Having friends and feeling lonely: a daily process examination of transient loneliness, socialization, and drinking behavior

Differential impact of emotional and social loneliness on daily alcohol consumption in individuals with alcohol use disorder

BACKGROUND

Loneliness is a predisposing and maintaining factor of alcohol use behavior. Several studies have linked loneliness to daily drinking and elevated alcohol use disorder (AUD) risk; however, operationalizations of both loneliness and drinking have varied greatly.

METHODS

The current study adopted a multidimensional framework of loneliness (i.e., emotional and social subtypes) to examine daily prospective relations between loneliness and drinking among non-treatment seeking individuals with AUD. Participants (N= 60) reported on current loneliness and drinking twice daily for 14-days. Scores on emotional and social loneliness were disaggregated into within- and between-person predictors, and a multilevel hurdle model proxy was fitted with drinking likelihood (logistic) and quantity (zero truncated negative binomial) specified as separate outcomes.

RESULTS

Emotional loneliness (within-person) was associated with increased drinking likelihood (OR=1.05, 95 % BCI [1.01, 1.10]) and quantity (IRR=1.05, 95 % BCI [1.02, 1.09]), while social loneliness (within-person) was associated with decreases in both drinking likelihood (OR=.94, 95 % BCI [.89,.99]) and quantity (IRR=.96, 95 % BCI [.93,.99]). Between-person loneliness scores were unrelated to both outcomes.

CONCLUSIONS

These discrepant findings by loneliness subtype may be ascribed to differences in subjective manifestations, in that emotional loneliness is a more severe form of loneliness that overlaps significantly with other negative affective states and promotes a coping response, while social loneliness may be readily alleviated by adaptive behavioral strategies for some, and social withdrawal for others. These findings offer insight into the nuances of loneliness-drinking relations and their clinical implications.

Short-Term Coupling Associations Between State Loneliness and Cognitive Performance in Daily Life Among Older Adults

OBJECTIVES

Despite extensive efforts to study individual differences in loneliness and neurocognitive health, little is known about how within-person changes in state loneliness relate to cognitive performance. This study addressed this gap by examining the association between within-person variation in state loneliness and cognitive performance assessed objectively in daily life.

METHODS

Participants were 313 community-dwelling older adults (70-90 years) who reported momentary feelings of loneliness and completed smartphone-based cognitive tests 5 times daily for 14 consecutive days. Mobile cognitive tests assess visual associative memory, processing speed, and spatial memory.

RESULTS

At the day level, average state loneliness levels were negatively related to cognitive performance on the same day and subsequent day. Consistent with the day-level analysis, momentary assessments of increased loneliness were consistently linked to worse cognitive performance on concurrent assessments. However, moments characterized by lower cognitive performance predicted higher levels of loneliness 3-4 hr later (next occasion), but not vice versa.

DISCUSSION

The findings suggest a prospective association between loneliness and cognitive performance, with higher daily loneliness negatively associated with cognitive performance on the same day and predicting worse performance the following day. Notably, within a single day, lower cognitive performance at a given moment predicted elevated loneliness later in the day. This highlights a complex, reciprocal relationship-loneliness predicting and being predicted by cognitive performance depending on timescale.

Loneliness in daily life: A comparison between youths with autism spectrum disorders and 22q11.2 deletion syndrome (22q11DS)

Loneliness is a negative emotional experience that can stem from a gap between desires and the reality of social relationships. It is also a predictor of mental health. Loneliness is therefore important to investigate in neurodevelopmental populations known for having difficulties in the social sphere. This co-registered study involved 48 youths with autism spectrum disorders (ASD), 54 youths with 22q11.2 deletion syndrome (22q11DS) and 65 typically developing youths (TD) aged 12-30. State loneliness was assessed with an ecological momentary assessment. Paper-pencil questionnaires assessing attitude toward aloneness, trait loneliness, and mental health, were completed by the youths and their caregivers. A comparable level of state loneliness between clinical groups and TD were found, with greater loneliness when alone than in a social context. Clinical groups showed a greater intra-individual variability. Both individuals with ASD and 22q11DS revealed a greater affinity toward being alone than TD, but only individuals with ASD reported greater trait loneliness. However, no significant association was found between attitude toward aloneness, trait and state loneliness. Emotional reactivity to loneliness was different between the clinical groups. Self-reported mental health only was associated with loneliness in the clinical groups. These results provide new insights into the understanding of loneliness in these clinical populations and have an impact on clinical care by highlighting the need to remain vigilant when encountering youths who report feeling lonely, and that these youths need to be supported in developing their social network, which appears to be a protective factor against loneliness.

Loneliness, perceived social support, and their changes predict medical adherence over 12 months among patients with coronary heart disease

OBJECTIVES

This study investigated whether changes in loneliness and perceived social support predicted medical adherence in patients with coronary heart disease (CHD) over 12 months. Moreover, short-term and long-term buffering effects of social support on the association between loneliness and medical adherence were systematically examined.

DESIGN

A three-wave longitudinal study.

