investigated the prevalence of loneliness for people with disability in Australia annually from 2003 to 2020 to examine whether disability-related inequalities in loneliness have changed over time, and disaggregated results for subgroups of people with disability by age group, sex, and disability group.

METHODS

We used annual data (2003-2020) from the Household, Income and Labour Dynamics in Australia Survey. Loneliness was measured by a single question assessing the subjective experience of loneliness. For each wave, we calculated population-weighted age-standardised estimates of the proportion of people experiencing loneliness for people with and without disability. We then calculated the absolute and relative inequalities in loneliness between people with and without disability for each wave. Analyses were stratified by 10-year age groups, sex, and disability group (sensory or speech, physical, intellectual or learning, psychological, brain injury or stroke, other).

RESULTS

From 2003 to 2020, the prevalence of loneliness was greater for people with disability, such that people with disability were 1.5 to 1.9 times more likely to experience loneliness than people without disability. While the prevalence of loneliness decreased for people without disability between 2003 and 2020, the prevalence of loneliness did not decrease for people with disability during this period. Inequalities in loneliness were more substantial for people with intellectual or learning disabilities, psychological disability, and brain injury or stroke.

CONCLUSION

This study confirms that people with disability have increased risk of loneliness compared to people without disability. We add to the existing evidence by demonstrating that disability-related inequalities in loneliness have persisted for two decades in Australia without improvement. Our findings indicate that addressing inequalities in loneliness for people with disability is a critical public health concern given that loneliness is associated with a wide range of poor health outcomes.

Describing Outcomes in Autistic Young Adults One Year After High School Graduation

PURPOSE

Research documents poor outcomes for autistic adults in the domains of employment, independent living, and social relationships. Measurement and sample limitations in prior studies may have amplified past estimates of poor outcomes. The goal of the current study was to improve upon past approaches and to create and describe a measurement approach to capture adult outcomes that reflected the context of young adulthood and the perspectives of autistic individuals, pairing objective outcome indicators with subjective satisfaction indicators.

METHODS

Thirty-six autistic young adults (mean age 19.8 years) and a parent completed self-report surveys. Using these data, we defined an objective and subjective (i.e., satisfaction) outcome indicator in each of three domains: productivity (employment or post-secondary education), social well-being (frequency of contact with friends), and living situation (autonomy).

RESULTS

Three-quarters of young adults experienced at least 5 out of 6 positive outcomes. Over 90% were engaged in school, work, or a structured transition program, and an equal percentage were satisfied with their productivity activity. Over three-quarters of adults had a good amount of contact with friends and were satisfied with their social life. Most young adults had a moderate level of autonomy in their daily lives, and all were satisfied with their living situation.

CONCLUSION

Tailoring outcome measurement approaches specifically for autistic young adults provided a more optimistic portrayal of outcomes than previously noted in the literature. The approach used better reflects a neurodiversity approach and may be useful for evaluating the effectiveness of transition services or interventions.

Gender Differences in Loneliness Over Time: A 15-Year Longitudinal Study of Men and Women in the Second Part of Life

Evidence suggests that in old age, women are lonelier than men. Gender differences in loneliness are often explained by gender differences in longevity, social status and loss, health, and mobility-well-established predictors that may influence loneliness differently in "younger" (40-59 years) and "older" (60-80 years) groups of men and women in the second part of life. This study explores loneliness in men and women ages 40 to 80 years at baseline over a 15-year period using panel data from three waves of the Norwegian Life Course, Ageing and Generation Study (N = 2,315). Our analyses show that women were more lonely than men also in adjusted analyses. Logistic regression analyses indicated that loss of a partner and poor mental health are prospectively related to loneliness among men and women, whereas other factors like becoming a partner, stable singlehood, and poor physical health were related to loneliness among women but not men.

Mitigating the Harmful Impact of Ageism among Older Individuals: The Buffering Role of Resilience Factors

Frequent exposure to ageism has significant repercussions on the quality of life and mental well-being/health of older adults. Resilience may play a crucial role in mitigating these effects. The current study aimed to investigate the potential buffering roles of two types of coping variables-behavioral coping and a positive appraisal style-in older adults (N = 2000, aged 55-93). Confirming previous findings, higher levels of perceived negative ageism (PNA) were associated with diminished quality of life and mental well-being, increased depression and loneliness. However, individuals that tend to employ behavioral coping strategies when confronted with challenging/stressful situations showed a weaker relationship between PNA and quality of life, mental well-being, and depression. Embracing a positive appraisal style attenuated the negative impact of PNA on feelings of depression and loneliness. Interestingly, younger older adults appeared to benefit the most from these resilience factors. Despite considerable inter-individual variability, encouraging the utilization of behavioral coping strategies and nurturing a positive appraisal style could serve as effective approaches to mitigate the detrimental effects of PNA.

Factors enabling comorbidities and secondary conditions in older adults with spinal cord injury

OBJECTIVE

To examine the role of personal, social, and environmental factors predicting comorbidities and secondary conditions among older adults with spinal cord injury (SCI).

DESIGN

Cross-sectional study utilizing survey methods were used to collect the data analyzed with two distinct general linear models.

SETTING

Community-dwelling participants who resided in rural and urban areas.

PARTICIPANTS

One hundred and eighty-three (183) participants with SCI ages 45 and over at least five years post injury.

INTERVENTIONS

Not applicable.

MEASURES

Spinal Cord Injury Secondary Conditions Scale (SCI-SCS); Comorbidities Questionnaire; Spinal Cord Injury Functional Index Assistive Technology (SCI-FI/AT) Basic - Mobility; Spinal Cord Injury Quality of Life (SCI-QOL) Satisfaction with Social Roles and Activities Scale (SSRA); Cohen's Social Network-Social Integration Index, the Medical Outcomes Study (MOS) Social Support Emotional/Informational Support Scale, and the Facilitators and Barriers Survey for Mobility (FABS-Mv2). Questions were also asked from the Behavioral Risk Factor Surveillance System (BRFSS).

RESULTS

Common predictors of comorbidities and secondary conditions included age, basic mobility, primary health care payer and parking limitations. An interaction between parking and neurological classification was observed for comorbidities. Neurological classification and employment were significantly associated with comorbidities while for secondary conditions, sex, years since injury, education, satisfaction with social roles and the home environment were critical factors.

CONCLUSIONS

Our study shows the effects of demographic and injury factors, physical functioning, satisfaction with social roles, access to home environment adaptations and health resources in predicting comorbidities and secondary conditions among older adults with SCI.

Risk factors for loneliness: A literature review

RATIONALE

Increasingly, loneliness is being recognised as a serious problem with detrimental effects on health, as well as on social cohesion and community trust. To effectively tackle this complex issue, a clear understanding of the phenomenon and its main drivers is needed. Over years of scientific research on loneliness, many potential risk factors have emerged and been tested empirically.

OBJECTIVE

This narrative review of 109 studies provides a concise summary of empirical evidence on the main potential risk factors for loneliness and presents an additional section dedicated to the COVID-19 pandemic.

METHOD

Given the very large number of existing studies, emphasis is placed on recent meta-analyses and systematic literature reviews as well as longitudinal studies. Similarly, given the large number of possible risk factors for loneliness, which may differ based on the geographical and cultural context, this review focuses on studies from Europe and North America.

RESULTS

The results show that demographic factors often correlate with loneliness, but in many cases the link becomes negligible when controlling for other factors. Often, physical and mental health problems are found to be associated with loneliness, and so are some psychological factors, such as neuroticism or extroversion. Loneliness also depends on the environment in which one lives, and possibly the broader socio-economic and socio-cultural contexts. Nevertheless, the review shows that ultimately everything comes down to the quantity and quality of social relationships. In particular, marital status, living arrangements and the characteristics of one's personal social network are quite consistently found to be among the strongest predictors of loneliness. These main findings about the risk factors for loneliness remained valid also during the COVID-19 pandemic.

POLICY IMPLICATIONS

The findings of this review have implications for policy, as understanding who the most vulnerable groups are is key for designing targeted policy solutions that tackle loneliness.

The association between psychosocial factors, protective factors, and its associated triggers with psychological distress among Bolivian adolescents

The purpose of this study is to investigate the association between psychosocial factors, protective factors, and its associated triggers with psychological distress among Bolivian adolescents. This cross-sectional study was conducted by investigating the 2018 Bolivia global school-based student health survey (GSHS). The total number of students who participated in this survey was 7931, and the final sample was 7377. The mean age of the participants was 15.3 years (SD = 1.4). Psychological distress was assessed with a 2-item screener (loneliness and worry induced sleep disturbance). In all 22.3% of participants reported experiencing psychological distress, with 18.1% among adolescent males and 26.2% among adolescent females. In adjusted logistic regression analysis (AOR, 95% CI), there are two significant directions of association. One is the negative association, such as parental involvement as a protective factor. School adolescents who had more parental involvement were less likely to experience psychological distress. Parents understand problems or worries (0.64, 0.54-0.75, p < .001) and parents disregard privacy (0.69, 0.58-0.82, p < .001). On the other hand, many psycho-social factors are significantly positively associated with psychological distress. School adolescents who experience more psychosocial factors are more likely to experience psychological distress. Physical assault in the previous year (1.83, 1.59-2.11, p < .001), being bullied at school (1.27, 1.07-1.52, p < .01), being bullied outside of school (1.36, 1.15-1.61, p < .001), and being cyberbullied (1.60, 1.37-1.88, p < .001), were all significantly associated with psychological distress. Healthy relationships in a family, and interventions to reduce violence and bullying, should be encouraged and promoted.

Thinking Beyond COVID-19: How Has the Pandemic Impacted Future Time Horizons?

Older age is reportedly protective against the detrimental psychological impacts of the COVID-19 pandemic, consistent with the theory that reduced future time extension (FTE) leads to prioritization of socioemotional well-being. We investigated whether depression severity and pandemic-related factors (regional severity, threat, social isolation) reduce FTE beyond chronological age and whether these relationships differ between younger and older adults. In May 2020, we recruited 248 adults (younger: 18-43 years, older: 55-80 years) from 13 industrialized nations. Multigroup path analysis found that depression severity was a better predictor of FTE than the reverse association in both age groups, suggesting an affective foreshortening of future time. In both age groups, older age was protective against depression severity, and younger age was associated with heightened vulnerability to the negative impacts of pandemic-related factors. Future research should consider the complex interrelationships between FTE, age, and depression severity and the potential impacts of the broader psychosocial milieu.

'... You feel like the one that got left behind': a narrative inquiry into the friendships of people who have endured mental health difficulties

AIMS

To explore insights between friendship and mental health through a critical narrative inquiry. To conceptualise friendship and inform public health approaches to loneliness and mental health.

METHOD

Seventeen interviews were conducted with middle-age people who had experienced mental health difficulties. Stories were subjected to a narrative analysis and interrogated further using critical theory.

RESULTS

Compassion in friendship reduces alterity and loneliness, and results in mutual discovery of dignity in relation to distress and stage of life. This is not achievable in all friendship.

CONCLUSION

The temporary encounter of friendship can provide new bases for authentically relating. Through dignity and authenticity, friendship can contribute to mental health and reduce loneliness. Suggestions are made to inform public health approaches to friendship.

What factors explain the changes in major depressive disorder symptoms by age group during the COVID-19 pandemic? A longitudinal study

BACKGROUND

Data collected during the COVID-19 pandemic suggest an increase in major depressive disorder (MDD) among younger adults. The current study aims to assess the association of age groups and MDD risk before and during the COVID-19 pandemic and quantify the effect of potential mediating variables such as loneliness, social support, resilience, and socioeconomic factors.

METHODS

A representative sample of Spanish adults was interviewed before (2019, N = 1880) and during (2020, N = 1103) the COVID-19 pandemic. MDD was assessed using the CIDI, loneliness through the UCLA scale, social support through the OSSS-3, resilience with the 6-BRS, and worsened economic circumstances and unemployment through a single question. Mixed-models were used to study changes in MDD by age group. Regression models were constructed to quantify the association between age and potential mediators, as well as their mediating effect on the association between age group and MDD.

RESULTS

Among the younger age cohorts (18-29 and 30-44 years) the probability of having MDD during the pandemic increased from 0.04 (95 % CI: 0.002-0.09) to 0.25 (0.12-0.39) and from 0.02 (-0.001-0.03) to 0.11 (0.04-0.17), respectively. Some 36.6 % of the association between age and risk of MDD during the pandemic was explained by loneliness (12.0 %), low resilience (10.7 %), and worsened economic situation (13.9 %).

LIMITATIONS

Reliance on self-report data and generalizability of the findings limited to the Spanish population.

CONCLUSIONS

Strategies to decrease the impact of a pandemic on depressive symptoms among young adults should address loneliness, provide tools to improve resilience, and enjoy improved financial support.

Friendship in Befriending? Older Service Users' Notions of Friendship in a Befriending Scheme

Social isolation and feelings of loneliness are main reasons that befriending services are approached by older adults. The promise of an individually matched volunteer, a befriender, paying them regular visits, offers hope of increased social interaction, meaningfulness, and connectedness in everyday life. The current consensus in qualitative research literature is that loneliness and isolation may be alleviated by such home visits. Still, the actual mechanisms of successful befriending have not been identified. In this small-scale qualitative study, we highlight older befriendees' notions of friendship in befriending. Drawing on in-depth interviews with seven Norwegian befriendees over the age of 80 years, we suggest that having a befriender visit regularly spurs a new bond and supports befriendees' notions of a relationship consistent with a traditional understanding of friendship. Our findings illustrate how the older befriendees identify and portray notions of friendship in terms of bonding, compatibility and meaningful activities, commitment, appreciation, and insecurities. Understanding how a formalized volunteer service is recognized and valued as a friendship may contribute to a better starting point for improving befriending services. Furthermore, it can improve our understanding of the significance of friendship in old age.

A systematic review evaluating loneliness assessment instruments in older adults

Introduction and objectives

The experiences and changes that come along with old age may lead to a feeling of loneliness, usually followed by negative physical and mental manifestations. In this systematic review, we evaluated the existing tools to assess loneliness in older adults.

Methods

We performed a literature search in the Web of Science, Medline, and PsycINFO, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After, we examined the psychometric properties of the instruments with a focus on reliability, validity, and main conclusions.

Results

We included 27 articles published between 1996 and 2021.