METHODS

Participants were 255 CHD patients with a mean age of 63 years. Medical adherence, loneliness, and perceived social support were assessed at baseline, 3 months, and 12 months. Hierarchical regression analyses were conducted to examine the influences of loneliness and social support as well as their changes on medical adherence over 12 months. Moderation analyses were performed to test buffering effects of baseline social support and its changes against loneliness and its changes, respectively.

RESULTS

Changes in loneliness significantly predicted medical adherence at 12 months (β = -.23, p = .001) but not at 3 months (β = -.10, p = .142). Changes in social support predicted medical adherence at both 3 (β = .23, p = .002) and 12 months (β = .26, p = .001). Social support concurrently buffered the adverse impact of loneliness on medical adherence (B = .29, SE = .12, p = .020) at baseline but did not at 3 or 12 months (Bs = -.21 to .40, SEs = .12 to .30, ps = .177 to .847).

CONCLUSIONS

Findings highlight the importance of monitoring loneliness and perceived social support continuously over time for CHD patients to promote medical adherence.

On social health: history, conceptualization, and population patterning

We propose a psychologically-informed concept of social health to join physical and mental components in a more comprehensive assessment of human health. Although there is an extensive literature on the importance of social relationships to health, a theoretical framework is needed to coalesce this work into a codified conceptualisation of social health, defined here as adequate quantity and quality of relationships in a particular context to meet an individual's need for meaningful human connection. Informing this novel conceptualisation, we outline eight key propositions to guide future research and theory on social health, including five propositions focused on the conceptualisation of social health and three focused on its population patterning. The former five propositions include that social health is an outcome in its own right, that health interventions can have divergent effects on social versus physical and mental aspects of health, that social health has independent effects on quality of life, that it is a dynamic and contextual construct, and that it is embedded and encoded in the human body (and mind). The utility of the social health concept is further revealed in its significance for understanding and addressing population health concerns, such as health inequalities experienced by marginalised groups.

Loneliness and Mode of Social Contact in Late Life

OBJECTIVES

Social contact may alleviate loneliness, but little is known about within-person daily fluctuations in loneliness and social encounters. Older adults who feel lonely may engage in different modes of social contact (in-person, phone, digital). This study asked how different forms of contact are associated with loneliness throughout the day.

METHODS

Participants were 313 community-dwelling older adults (aged 65-90). They completed ecological momentary assessments reporting on their social encounters (e.g., type of social partner, mode of contact) and their loneliness every 3 hr for 5-6 days. We differentiated close social ties from ties not identified as close (i.e., weak ties).

RESULTS

We examined within-person effects using multilevel models. Findings revealed that momentary loneliness predicted a greater likelihood of phone contact in the next 3 hr. However, only in-person contact was associated with lower levels of loneliness. Regarding close and weak ties, momentary loneliness was associated with more in-person and phone contact with close ties, yet fewer in-person contacts with weak ties. In-person contact with both close and weak ties predicted lower levels of loneliness.

DISCUSSION

Although older adults engage in both in-person and phone contact when they feel lonely, it appears that only in-person contact may reduce loneliness. Digital contact was not widely adopted as a response to momentary loneliness among these older adults. Findings underscore older adults' willingness to maintain regular contact with close ties. Interventions addressing older adults who are lonely may consider innovative approaches to increase in-person contact.

Involuntary social isolation and alcohol consumption: an ecological momentary assessment in Germany amid the COVID-19 pandemic

AIMS

Alcohol consumption often occurs in a social setting, which was affected by social distancing measures amid the coronavirus disease-2019 (COVID-19) pandemic. In this study, we examine how involuntary social isolation (i.e. comparing a no-lockdown stage with a lockdown stage) affects the association between loneliness, social activities, and drinking behavior.

METHOD

We performed an ecological momentary assessment eight times per day for 7 days amid the COVID-19 pandemic in Germany. We recruited 280 participants and assessed their trait loneliness, daily state loneliness, social activities, and drinking behaviors.

RESULTS

We found that a lockdown condition moderates the association between trait and daily state loneliness and alcohol consumption. During a lockdown stage, trait loneliness was positively associated, whereas state loneliness was negatively associated with alcohol consumption. During a no-lockdown stage, trait and state loneliness were both negatively associated with alcohol consumption. For both no-lockdown and lockdown stages, duration of social interaction, male gender, and weekends was positively associated with alcohol consumption.

CONCLUSION

Our study suggests that an involuntary social isolation condition (i.e. a lockdown stage) changes how trait loneliness is associated with alcohol consumption.