Conclusion

To date, there are few instruments to assess loneliness in older adults. In general, they present adequate psychometric properties, although it is true that some scales show somewhat low levels of reliability and validity.

Association between Loneliness, Mental Health Symptoms, and Treatment Use among Emerging Adults

Loneliness research has focused primarily on older adult populations. There is limited research on how loneliness and social support impact young people's mental health and mental health services use. This article reports an assessment of whether loneliness and social support are associated with mental health services use and mental health symptoms (psychological distress and suicidal ideation) among emerging adults. A subsample of emerging adults ages 18 to 29 (N = 307) was drawn from the 2017 Survey of Police-Public Encounters, a cross-sectional, general population survey administered to residents of New York City and Baltimore. Ordinary least squares and binary logistic regression analyses were performed to model associations between loneliness and mental health symptoms and services use outcomes. Emerging adults with higher levels of loneliness reported higher levels of distress and suicidal ideation. Having more social support, experiencing higher levels of distress, and suicidal ideation were associated with increased odds for using services. First-generation American emerging adults and Black emerging adults were less likely to use services than their U.S.-born and non-Black counterparts. The significant impact of loneliness on mental health symptoms and the effect of social support on service use highlight the importance of developing interventions to prevent and reduce loneliness over the life course.

Interdependencies Between Family and Friends in Daily Life: Personality Differences and Associations with Affective Well-Being Across the Lifespan

Family and friends are central to human life and well-being. Yet, interdependencies between family and friends have scarcely been examined. How is the relative frequency of daily contact with family and friends (i.e., the friends/family-ratio) related to personality and to well-being? In an experience sampling study with 396 participants (M age= 40 years, range 14-88 years, 52% females), we studied how the friends/family-ratio in contact differed along Big Five personality trait scores and was connected to affective well-being across six daily measurements on nine days (average of 55 assessments). Most participants reported more daily contact with family than friends (i.e. they held a family orientation), but individual differences were substantial. More agreeable individuals reported a greater family orientation. More extraverted individuals reported more positive affect in the company of friends than with family. Age moderated the effect of the friends/family-ratio on positive affect. Younger adults reported less positive affect in the company of family, yet older adults reported more positive affect in the company of family, the more they were friendship oriented. We discuss how examining the friends/family-ratio extends previous knowledge on personality differences in social relationships, and how the friends/family-ratio yields promising, yet challenging, future directions in personality-relationship associations.

The Association of Social Support and Loneliness with Symptoms of Depression, Anxiety, and Posttraumatic Stress during the COVID-19 Pandemic: A Meta-Analysis

BACKGROUND

Research suggests that changes in social support and loneliness have affected mental disorder symptoms during the COVID-19 pandemic. However, there are a lack of studies comparing the robustness of these associations.

AIMS

The aims were to estimate the strength of the associations of loneliness and social support with symptoms of depression, anxiety, and posttraumatic stress during the COVID-19 pandemic (2020-2022) in the general population.

METHOD

The method entailed a systematic review and random-effects meta-analysis of quantitative studies.

RESULTS

Seventy-three studies were included in the meta-analysis. The pooled correlations of the effect size of the association of loneliness with symptoms of depression, anxiety, and posttraumatic stress were 0.49, 0.40, and 0.38, respectively. The corresponding figures for social support were 0.29, 0.19, and 0.18, respectively. Subgroup analyses revealed that the strength of some associations could be influenced by the sociodemographic characteristics of the study samples, such as age, gender, region, and COVID-19 stringency index, and by methodological moderators, such as sample size, collection date, methodological quality, and the measurement scales.

CONCLUSIONS

Social support had a weak association with mental disorder symptoms during the COVID-19 pandemic while the association with loneliness was moderate. Strategies to address loneliness could be highly effective in reducing the impact of the pandemic on social relationships and mental health.

The Association of Age With Depression, Anxiety, and Posttraumatic Stress Symptoms During the COVID-19 Pandemic in Spain: The Role of Loneliness and Prepandemic Mental Disorder

OBJECTIVE

Older adults may be at lower risk of common mental disorders than younger adults during the coronavirus disease 2019 (COVID-19) pandemic. Previous research has shown shown differences by age in psychosocial well-being during the pandemic and have highlighted the moderating effect of prepandemic mental disorders on that association. In this line, we examined the association of age with self-reported symptoms of loneliness, depression, anxiety, and posttraumatic stress, as well as potential roles of loneliness symptoms and prepandemic mental disorders on the association between age and mental disorder symptoms.

METHODS

Cross-sectional data of 2000 adults in Spain interviewed by telephone during the COVID-19 pandemic (February-March 2021) were analyzed. Depression, anxiety, and posttraumatic stress were measured with the eight-item Patient Health Questionnaire, the seven-item Generalized Anxiety Disorder Scale, and the four-item checklist for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), respectively. Loneliness was measured with the three-item University of California at Los Angeles Loneliness Scale. Several regression models were constructed to assess factors related to loneliness and mental disorders.

RESULTS

According to cutoff points used, 12.4% of participants revealed depression, 11.9% revealed anxiety, and 11.6% revealed posttraumatic stress. Age was negatively related to mental disorder symptoms and loneliness. Loneliness was associated with higher levels of mental disorder symptoms. This association was stronger in younger adults without prepandemic mental disorders and in older adults with them. The association between age and loneliness was stronger in those with prepandemic mental disorders. Loneliness mediated the association of age with mental disorder symptoms.

CONCLUSIONS

Interventions focused on loneliness could alleviate the impact of the COVID-19 pandemic on mental health.

Effectiveness of a multicomponent intervention to reduce social isolation and loneliness in community-dwelling elders: A randomized clinical trial

AIMS

To assess the effect of a multicomponent intervention on reducing social isolation and loneliness and improving the quality of life in community-dwelling older adults.

DESIGN

A cluster-randomized controlled clinical trial.

METHODS

A total of 56 older adults participated in the control group and 63 older adults in the experimental group. The intervention consisted of 6 home-based face-to-face sessions, intercalated with 5 telephone calls and was conducted by nursing students and volunteer staff with experience in the subject. The study was conducted between April 2018 and December 2019. In terms of statistical analysis, several procedures were carried out: a statistical analysis per protocol and intention to treat, considering isolation, loneliness and quality of life as endpoints; a comparison of paired means, to analyse the behaviour of the outcome variables at baseline and the end of the study; and finally, a binary logistic regression analysis, considering social support as a dependent variable.

RESULTS

The study results do not show the effectiveness of the modified CARELINK programme, analysed as a whole, on the decrease in social isolation or loneliness or the improvement in HRQL. However, a detailed analysis of the behaviour of some of the variables during the study indicates some results that deserve to be commented on. Comparing the mean confidential support scores between the experimental and control group at the initial and final stages shows significant differences in the analysis by protocol, and close to statistical significance in the analysis by intention to treat. Comparing the paired means obtained in the experimental group, an improvement in emotional loneliness scores was found. Finally, the variables associated with the social support of the subjects at the end of the follow-up period were as follows: having people who help them and mobility.

CONCLUSION

Although the results obtained do not allow us to affirm that the intervention programme is effective, these same results point to improved confidential support and emotional loneliness in older adults participating in the intervention. Having people to help them and a greater degree of mobility are factors favouring the decrease in social isolation.