Associations between social loneliness trajectories and chronotype among adolescents

Late chronotype during adolescence is a critical risk factor for poor physical and mental health among adolescents. While social loneliness is confirmed to negatively influence sleep behaviors, the long-term effect of social loneliness on chronotype remains unknown. This study aims to investigate whether social loneliness trajectories from middle childhood to adolescence are associated with chronotype in late adolescence and examine the potential sex differences in these associations. Data were obtained from 2398 adolescents who participated in the Child and Adolescent Behaviors in Long-Term Evolution project. Chronotype was calculated as the midpoint of sleep on free days adjusted for sleep debt. Group-based trajectory modeling and multiple linear regression were employed to establish social loneliness trajectories and determine their associations with chronotype. Social loneliness trajectories were significantly associated with chronotype and varied by sex. Specifically, boys following a high-decreasing trajectory had earlier chronotype during late adolescence than did those following a low-decreasing trajectory (B =  - 0.07; p < 0.05). By contrast, girls following a low-to-moderate-increasing trajectory exhibited later chronotype than did those following a low-stable trajectory (B = 0.07; p < 0.01). Social loneliness trajectories, especially those displaying significant fluctuations over time, are critical indicators influencing chronotype among adolescents. Furthermore, these trajectories and their associations with chronotype display sex differences. These findings highlight the need for early interventions for psychological factors such as social loneliness to ensure that the late chronotype can be prevented. In addition, sex variations must be considered.

The relationship between loneliness and problematic smartphone use among adolescents during the COVID-19 pandemic: The mediating role of negative emotions and maladaptive coping

INTRODUCTION

Given the observed increased feelings of loneliness and problematic smartphone use among adolescents during the COVID-19 pandemic, further research was needed to determine whether and how the increased loneliness of adolescents during such major public health crisis events affects the risk of problematic smartphone use among adolescents. This study aimed to examine the relationship between loneliness and problematic smartphone use among Chinese adolescents (aged 10-16 years) during the COVID-19 pandemic and to investigate the possible mediating role of negative emotions and maladaptive coping.

METHODS

A total of 672 Chinese adolescents (Mage  = 13.05, SD = 1.51, 50.4% boys, 93.8% from rural areas, 22.5% of whom were only children) took part in this cross-sectional study in April 2022 by completing the Chinese adolescent version of the Loneliness Scale, the Positive and Negative Affect Scale (subscale), the Ways of Coping Questionnaire, and the Mobile Phone Addiction Index Scale.

RESULTS

The serial mediation model revealed that negative emotions and maladaptive coping independently mediated the relationship between adolescents' loneliness and problematic smartphone use. In addition, the mediation effects of "negative emotions-maladaptive coping" could also mediate the relationship between loneliness and problematic smartphone use.

CONCLUSIONS

Loneliness may be positively related to problematic smartphone use through negative emotions and maladaptive coping among adolescents during major public health crisis events, such as the COVID-19 pandemic.

Trajectories of loneliness during COVID-19 pandemic and associations with mental health and substance use

We examined patterns of longitudinal trajectories of loneliness during the COVID-19 pandemic using six time points (January 2020 [pre-pandemic] to March/April 2021) and whether trajectories were associated with psychological distress (depression/anxiety) and substance use (alcohol/cannabis) outcomes in Spring 2021. Participants were 644 young adults who completed online assessments. Outcomes were regressed on most-likely loneliness trajectory adjusting for pre-pandemic measures. Three loneliness trajectories varied from consistently lower to consistently higher. Pre-pandemic social support was associated with lower odds of a higher loneliness trajectory. Higher loneliness trajectories were associated with greater odds of past-month cannabis use compared to Low trajectories, but not significantly associated with depression, anxiety, or alcohol use in Spring 2021. Interventions addressing co-occurring loneliness and cannabis use are needed.

A retrospective examination of changes in drinking motives during the early COVID-19 pandemic

OBJECTIVE

The COVID-19 pandemic has led to substantial changes in college student alcohol use. Changes in drinking motives may explain some of these changes in drinking patterns. The purpose of the present study is to explore how drinking motives and alcohol use have changed amongst college students considering the timeframes before and after the onset of COVID-19 pandemic (i.e., March 2020) in the United States. We hypothesized that there would be significant changes in drinking motives after March 2020, which would be significantly related to changes in alcohol use.

METHODS

Participants for the current study were undergraduate students reporting lifetime alcohol use (n = 198, M_age = 21.3, 66.7% female, 86.4% White) recruited through online advertisements in classes to complete an online survey in April 2020. Participants were asked to report on their drinking motives and alcohol use considering the timeframes before and after the onset of closures and stay-at-home orders during the COVID-19 pandemic (i.e., before and since March 2020).

RESULTS

Paired samples t-tests revealed that endorsement of social (t[171) = 12.79, p < .001, d = 1.16) and conformity motives significantly decreased (t[170] = 4.46, p < .001, d = 0.31), while endorsement of coping motives significantly increased (t[172] = -2.70, p = .008, d = .15) after the onset of COVID-19. Linear regression analyses, controlling for drinking motives before March 2020, revealed that changes in enhancement (β = -.47, p < .001) and coping motives (β = -.22, p = .04) were significantly associated with changes in alcohol use quantity.

CONCLUSIONS

Findings of the present study support the need for interventions to target coping and social drinking to reduce risk for alcohol use.

Consumer loneliness: A systematic review and research agenda

Treading on the heels of the spread of the coronavirus, the "loneliness virus" has been capturing territories globally. Consumers are not immune to loneliness. Although academics and the general public have recognized the devastating effects of loneliness, the academic attention given to consumer loneliness (CL) is scattered and fragmentary. The purpose of this article is to systematically review the antecedents (predictors and alleviators) and consequences (consumer behaviors, emotions, preferences, attitudes, and cognition) of CL in various consumption contexts. This review also presents findings on CL as a mediator and moderator in consumer studies. This work adds to the growing body of CL literature by synthesizing the existing findings and knowledge. More importantly, we present a future research agenda by linking CL to significant research lines and detailed implications for practitioners in the marketplace.

Home alone: Patterns and perceptions of solitary home alcohol consumption in an Australian convenience sample

INTRODUCTION

In contrast with extensive literature exploring sociable alcohol use, few studies focus on drinking alone at home, even though the home is the place where the majority of drinking occurs.

METHODS

We draw on survey and interview data gathered in 2018/2019 prior to the COVID-19 pandemic, to identify prevalence and perceptions of solitary home drinking in an Australian convenience sample of heavy and light drinkers (LD).

RESULTS

A substantial minority of survey participants identified drinking home alone, with over a quarter of heavy drinkers (27%) reporting that they only drank alone in their own home (compared to 15% of LD). In interviews, solitary home drinking was frequently constructed as signifying personal inadequacy, heavy consumption and harm. However, tensions arose through solitary home drinking bringing pleasures, such as relaxation. It was regarded as more socially acceptable for men than women and lighter home drinking patterns were viewed more positively than heavy drinking. Perceptions of what constitutes solitary home drinking varied, with some suggesting it includes drinking with others present who are not themselves drinking, and others using a more limited definition of consuming alcohol while alone in a house.

DISCUSSION AND CONCLUSIONS

While strong social sanctions against it persist, solitary home drinking can reflect a lack of opportunity to drink with others and also be associated with more harmful regular patterns of alcohol use. Increasing recognition of home drinking provides a new imperative to better understand the complex stigmatisation that frames solitary home drinking and to explore opportunities to limit associated harms.

Daily diary study of loneliness, alcohol, and drug use during the COVID-19 Pandemic

BACKGROUND

Research conducted during the COVID-19 Pandemic has identified two co-occurring public health concerns: loneliness and substance use. Findings from research conducted prior to the pandemic are inconclusive as to the links between loneliness and substance use. This study aimed to measure associations of loneliness with three different types of substance use during COVID-19: daily number of alcoholic drinks, cannabis use, and non-cannabis drug use.

METHOD

Data were obtained between October 2020 and May 2021 from 2,648 US adults (Mage  = 38.76, 65.4% women) diverse with respect to race and ethnicity using online recruitment. Participants completed baseline surveys and daily assessments for 30 days. A daily loneliness measure was recoded into separate within- and between-person predictor variables. Daily outcome measures included the number of alcoholic drinks consumed and dichotomous cannabis and non-cannabis drug use variables. Generalized linear multilevel models (GLMLM) were used to examine within- and between-person associations between loneliness and substance use.

RESULTS

The unconditional means model indicated that 59.0% of the variance in the daily number of alcoholic drinks was due to within-person variability. GLMLM analyses revealed that, overall, people drank more on days when they felt a particularly high or particularly low degree of loneliness (positive quadratic effect). There was a negative and significant within-person association between daily loneliness and the likelihood of cannabis use. There was also a positive and significant within-person association between daily loneliness and the likelihood of non-cannabis drug use.

CONCLUSIONS

Associations between loneliness and substance use vary with substance type and whether within- or between-person differences are assessed. These findings are relevant to the persistence of substance use disorders and thus of potential clinical importance. Individuals who do not experience severe loneliness at intake but who show daily increases in loneliness above baseline levels are at heightened risk of alcohol and non-cannabis drug use. Future research could profitably examine just-in-time adaptive interventions that assess fluctuations in loneliness to prevent the development or exacerbation of substance use disorders.

Social and emotional loneliness in a large sample of Dutch adults aged 19-65: Associations with risk factors

Loneliness is common in adults of all ages. Prior research among older adults has shown that social loneliness (feelings of missing a wider social network) and emotional loneliness (missing an intimate relationship) differ in risk factors. Therefore, this study examined risk factors of social and emotional loneliness among adults aged 19-65 years. This study was conducted within the framework of a community-based health study in the northwest of the Netherlands in 2016. Cross-sectional data of 7,885 participants were analysed using structural equation modelling. Social and emotional loneliness were measured using the validated scale of de Jong-Gierveld. Socio-demographic and health-related risk factors were self-reported. Multiple socio-demographic, health indicators and health behaviours were associated with higher scores on both types of loneliness, although the predictive power of multiple risk factors differed by type. Additionally, female gender, younger age, medium or high educational level and smoking were associated with lower social loneliness scores specifically, while having a paid job and lower body mass index were associated with lower emotional loneliness scores. To conclude, associations with risk factors were partly consistent across social and emotional loneliness, however, some important differences have been shown. These differences are important to consider when developing targeted prevention and intervention strategies.