IMPACT

This study suggested that modified CARELINK, a multicomponent intervention performed by trained volunteers, could improve confidential support in community-dwelling older adults. It also reports the importance of considering the level of mobility and support networks as determinants of the improvement caused by the intervention.

Screening for loneliness in representative population samples: Validation of a single-item measure

BACKGROUND

Loneliness is a highly relevant public mental health issue. This work presents the validation of a single-item measure of loneliness and its subjective experience: "I am frequently alone/have few contacts". It can be used in large-scale population surveys where an economical assessment is of key importance.

METHODS

Data was drawn from two representative German population surveys conducted in early and late 2020 (combined N = 4,984; 52.9% women; age: M = 48.39 years (SD = 17.88)). We determined the prevalence of loneliness in men and women across different age groups. In order to test concurrent validity, bivariate correlation analyses and Chi-square tests were performed. Convergent and discriminant validity were tested by investigating intercorrelations of the single-item measure of loneliness with another loneliness measure, other mental health outcomes, and associations with sociodemographic characteristics.

RESULTS

Based on the single-item measure, 23.4% of participants reported some degree of loneliness, 3.4% among them severe loneliness. Comparisons with the LS-S showed similar prevalence rates of loneliness. A moderately positive relationship between the two loneliness measures was found by bivariate correlation analysis (ρ = .57, p < .001), but results indicated only weak convergent validity. Construct validity was supported by associations with depressive symptoms, anxiety symptoms, satisfaction with life, household size, and partnership.

CONCLUSIONS

Loneliness is frequently reported in the general population. The single-item measure of loneliness is suitable as a brief screening measure in population-based assessments.

Staying connected in old age: associations between bonding social capital, loneliness and well-being and the value of digital media

OBJECTIVES

We examined associations between age, bonding social capital (BSC), loneliness and psychological, social and emotional well-being in old age. As in theory digital media can support both preservation of and access to someone's social capital, we also explored associations between the use of WhatsApp, social network sites (SNS) and Internet applications and respectively BSC and loneliness.

METHOD

In this cross-sectional study a sample of 349 older adults (range = 70y-93y; Mean(SD)=74.8y(4.9y); 59.6% male) filled out a questionnaire including the bonding social capital subscale of the personal social capital scale for elderly (PSCSE), validated scales measuring social, emotional, and psychological well-being and loneliness, the SNS intensity scale and items measuring frequencies of Whatsapp use and use of various Internet functions. Also relevant demographic and other covariates were included.

RESULTS

Regression analyses including relevant covariates confirmed our hypotheses, finding negative associations between BSC and both age and loneliness, and positive associations between BSC and psychological, social and emotional well-being. WhatsApp and Internet use were both found positively associated with BSC, whilst a negative association between WhatsApp use and loneliness was found. SNS use was not associated with BSC nor with loneliness.

CONCLUSION

Our findings indicate BSC as an important factor in positive aging and illustrate a widening gap between the need for socio-emotional resources versus their availability. With regard to digital media, we conclude that its value in old age should be sought in providing access to one's bonding social capital rather than adding to it by expanding the number of social relations.

Understanding perspectives of older adults on the role of technology in the wider context of their social relationships

Technological interventions are increasingly popular methods of targeting and preventing loneliness in older adults. Research has identified various factors that influence the willingness and propensity of older adults to integrate technology into their social lives and the ways in which this may enhance their social connectedness. Given prevalence rates and negative outcomes associated with loneliness for this population, further research is warranted to clarify the mechanisms through which technological interventions may decrease loneliness. This study aimed to better understand the perspectives of older adults on the role of technology in their social relationships in later life. Four focus groups were conducted with 27 older adults, aged 65–80 years. Transcripts were analysed using thematic analysis, and results were validated via written participant feedback. Participants reported technology as one of many tools used to maintain their social relationships. Their choice to use technology for social interaction was influenced by their estimation of effort required, likely quality of the interaction, and the privacy and security provided. These factors were the same as those that influenced decisions to use other methods (e.g. face-to-face meetings). Based on the results, we recommend that loneliness interventions should be technology-agnostic and multifaceted, providing a wide range of tools that recognise the technological competencies of older adults and supporting different interaction types to meet the preferences of the individual.

Examining Differences, Relationships, and Predictors for Loneliness in an Adult Population: The Roles of Personal Characteristics, Place of Residence, Leisure Activities, Mental Health, and Social Outcomes

Loneliness is associated with poor mental and social outcomes globally. The literature suggests an association between loneliness and personal characteristics, place of residence, and leisure activities. However, the current literature has produced inconsistent findings and has focused largely on older adults. This study is one of the first to examine the differences, relationships, and predictors of loneliness in an adult population, and the roles of personal characteristics, place of residence, leisure activities, mental health, and social outcomes. A cross-sectional online survey was undertaken. A sample of 155 adults responded, with a mean age of 34.5 years (SD = 13.2), and with 54.1% identifying as female. An analysis revealed experiences of loneliness across the sample. In addition, age was moderately associated with loneliness, while psychological distress, depressive symptoms, and social networks were significantly associated with loneliness. Depressive symptoms were a positive predictor for loneliness, and social networks were a negative predictor for loneliness. This study has confirmed findings from previous research and provided new information on loneliness, which can guide future research and interventions to prevent or support people who suffer from loneliness.

Population Aging, Demographic Metabolism, and the Rising Tide of Late Middle Age to Older Adult Loneliness around the World

This study examines how population aging will shape a crucial aspect of mental health and social well-being - loneliness. Drawing on theories of demographic metabolism, United Nations' population estimates and projections, and survey data covering approximately 50% of the world's population aged 50 and above living in 27 countries, we estimate the role of population aging in shaping cross-national differences in loneliness from 1990 to 2050. We use survey data to estimate the prevalence of late middle age and older adult loneliness by age and sex, and then apply these rates to the evolving age and sex distributions of the populations. Our results highlight massive increases in loneliness at ages 50 and above with a tripling of the number of lonely adults in these age groups in our sample countries from 104.9 million in 1990 to 333.5 million in 2050, increasing variability across countries in the share of their populations composed of lonely adults 50 and above, and the feminization of global later life loneliness with an increasing share of lonely adults in these age ranges being women. These results illustrate the power of demographic modeling to advance understandings of national profiles of mental health and social well-being.

Friendships, loneliness and psychological wellbeing in older adults: a limit to the benefit of the number of friends

Loneliness is linked to many negative health outcomes and places strain on the economy and the National Health Service in the United Kingdom. To combat these issues, the determinants of loneliness need to be fully understood. Although friendships have been shown to be particularly important in relation to loneliness in older adults, this association has thus far not been explored more closely. Our exploratory study examines the relationship between number of friends and loneliness, depression, anxiety and stress in older adults. Data were obtained from 335 older adults via completion of an online survey. Measures included loneliness (UCLA Loneliness Scale version 3), depression, anxiety and stress (Depression Anxiety Stress Scales DASS-21). Participants also reported their number of close friends. Regression analyses revealed an inverse curvilinear relationship between number of friends and each of the measures tested. Breakpoint analyses demonstrated a threshold for the effect of number of friends on each of the measures (loneliness = 4, depression = 2, anxiety = 3, stress = 2). The results suggest that there is a limit to the benefit of increasing the number of friends in older adults for each of these measures. The elucidation of these optimal thresholds can inform the practice of those involved in loneliness interventions for older adults. These interventions can become more targeted; focusing on either establishing four close friendships, increasing the emotional closeness of existing friendships or concentrating resources on other determinants of loneliness in this population.