Daily social interactions and momentary loneliness: The role of trait loneliness and neuroticism

OBJECTIVES

Loneliness has been linked to poor mental and physical health outcomes in later life. Little is known about how daily social interactions relate to older adults' everyday experiences of loneliness. This study examined the dynamic associations between social interactions and the momentary feelings of loneliness in older adults' daily lives. We further examined whether individual differences in trait loneliness and neuroticism influenced the extent to which daily social interactions were related to moment-to-moment change in loneliness.

METHOD

Participants were 317 community-dwelling older adults (aged 70-90 years) who reported their social interactions and momentary feelings of loneliness 5 times daily for 14 consecutive days using smartphones.

RESULTS

Having more frequent, more pleasant, and in-person social interactions, as well as interactions with family and friends specifically, significantly predicted lower momentary loneliness a few hours later. Higher levels of momentary loneliness, in turn, predicted less likelihood of engaging in these types of social interactions subsequently. In addition, older adults with higher (vs. lower) trait loneliness and neuroticism experienced greater decreases in momentary feelings of loneliness after having more frequent or pleasant social interactions, or interactions with family members.

DISCUSSION

These results expand our understanding of the dynamic associations between daily social interactions and loneliness in later life and provide insights to inform future research, including the possibility of behavioral interventions that target social interactions to reduce the risk for loneliness.

Privacy and housing: research perspectives based on a systematic literature review

Grounded in psychological and social constructs, the need for privacy is reflected in human socio-spatial behaviour and in our own home. To discuss housing privacy, this article presents a systematic literature review (SLR) that identified theoretical and methodological aspects relevant to the topic. The research was based on consolidated protocols to identify, select and evaluate articles published between 2000 and 2021 in three databases (Web of Science, Google Scholar and Scielo), with 71 eligible articles identified for synthesis. The results showed a concentration of studies in the American, European and Islamic context, and the increase in this production since 2018. This was guided by the inadequacy of architectural and urban planning projects, by new forms of social interaction and, recently, by the COVID-19 pandemic. From a theoretical point of view, the SLR demonstrated the importance of investigating privacy in housing from a comprehensive perspective, observing its different dimensions (physical, social and psychological) and characterizing the issues involved and the context under analysis. Methodologically, the main instruments identified were: (i) to behavioural analysis, questionnaires, interviews and observations; (ii) to built environment evaluation, in addition to the previous ones, space syntax analysis, architectural design and photographs analysis; (iii) for the general characterization of users, the data collection regarding the socio-demographic and cultural context and the meanings attributed to spatial organizations; (iv) to characterize the participants of the investigations, the analysis of personality traits, the ways to personalize the space, user satisfaction/preferences and the influence of social interactions on these perceptions.

Do Loneliness and Social Isolation Predict Mortality Because of Hazardous Drinking?

Introduction: Subjective feelings of loneliness and objective social isolation have been consistently connected with ill-health and mortality, though little work has empirically examined the mechanisms explaining the adverse effects. This study examines whether alcohol consumption explains the connection of loneliness and social isolation on mortality in different age and gender groups. Methods: The sample comprised a representative 1994 Finnish sample (n = 8,650) matched with 22-year follow-up mortality data. A multigroup path analysis with discrete survival time analyses was conducted. Results: There were unique differences in the associations between loneliness, social isolation, alcohol consumption, and mortality based on age and gender groups. Loneliness and particularly social isolation predicted mortality partly through subjective intoxication for women under 40 and men 40–65. Discussion: Loneliness and social isolation are associated with mortality, partly through subjective intoxication. Interventions targeted at reducing loneliness and social isolation may help address underlying causes of excess alcohol consumption and mortality.

A systematic review and meta-analysis on the association between solitary drinking and alcohol problems in adults

BACKGROUND AND AIMS

Solitary drinking in adolescents and young adults is associated with greater risk for alcohol problems, but it is unclear whether this association exists in older demographics. The current paper is the first meta-analysis and systematic review, to our knowledge, to determine whether adult solitary drinking is associated with greater risk for alcohol problems.

METHODS

PsychINFO, PubMed and Google Scholar were searched following a pre-registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42019147075) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Following the methodology used in our recent systematic review and meta-analysis on adolescent/young adult solitary drinking, we systematically reviewed solitary drinking measures/definitions, prevalence rates and associated demographic variables in adults. We then meta-analyzed (using random-effects models) associations between adult solitary drinking and alcohol use/problems, negative affect and negative/positive reinforcement-related variables (e.g. drinking to cope or for enhancement).