Links between Best Friendship, Romantic Relationship, and Psychological Well-Being in Emerging Adulthood

Best friendships and romantic relationships are linked to psychological well-being in emerging adulthood, but few studies have assessed their contribution simultaneously. This research (n = 190; 64.4% women) examined the links between intimacy and conflict with the best friend and the romantic partner on psychological well-being (self-esteem, depression, loneliness). Results showed that both relationships were independently linked to well-being, while also interacting with one another. Among participants reporting a less intimate or conflictual romantic relationship, an intimate best friendship was linked to higher self-esteem. Moreover, a conflictual best friendship was related to higher depressive symptoms only among those having a conflictual romantic relationship. Thus, best friendships and romantic relationships show distinct and combined contributions to well-being in emerging adulthood.

Social attitudes and activities associated with loneliness: Findings from a New Zealand national survey of the adult population

There has been growing recognition of the harmful consequences of loneliness for health and well-being, and the need for community intervention, particularly in times of global crisis such as the Covid-19 pandemic with its imperatives of distancing, isolation, and quarantine. Social capital and a sense of social cohesion are known to have roles in buffering against the effects of adverse life circumstances. Our study sought to investigate the association of a range of social attitudes and activities - as proxies for social capital - with loneliness while taking into account socio-demographic factors. We undertook a national survey on a stratified random sample of the New Zealand (NZ) adult population aged 18+ in 2017 (n = 1,358), data from which included the requisite variables. The prevalence of loneliness was highest in young adults (18-30), falling with age until a slight rise in older people (76+). Loneliness was associated with socio-demographic factors, being more prevalent in the more disadvantaged groups: the deprived, Māori (the indigenous people of NZ), the non-partnered, and the less educated. Controlling for these socio-demographic factors, pro-social attitudes (that is towards political efficacy, trust in others, not feeling exploited, or being committed to family) and participation in social activities (that is being employed or being involved in recreation groups) - were protective against loneliness. Our study supports asset-based approaches to tackling loneliness - with implications for health and social care - that emphasise mobilising existing social resources, building social capital, and raising social cohesion in our communities. Such intervention on loneliness would help to prevent and ameliorate its detrimental consequences for public health.

Age differences in the association between loneliness and anxiety symptoms during the COVID-19 pandemic

Loneliness and associated mental health problems are of particular concern during the COVID-19 pandemic due to physical distancing and lockdown restrictions. Loneliness is most common among young adults and women during the pandemic, but it is unclear if the association between loneliness and mental health problems, notably anxiety, is strongest in these groups. The objective of this study was to examine whether the association between loneliness and anxiety differed by age and/or gender during the pandemic. We analyzed data from a multi-wave national online survey of Canadians aged 18+ years from May 2020 to March 2021 (n = 7,021). Multivariable modified least-squares regression was used to examine whether the association between loneliness and moderate to severe anxiety symptoms (GAD-7 10+) differed by age and/or gender on the additive scale, controlling for socio-demographic factors, depression, hopefulness, and survey wave. Age significantly moderated the association between loneliness and anxiety symptoms while gender did not. Loneliness was associated with anxiety symptoms for all age groups, but the association was not as strong among those aged 70+ years compared to other age groups. Evidence-based loneliness interventions that target younger adults are needed to mitigate the mental health effects of infectious disease events such as COVID-19.

Psychometric assessment of scales for measuring loneliness and social isolation: an analysis of the household, income and labour dynamics in Australia (HILDA) survey

BACKGROUND

Loneliness and social isolation are increasingly recognised as global public health threats, meaning that reliable and valid measures are needed to monitor these conditions at a population level. We aimed to determine if robust and practical scales could be derived for conditions such as loneliness and social isolation using items from a national survey.

METHODS

We conducted psychometric analyses of ten items in two waves of the Household, Income and Labour Dynamics in Australia Survey, which included over 15,000 participants. We used the Hull method, exploratory structural equation modelling, and multidimensional item response theory analysis in a calibration sample to determine the number of factors and items within each factor. We cross-validated the factor structure using confirmatory factor analysis in a validation sample. We assessed construct validity by comparing the resulting sub-scales with measures for psychological distress and mental well-being.

RESULTS

Calibration and cross-validation consistently revealed a three-factor model, with sub-scales reflecting constructs of loneliness and social isolation. Sub-scales showed high reliability and measurement invariance across waves, gender, and age. Construct validity was supported by significant correlations between the sub-scales and measures of psychological distress and mental health. Individuals who met threshold criteria for loneliness and social isolation had consistently greater odds of being psychologically distressed and having poor mental health than those who did not.

CONCLUSIONS

These derived scales provide robust and practical measures of loneliness and social isolation for population-based research.

Coping in the Emergency Medical Services: Associations With the Personnel's Stress, Self-Efficacy, Job Satisfaction, and Health

Background

Emergency Medical Services personnel (EMSP) are recurrently exposed to chronic and traumatic stressors in their occupation. Effective coping with occupational stressors plays a key role in enabling their health and overall well-being. In this study, we examined the habitual use of coping strategies in EMSP and analyzed associations of coping with the personnel's health and well-being.

Method

A total of N = 106 German Red Cross EMSP participated in a cross-sectional survey involving standardized questionnaires to report habitual use of different coping strategies (using the Brief-COPE), their work-related stress, work-related self-efficacy, job satisfaction, as well as mental and physical stress symptoms.

Results

A confirmatory factor analysis corroborated seven coping factors which have been identified in a previous study among Italian emergency workers. Correlation analyses indicated the coping factor "self-criticism" is associated with more work-related stress, lower job satisfaction, and higher depressive, posttraumatic, and physical stress symptoms. Although commonly viewed as adaptive coping, the coping factors "support/venting", "active coping/planning", "humor", "religion", and "positive reappraisal" were not related to health and well-being in EMSP. Exploratory correlation analyses suggested that only "acceptance" was linked to better well-being and self-efficacy in EMSP.

Conclusion

Our results emphasize the need for in-depth investigation of adaptive coping in EMSP to advance occupation-specific prevention measures.

Loneliness and mental well-being in the Polish population during the COVID-19 pandemic: a cross-sectional study

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.

Can Acting Out Online Improve Adolescents' Well-Being During Contact Restrictions? A First Insight Into the Dysfunctional Role of Cyberbullying and the Need to Belong in Well-Being During COVID-19 Pandemic-Related Contact Restrictions

Connecting with peers online to overcome social isolation has become particularly important during the pandemic-related school closures across many countries. In the context of contact restrictions, feelings of isolation and loneliness are more prevalent and the regulation of these negative emotions to maintain a positive well-being challenges adolescents. This is especially the case for those individuals who might have a high need to belong and difficulties in emotional competences. The difficult social situation during contact restrictions, more time for online communication and maladaptive emotion regulation might lead to aggressive communication patterns in the form of cyberbullying perpetration. In an online study with N = 205 adolescents aged 14–19 (M = 15.83, SD = 1.44; 57% girls), we assessed the frequency of online and offline contacts, need to belong, emotion regulation problems, feelings of loneliness, and cyberbullying perpetration as predictors of adolescents’ well-being. In particular, we explored whether cyberbullying perpetration might function as a maladaptive strategy to deal with feelings of loneliness and therefore predicts well-being. This effect was expected to be stronger for those with a higher need to belong and with higher emotion regulation problems. Results of a hierarchical regression analysis revealed that well-being was significantly predicted by less emotion regulation difficulties, less feeling isolated and more cyberbullying perpetration. We also tested whether the need to belong or emotion regulation problems moderated the association between cyberbullying and well-being. While the results for emotion regulation problems were not significant, the moderation effect for the need to belong was significant: For students with a high need to belong, well-being was more strongly related to cyberbullying perpetration than for students with a medium need to belong. For students with a low need to belong, cyberbullying was not significantly associated with well-being. That cyberbullying perpetration predicted well-being positively is rather surprising in the light of previous research showing negative psychosocial outcomes also for cyberbullying perpetrators. The moderation analysis provides a hint at underlying processes: In times of distance learning and contact restrictions, cyberbullying may be a way of coming into contact with others and to regulate loneliness maladaptively.

Loneliness from Young Adulthood to Old Age: Explaining Age Differences in Loneliness

Prior research in non-U.S. samples has found a complex nonlinear relationship between loneliness and age. This research has shown that established predictors of loneliness - poor health, being unmarried, living alone, and having infrequent social interactions - help to explain age differences in loneliness. However, while some variables were found to be universal predictors of loneliness at all ages, others were relevant in specific age groups only. In this study, we describe age differences in frequency of loneliness from age 18 to 89+ years in the U.S., and examine age differences in predictors of loneliness from age-specificity and age-normative perspectives. We used cross-sectional nationally representative data from the General Social Survey (N = 2,477) and found a nonlinear relationship between age and loneliness that closely resembles prior research. However, we found no evidence for age-specific predictors of loneliness. Household income, household size, marital status, health, and frequency of socializing were "universal" predictors of loneliness; their associations with loneliness did not differ in strength with age. Our hypothesis that individuals who deviated from age-specific norms would experience more intense loneliness was not supported. Implications for research and loneliness interventions are discussed.

Tell Me about Loneliness: Interviews with Young People about What Loneliness Is and How to Cope with It

Background: loneliness is a common experience for adolescents, yet the voices of adolescents are missing from current conceptualisations of loneliness. That means, measures that have been created based on current conceptualisations may miss important contexts of adolescence, such as the roles of friendships, that determine the way loneliness is experienced. The current study aims to centre adolescent voices to identify how they conceptualise loneliness and what strategies they consider to be useful for adolescents to cope with loneliness. Method: thematic framework analysis (TFA) was conducted on qualitative interviews with young people aged 8–14 years in Belgium and Italy to identify salient themes in their conceptualisations of loneliness. Results: Loneliness was conceptualised as a negative emotional state involving negative thinking patterns that occurs when an individual perceives they are missing out on a desired aspect in their social relationships. Coping strategies related to alleviating negative affect, and aiding social reconnection. Conclusions: friendships with peers were understood to be central to adolescent loneliness experiences. In line with that, loneliness was seen to be experienced at school. Age-related differences in friendship expectations were identified, highlighting how developmental needs relate to the loneliness experience.

Relationship dissolution in the friendships of emerging adults: How, when, and why?

Maintaining high-quality friendships is a key predictor of well-being during emerging adulthood, yet factors leading to friendship dissolution-defined here as actions that may decrease friendship quality or end the relationship completely-are poorly understood. Using an open-ended interview paradigm, we elicited 179 emerging adults' (55.9% female; M_age = 20.42, SD = 1.54; 95.0% full-time university students) description of their behavioral responses to 53 hypothetical vignettes involving challenging situations with same-gender friends. We systematically coded participants' 9,487 verbatim responses, identifying three types of friendship dissolution behaviors: completely ending the friendship, distancing from the friend, or compartmentalizing aspects of the friendship. Examining the occurrence of each response across different types of challenging situations, we found that transgressions by friends were more likely to elicit reported use of distancing and ending strategies. We also began to investigate associations between interpersonal goals and dissolution strategies, finding that stronger endorsement of the goal of asserting oneself was linked to greater odds of reporting ending the friendship, whereas the more participants reported that they would be trying to stay friends, the lower the odds of reporting either ending the relationship or distancing from the friend. Implications for future research on interpersonal processes in friendships are discussed.

Psychological Factors, Leisure Activities, and Satisfaction during the COVID-19 Pandemic: A Cross-Sectional Study in Eleven Spanish-Speaking Countries

The COVID-19 pandemic has affected the lives of millions of people worldwide. This study aimed to analyze the effects of several psychological factors (self-esteem, self-control, and emotional stability) over lifestyle-related variables (time spent on leisure activities) and the levels of satisfaction (family, friends, work, and leisure satisfaction) experienced during the COVID-19 outbreak. Data for this article were retrieved as part of a cross-sectional international study conducted in eleven Spanish-speaking countries between March and September 2020. The analyses were conducted using the responses of 9500 persons (65.95% women, 34.05% men). Structural equation modeling was used to test the direct and indirect effects of the psychological variables on satisfaction variables mediated by the time engaged in leisure activities. Our model indicated that psychological factors significantly predicted the amount of time spent in leisure activities and satisfaction. Overall, results indicate that self-esteem is a relevant psychological factor to consider in the development of psychological interventions directed at promoting healthy lifestyles. Nevertheless, further research is needed to validate the direction of the associations found in this study.

Loneliness in older adult mental health services during the COVID-19 pandemic and before: Associations with disability, functioning and pharmacotherapy

OBJECTIVES

Loneliness is associated with psychiatric morbidity. Restrictions placed on the population during the first COVID-19 lockdown may have disproportionately affected older adults, possibly through increasing loneliness. We sought to investigate this by examining loneliness in referrals to mental health of older adults (MHOA) services during the first UK COVID-19 lockdown.

METHODS

Referrals to MHOA services from a large South London catchment area were identified for the 16-week period of the UK lockdown starting in March 2020 and for the corresponding period in 2019. A natural language processing algorithm identified loneliness in the patients' records. We applied logistic regression models adjusted for age, gender, ethnicity and diagnosis, to examine associations of loneliness in the study population.

RESULTS

1991 referrals were identified, 56.9% of whom were female, with a mean age of 77.9 years. Only 26.9% occurred during the 2020 lockdown, but with a higher prevalence of loneliness (22.0 vs. 17.7%, p = 0.028). In the whole sample, loneliness was associated with non-accidental self-injury (Odds ratio [OR]: 1.65), depressed mood (OR: 1.73), psychotic symptoms (OR: 1.65), relationship problems (OR: 1.49), problems with daytime activities (OR: 1.36), and antidepressant use (OR: 2.11). During lockdown, loneliness was associated with non-accidental self-injury (OR: 2.52), problem drinking or drug-taking (OR 2.33), and antidepressant use (OR 2.10).

CONCLUSIONS

Loneliness is associated with more severe symptoms of affective illness, worse functional problems and increased use of antidepressant medication in older adults. During lockdown, loneliness in referrals to MHOA services increased and was associated with increased risk-taking behaviour. Loneliness is a potential modifiable risk factor for mental illness, and efforts to minimise it in older adults should be prioritised as we emerge from the pandemic.