RESULTS

Solitary drinking was defined as drinking while physically alone in nearly all studies, but measures varied. Prevalence rates were generally in the 30-40% range, with some exceptions. In general, males were more likely than females to report drinking alone, and married individuals were less likely than unmarried individuals to report drinking alone; racial/ethnic differences were mixed. Meta-analytical results showed significant effects for the associations between solitary drinking and the following factors: alcohol consumption, r = 0.25, 95% confidence interval (CI) = 0.18, 0.33, k = 15, I²  = 97.41; drinking problems, r = 0.15, 95% CI = 0.10, 0.21, k = 14, I²  = 92.70; and negative reinforcement, r = 0.24, 95% CI = 0.14, 0.32, k = 11, I²  = 89.77; but not positive reinforcement, r = 0.02, 95% CI = 0.06, 0.09, k = 8, I²  = 76.18; or negative affect, r = 0.03, 95% CI = -0.02, 0.08, k = 8, I²  = 52.06. Study quality moderated the association between solitary drinking and negative affect (β = -0.07, P < 0.01) such that lower-quality studies were significantly associated with larger effect sizes. Study quality was generally low; the majority of studies were cross-sectional.

CONCLUSIONS

Solitary drinking appears to have a small positive association with alcohol problems.

Loneliness and Daily Alcohol Consumption During the COVID-19 Pandemic

Aims

This pilot study aimed to identify associations of loneliness and daily alcohol consumption among US adults during the Coronavirus Disease-2019 pandemic.

Method

Participants completed daily assessments for 30 days.

Results

Results suggest people who feel lonelier on average drink more alcohol, however, people who feel lonelier than usual drink less.

Conclusion

Findings highlight the need to disaggregate within- and between-person components of alcohol use.

"Surviving the Violence, Humiliation, and Loneliness Means Getting High": Violence, Loneliness, and Health of Female Sex Workers

Sex workers are particularly vulnerable to violence, isolation, and stigmatization. This study uses the theory of loneliness to explore the relations among violence, self-esteem, loneliness, health, and drug use. Specifically, this study tested a model in which loneliness mediates the relationship between situational (violence) and characterological (self-esteem) loneliness factors and physical and psychological health and drug abuse. The study sample consisted of 146 sex workers from one region of Spain, recruited through the purposive sampling method. Partial least squares (PLS) path modeling has been employed to test the hypothesis. The findings of this study suggest that two kinds of violence (physical and psychological) have a direct and positive influence on loneliness, so that higher levels of violence increase loneliness, while self-esteem has a protector role on loneliness. Loneliness has a direct and negative impact on psychological and physical health, and determines an increase in drug use, which, in turn, decreases both physical and psychological health. The results support, among other points, that policy makers and sex worker service programs need to be aware of how loneliness plays a role in the health and risk behavior of sex workers. Society has an important role to improve sex workers' health and minimize their risk behavior.

Using machine learning to identify predictors of imminent drinking and create tailored messages for at-risk drinkers experiencing homelessness

Adults experiencing homelessness are more likely to have an alcohol use disorder compared to adults in the general population. Although shelter-based treatments are common, completion rates tend to be poor, suggesting a need for more effective approaches that are tailored to this understudied and underserved population. One barrier to developing more effective treatments is the limited knowledge of the triggers of alcohol use among homeless adults. This paper describes the use of ecological momentary assessment (EMA) to identify predictors of “imminent drinking” (i.e., drinking within the next 4 h), among a sample of adults experiencing homelessness and receiving health services at a homeless shelter. A total of 78 mostly male (84.6%) adults experiencing homelessness (mean age = 46.6) who reported hazardous drinking completed up to five EMAs per day over 4 weeks (a total of 4557 completed EMAs). The study used machine learning techniques to create a drinking risk algorithm that predicted 82% of imminent drinking episodes within 4 h of the first drink of the day, and correctly identified 76% of nondrinking episodes. The algorithm included the following 7 predictors of imminent drinking: urge to drink, having alcohol easily available, feeling confident that alcohol would improve mood, feeling depressed, lower commitment to being alcohol free, not interacting with someone drinking alcohol, and being indoors. The research team used the results to develop intervention content (e.g., brief tailored messages) that will be delivered when imminent drinking is detected in an upcoming intervention phase. Specifically, we created three theoretically grounded message tracks focused on urge/craving, social/availability, and negative affect/mood, which are further tailored to a participant’s current drinking goal (i.e., stay sober, drink less, no goal) to support positive change. To our knowledge, this is the first study to develop tailored intervention messages based on likelihood of imminent drinking, current drinking triggers, and drinking goals among adults experiencing homelessness.