Friendships in Old Age: Daily Encounters and Emotional Well-Being

OBJECTIVES

Having friends in old age is linked to higher levels of happiness and life satisfaction. Yet, we know little about older adults' emotional experiences when they encounter friends throughout the day. This study examined whether older adults reported (a) more pleasantness, (b) fewer conversations about stressful experiences, and (c) better mood when they had contact with friends compared to when they had contact with other social partners or were alone throughout the day. We also examined whether these experiences varied by the friendship closeness.

METHOD

Adults aged 65+ (n = 313) from the Daily Experiences and Well-being Study provided background information and listed and described their close social partners. Participants then completed ecological momentary assessment (EMA) surveys every 3 hr for 5 to 6 days where they reported their encounters with social partners, rated the pleasantness and indicated whether they discussed stressful issues during these encounters, and rated positive and negative mood.

RESULTS

Multilevel models revealed that encounters with friends were more pleasant and were associated with fewer discussions about stressful experiences compared to encounters with romantic partners or family members throughout the day. Encounters with friends were also associated with better mood, though this link only held for encounters with friends who were not considered close.

DISCUSSION

Findings are discussed in terms of functionalist theory, socioemotional selectivity theory, relationship ambivalence, and the benefits of less close ties. This work facilitates the understanding of how daily contact with friends can promote older adults' emotional well-being.

Associations of the Initial COVID-19 Lockdown on Self-Reported Happiness and Worry about Developing Loneliness: A Cross-Sectional Analysis of Rural, Regional, and Urban Australian Communities

Australia adopted hard lockdown measures to eliminate community transmission of COVID-19. Lockdown imposes periods of social isolation that contributes to increased levels of stress, anxiety, depression, loneliness, and worry. We examined whether lockdowns have similar psychosocial associations across rural and urban areas and whether associations existed between happiness and worry of loneliness in the initial wave of the COVID-19 pandemic in Australia. Data were collected using the "COVID-19 Living Survey" between 13 and 20 May 2020 by BehaviourWorks Australia at the Monash Sustainable Development Institute. The mean self-reported feeling of happiness and anxiousness (N = 1593), on a 10-point Likert scale with 0 being least happy or highly anxious, was 6.5 (SD = 2.4) and 3.9 (2.9), respectively. Factors associated with happiness were older age and having a postgraduate education. Participants worried about becoming lonely also exhibited reduced happiness (estimate = -1.58, 95%CI = -1.84--1.32) and higher anxiousness (2.22, 1.93-2.51) scores, and these conditions remained associated after adjusting for demographics. Interestingly, worry about loneliness was greater in rural areas than in urban communities. The negative impact of the COVID-19 lockdown on rural youth and those less-educated was evident. Participants in rural Australia who were worried about becoming lonely were reportedly less happy than participants in major cities. This dataset provides a better understanding of factors that influence psychological well-being and quality of life in the Australian population and helps to determine whether happiness may be an associative factor that could mitigate self-feelings of anxiety and worry about loneliness.

Anxiety, Loneliness, Drug Craving, and Depression Among Substance Abusers in Sichuan Province, China

Studies have reported that anxiety had a positive effect on depression among substance abusers in males. However, little is known about the mechanism underlying this relationship in substance abusers in males. The purpose of this study was to investigate the mediating effect of loneliness and drug craving between anxiety and depression in substance abusers in males. State-Trait Anxiety Inventory, The UCLA Loneliness Scale, Drug Craving Scale, and The Center for Epidemiologic Studies Depression Scale were employed into this study to investigate 585 substance abusers in males (age range of 20–58 years: M = 33.21, SD = 6.97). Structural equation modeling and the bootstrap approach were used to analyze the mediating effect of loneliness and drug craving on the relationship between anxiety and depression. The results indicated that: Loneliness had a significant positive correlation with anxiety (r = 0.37, p < 0.001) and depression (r = 0.49, p < 0.001); Drug craving had a significant positive correlation with anxiety (r = 0.28, p < 0.001) and depression (r = 0.39, p < 0.001). Loneliness and drug craving mediated the link between anxiety and depression. There was a significant positive correlation between substance abusers in male’s anxiety, loneliness, drug craving, and depression. Loneliness and drug craving had a significant mediating effect on the relationship between anxiety and depression. Therefore, it was suggested that substance abusers in male’s anxiety and depression might be improved and driven by decreasing loneliness and drug craving. Targeted interventions to decrease substance abusers in male’s loneliness and drug craving should be developed, implemented, and help them to recover.

Predictors and consequences of loneliness during the COVID-19 Pandemic

The COVID-19 pandemic has created a global context in which social isolation has become normative in order to reduce the risk of COVID-19 transmission. As a result of social distancing policies, the risk for loneliness and associated decline in quality of life has increased. The current study examined factors associated with loneliness and quality of life during the COVID-19 pandemic cross-sectionally (n = 797) and longitudinally (n = 395). Older age and larger social network size were associated with less loneliness, whereas having multiple physical or mental health diagnoses was associated with greater loneliness. Greater virtual social contact was also associated with increased loneliness. Greater loneliness was associated with all domains of quality of life both cross-sectionally and longitudinally. Understanding factors associated with loneliness is critical to developing effective strategies at reducing loneliness and improving quality of life during the pandemic. Contrary to popular perceptions, older age was associated with less loneliness and more virtual social contact was associated with more loneliness. Thus, it may be prudent to deemphasize virtual social contact in public campaigns and to emphasize safe methods of interacting in person.

Loneliness in the COVID-19 pandemic: Associations with age, gender and their interaction

Loneliness is associated with mental health and thus is of particular concern in the COVID-19 pandemic, due to physical distancing restrictions and shelter-in-place orders. The current study assessed the associations of age, gender and their interaction with loneliness during the COVID-19 pandemic, controlling for other sociodemographic variables. A pooled sample of 3,012 English-speaking Canadian adults aged 18+ years completed a web-based survey in one of three waves between May 8 and June 23, 2020. Multivariable logistic regression was used to examine the associations of loneliness with age and gender controlling for marital status, household income, education, living alone, employment situation, and survey wave. A likelihood ratio test assessed the model with interaction between age and gender included. Approximately 8.4% of the sample reported feeling lonely 5+ days in the past week. The regression model with main effects found greater odds of loneliness among women than men (AOR = 1.76, 95%CI = 1.32, 2.34) and among all age groups younger than 60 years compared to those aged 60+ years (p = 0.002). In the final regression model, a significant interaction effect between age and gender on loneliness was found. The interaction showed that women had greater odds of loneliness than men among those aged 18-29 years (AOR = 3.53, 95%CI = 1.69, 7.37) and 60+ years (AOR = 2.62, 95%CI = 1.33, 5.17). Special consideration of loneliness among younger and older adult women is needed in service planning. Given inconsistencies with pre-pandemic studies, detailed data collected during the current crisis is essential to inform proactive resource allocation to prevent and treat mental health consequences of the pandemic.