The influence of negative mood on solitary drinking preference: An experiment with young adult solitary drinkers

Solitary drinking is a risk marker for alcohol use disorder; thus, it is important to identify why individuals drink alone and for whom this association is particularly relevant. Evidence suggests the desire to ameliorate negative affect (NA) motivates solitary drinking, with some individuals particularly likely to drink alone to cope, but all past studies are cross-sectional. The present study therefore aimed to determine whether 1) experimentally induced NA increased preferences to drink alcohol alone, and 2) whether the relationship between NA and choosing to drink alcohol alone was moderated by neuroticism, drinking to cope motives, and social anxiety. Current drinkers (ages 21-29) with a solitary drinking history (N=126) were randomly assigned to either NA, positive affect [PA], or no affect change (control) conditions via differing cognitive task feedback. After the mood manipulation, participants chose between drinking alcoholic or nonalcoholic beverages in one of two contexts: alone or socially. Evidence regarding effectiveness of the mood manipulation was mixed, and few chose non-alcoholic beverages in either context. Condition did not influence outcome choice. Across conditions, increases in NA and the importance placed on receiving one's context choice were associated with solitary (versus social) alcohol preference. Neuroticism and its interaction with NA change also influenced choice; individuals high in neuroticism chose more solitary (versus social) drinking contexts while the opposite was true for those low in neuroticism, and among the latter, the preference difference was more pronounced with relatively smaller NA increases. Findings are discussed based on the existing solitary drinking literature.

Loneliness is associated with the subjective evaluation of but not daily dynamics in partner relationships

Loneliness describes a perceived deficiency in quantitative or qualitative aspects of individuals’ social relationships. Whereas the health-related consequences of loneliness are well-documented, surprisingly little is known about its interpersonal features and its consequences for relationship outcomes. In the present study, we investigated the association between loneliness and relationship experiences in partner relationships with a sample of 937 individuals from 480 mixed-sex couples. By employing actor-partner interdependence models and dyadic cross-lagged moderated multilevel models, we found higher loneliness to be robustly related to (a) lower relationship satisfaction for both oneself and the partner, (b) more self-reported, but not partner-reported conflicts, (c) lower average levels of one’s own, but not the partner’s closeness, and (d) less own self-disclosure. In contrast, loneliness was not associated with (a) sexual contact frequency, (b) average levels of physical affection, or (c) the daily dynamics between closeness and self-disclosure/physical affection. Thus, the results of the present study indicated that loneliness is primarily associated with the perception of the partner relationship but not its rather objective features or daily dynamics.

Drinking to Cope During COVID-19 Pandemic: The Role of External and Internal Factors in Coping Motive Pathways to Alcohol Use, Solitary Drinking, and Alcohol Problems

BACKGROUND

The COVID-19 pandemic has resulted in massive disruptions to society, to the economy, and to daily life. Some people may turn to alcohol to cope with stress during the pandemic, which may put them at risk for heavy drinking and alcohol-related harms. Research is needed to identify factors that are relevant for coping-motivated drinking during these extraordinary circumstances to inform interventions. This study provides an empirical examination of coping motive pathways to alcohol problems during the early stages of the COVID-19 pandemic.

METHODS

Participants (N = 320; 54.7% male; mean age of 32 years) were Canadian adult drinkers who completed an online survey assessing work- and home-related factors, psychological factors, and alcohol-related outcomes over the past 30 days, covering a time period beginning within 1 month of the initiation of the COVID-19 emergency response.

RESULTS

The results of a theory-informed path model showed that having at least 1 child under the age of 18, greater depression, and lower social connectedness each predicted unique variance in past 30-day coping motives, which in turn predicted increased past 30-day alcohol use (controlling for pre-COVID-19 alcohol use reported retrospectively). Income loss was associated with increased alcohol use, and living alone was associated with increased solitary drinking (controlling for pre-COVID-19 levels), but these associations were not mediated by coping motives. Increased alcohol use, increased solitary drinking, and greater coping motives for drinking were all independently associated with past 30-day alcohol problems, and indirect paths to alcohol problems from having children at home, depression, social connectedness, income loss, and living alone were all supported.

CONCLUSIONS

Findings provide insight into coping-motivated drinking early in the COVID-19 pandemic and highlight the need for longitudinal research to establish longer term outcomes of drinking to cope during the pandemic.

The association between sleep quality and loneliness in rural older individuals: a cross-sectional study in Shandong Province, China

Background

There is a evidence of negative association between loneliness and sleep quality in older adults. However, little is known regarding the relationship between loneliness and sleep quality among Chinese rural older adults. This study examined the associations of loneliness and sleep quality in a cross-sectional study of older adults.

Methods

A face-to-face questionnaire survey was conducted among 1658 rural older adults in Shandong Province, China. Loneliness was assessed using the University of California at Los Angeles Loneliness Scale. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Ordinal logistic regression was conducted to examine the association of loneliness and sleep quality after adjustment for multiple confounding variables.

Results

After variables such as age, marriage, education, occupation, economic income, family relationships, living arrangement, smoking behavior, alcohol consumption, chronic disease experience, and quality of life were controlled in a multivariable analysis, poor sleep quality was still associated with loneliness in the rural older population.

Conclusion

This finding implied an adverse effect of sleep quality on the loneliness of older adults. Poor sleep quality was associated with increased odds of loneliness in Chinese rural older adults. Sleep-based interventions should be developed to prevent loneliness in rural older adults in China.