Loneliness Among College Students: The Influence of Targeted Messages on Befriending

The objective of the current research was to examine the influence of targeted messages in increasing helping behaviors towards lonely individuals. Previous research on loneliness interventions typically focuses on the lonely individual and working to reduce feelings of loneliness. The current study expands on this research by targeting individuals around lonely others to notice and consider helping those who might be lonely. Five targeted messages, based on Latané and Darley's (1970) bystander intervention model, were utilized. These messages included a "notice" condition (increasing awareness of lonely others), an "assume responsibility" condition (awareness and responsibility towards helping lonely others), a "decide" condition (awareness, responsibility, and steps to reach out to lonely others), and two control conditions. Participants in the "decide" condition were significantly more likely to report feeling prepared to help lonely others in the future. Those in the "assume responsibility" and "decide" conditions also reported more awareness of lonely individuals during a one-week follow-up. Overall, findings indicate that it might be advantageous to approach reducing loneliness from the perspective of those around lonely individuals. Future research and implications of these findings are discussed.

Loss of friends and psychological well-being of older Chinese immigrants

BACKGROUND AND OBJECTIVES

Focusing on a less studied aspect of friendship and an overlooked type of loss, this study examined associations between loss of friends and psychological well-being among older Chinese immigrants and whether such associations are moderated by age, gender, marital status, and social connection.

RESEARCH METHODS

This study used baseline data from the Population Study of Chinese Elderly in Chicago. Linear and logistic regressions tested whether the loss of friends was associated depressive symptoms, loneliness, and quality of life . Interaction terms were created to test the moderating effects .

RESULTS

Losing friends was associated with a greater sense of loneliness but also a higher chance of reporting good quality of life. The association between the loss of friends and loneliness was stronger among married and young-old (59-69) participants . The association between the loss of friends and quality of life was stronger among young-old and old-old (70-79) participants and the participants with the high level of social connection.

DISCUSSION AND IMPLICATIONS

Findings shed light on the importance of the loss of friends in shaping psychological well-being among older immigrants. More research is needed to understand the needs of older friend survivors and develop relevant interventions.

Are friends electric? The benefits and risks of human-robot relationships

Social robots that can interact and communicate with people are growing in popularity for use at home and in customer-service, education, and healthcare settings. Although growing evidence suggests that co-operative and emotionally aligned social robots could benefit users across the lifespan, controversy continues about the ethical implications of these devices and their potential harms. In this perspective, we explore this balance between benefit and risk through the lens of human-robot relationships. We review the definitions and purposes of social robots, explore their philosophical and psychological status, and relate research on human-human and human-animal relationships to the emerging literature on human-robot relationships. Advocating a relational rather than essentialist view, we consider the balance of benefits and harms that can arise from different types of relationship with social robots and conclude by considering the role of researchers in understanding the ethical and societal impacts of social robotics.

A Closer Look at Loneliness: Why Do First-Generation Migrants Feel More Lonely Than Their Native Dutch Counterparts?

Background and Objectives

Along with the current aging demographics in the Netherlands, the number of older first-generation migrants is also increasing. Despite studies suggesting a higher quantity of social contacts of migrants, loneliness is more common among migrants as compared to native Dutch. We theorize that migrants experience more emotional and social loneliness due to a lower satisfaction with social relationships and lower participation in social activities, respectively, compared to their native counterparts.

Research Design and Methods

We use data from Statistics Netherlands (N = 7,920) with first-generation migrants aged 40 years and older and their Dutch counterparts. Contact frequency, household composition, satisfaction with social relationships, relationship quality with the partner, and social activities, are used as main predictors and separate regression models for social and emotional loneliness are analyzed.

Results

Compared to the native Dutch, first-generation migrants are both socially and emotionally more lonely. Migrants have a similar contact frequency as the native Dutch, but are less satisfied with their social relationships, which contributes to their higher emotional, social, and overall loneliness. Migrants engage less in social activities but this does not put them at additional risk of loneliness.

Discussion and Implications

Migrants experience more social and emotional loneliness and are less satisfied with their social relationships compared to their native counterparts. Interventions should focus on reducing both social and emotional loneliness among older migrants. Specific attention should be paid to fostering satisfying social interactions. Additionally, encouraging migrants to broaden their social network may reduce social loneliness.

Understanding loneliness in the twenty-first century: an update on correlates, risk factors, and potential solutions

PURPOSE

Loneliness is increasingly recognised as the next critical public health issue. A plausible reason for this concern may be related to emerging societal trends affecting the way we relate, communicate, and function in our social environment. In 2006, a prominent review of the clinical significance of loneliness was published. However, there has not been a comprehensive update on known and emerging risk factors and correlates of loneliness since then. Furthermore, there is no conceptual model that has been developed to better account for the complexity of loneliness and to inform the development of evidence-based solutions as we challenge the issues of the twenty-first century.

METHODS

We reviewed the current literature to identify either known or emerging risk factors and correlates of loneliness since 2006. This includes new or known evidence on: (1) demography; (2) health, including physical health; mental health; cognitive health; brain, biology, and genetics; and (3) socio-environmental factors including digital communication and the workplace.

RESULTS

We synthesized the literature according to a new proposed conceptual model of loneliness which showed the interplay between known and emerging correlates and risk factors from demography, health, to socio-environmental factors. In the conceptual model of loneliness, we illustrated how solutions can be delivered and tailored to an individual based on their life circumstances and preferences.

CONCLUSION

We concluded by making specific recommendations in advancing our scientific understanding of loneliness. Our knowledge can only be deepened if we increase scientific rigour via accounting for confounding variables and using longitudinal, multi-disciplinary, and multiple methodologies in research. We also call for the rigorous evaluation of programs targeting loneliness.

Risk factors for loneliness: The high relative importance of age versus other factors

Loneliness is a potent predictor of negative health outcomes, making it important to identify risk factors for loneliness. Though extant studies have identified characteristics associated with loneliness, less is known about the cumulative and relative importance of these factors, and how their interaction may impact loneliness. Here, 4,885 individuals ages 10-97 years from the US completed the three-item UCLA Loneliness Survey on TestMyBrain.org. Using census data, we calculated the population and community household income of participants' census area, and the proportion of individuals in the participant's census area that shared the participant's demographic characteristics (i.e., sociodemographic density). We evaluated the relative importance of three classes of variables for loneliness risk: those related to the person (e.g., age), place (e.g., community household income), and the interaction of person X place (sociodemographic density). We find that loneliness is highly prevalent and best explained by person (age) and place (community household income) characteristics. Of the variance in loneliness accounted for, the overwhelming majority was explained by age with loneliness peaking at 19 years and declining thereafter. The congruence between one's sociodemographic characteristics and that of one's neighborhood had no impact on loneliness. These data may have important implications for public health interventions.

Aging With a Physical Disability, Duration of Disability, and Life Satisfaction: A 5-Year Longitudinal Study Among People Aged 40 to 79 Years

Studies show that having physical disabilities is associated with lower life satisfaction (LS). People with disabilities have reduced opportunities and welfare compared with people without disabilities. During aging, disabilities may have different impact on LS. A question is whether disability duration plays a unique role by affecting LS or whether an association is caused by other factors. This study analyzed Norwegian panel data (N = 2,555) including people aged 40 to 79 years at baseline to examine how disability and its duration affect LS at follow-up 5 years later, controlling for sociodemographic, socioeconomic, and health factors using ordinary least-squares regression. People with disabilities had lower LS than those without disabilities. Disability duration affected LS among people aged 40 to 49 years and 60 to 69 years, but the association was due to the lack of social, economic, and health resources. The meaning of duration of disability and challenges of reduced resources will vary with life stages.