The contexts of heavy drinking: A systematic review of the combinations of context-related factors associated with heavy drinking occasions

Background

The amount of alcohol consumed during an occasion can be influenced by physical and social attributes of the setting, characteristics and state of individuals, and the interactions of these components. This systematic review identifies and describes the specific combinations and sequences of context-related factors that are associated with heavy drinking occasions.

Materials and methods

We conducted a systematic literature search of MEDLINE, Embase and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Eligible articles were event-level and event-based studies that quantitatively analysed associations of sequences or combinations of context-related factors with event-level alcohol consumption. We extracted information on study design, sample, variables, effect estimates and analytical methods. We compiled a list of combinations and sequences associated with heavier drinking (i.e., ‘risky contexts’) and with lighter drinking (‘protective contexts’). The review protocol was registered with PROSPERO (registration number: CRD42018089500).

Results

We screened 1902 retrieved records and identified a final sample of 65 eligible studies. Daily mood, day of week, location and drinking group characteristics are important drivers of whether an individual engages in a heavy drinking occasion. The direction and magnitude of some associations differed by gender, age, personality and motives, such that in particular social or physical contexts, some people may feel compelled to drink more while others are compelled to drink less. Very few sequences of factors were reported as being associated with event-level alcohol consumption.

Conclusions

Contexts or factors are experienced in specific sequences that shape the broader drinking context and influence drinking behaviours and consequences but are under-studied. Event-level studies such as those using ecological momentary assessment can harness new technologies for data collection and analysis to improve understandings of why people engage in heavy drinking. Continued event-level research will facilitate public health interventions and policies that reduce heavy drinking and alcohol-related harms.

Loneliness and Illicit Opioid Use Among Methadone Maintenance Treatment Patients

Background: Loneliness has been linked to greater substance use, especially among women. Yet little is known about how loneliness is associated with treatment outcomes for patients with opioid use disorder (OUD). Objectives: We evaluated how patient reports of using illicit opioids (i.e. heroin or non-prescription pain medications) are linked to perceptions of loneliness in a sample of adults receiving methadone maintenance treatment (MMT), and whether this link varies by gender. Methods: Participants for this cross-sectional observational study included 371 MMT patients aged 18 and older drawn from four opioid treatment programs in Southern New England and the Pacific Northwest. Patients completed a self-administered survey assessing sociodemographic and health information, loneliness, illicit opioid use, and MMT characteristics. Logistic regressions were estimated to examine the link between patient odds of illicit opioid use in the past month and perceived loneliness. Results: Patient gender moderated the association between illicit opioid use and loneliness such that severe loneliness was associated with higher odds of using illicit opioids among women (OR = 3.00, 95% CI [1.19, 7.57], p=.020) but lower odds of using illicit opioids among men (OR = 0.35, 95% CI [0.14, 0.87], p=.024), accounting for age, marital status, work status, depressive symptoms, and MMT characteristics (treatment episode, treatment duration, and methadone dose). Conclusions/importance: This study underscores the importance of considering loneliness in the management of OUD. Routine clinical care and treatment may benefit from strategies to build and sustain social connections that support long-term recovery among MMT patients.

Is shame a proximal trigger for drinking? A daily process study with a community sample

Between-subjects studies show that people with higher levels of shame tend to experience more negative drinking-related consequences than people with lower levels of shame. However, within-subjects studies of the association between daily fluctuations in shame and subsequent drinking have yielded mixed findings. This study aimed to resolve these inconsistencies by examining the association between daily fluctuations in shame, between-subjects differences in shame, and subsequent evening alcohol consumption in a sample of 70 community-dwelling drinkers. In addition, we examined whether the previous night's drinking predicted shame the next day based on the theory that shame may operate in a cyclical fashion in some people to maintain problematic drinking patterns. Multilevel model analyses showed a cross-level interaction in which individuals' average levels of ashamed mood moderated the effect of daily fluctuations in shame on solitary drinking. In contrast, previous day's drinking was only weakly related to shame the next day. This study contributes to existing literature by refining models of negative mood-related drinking and further elucidating the patterns by which shame serves as a trigger for drinking, particularly among high shame individuals. The authors interpret results in terms of self-control theory and demonstrate the importance of disaggregating between- and within-subjects variance when examining longitudinal data. (PsycINFO Database Record

Indirect Effects of Loneliness on Substance Use through Stress

Loneliness is associated with a range of physical health problems, and health behaviors (e.g., alcohol use) have been specified as one factor that explains the compromised health of lonely people. Accordingly, in this investigation, we sought to test direct and indirect (through stress) effects of loneliness on substance use (i.e., alcohol consumption, drinking problems, and prescription medication use) over the course of 1 year in a 2-wave longitudinal study. These effects were tested in a sample of 210 young adults who completed self-report measures of loneliness and substance use at time 1 and then completed measures of stress and substance use at time 2. The results showed that loneliness did not have prospective direct effects on substance use, but that it did have significant indirect effects, through increased stress, on all indicators of substance use. These findings highlight the important role of stress in potentially compromising the health of lonely people by increasing their propensity to engage in health risk behaviors.

Who are the lonely? A typology of loneliness in New Zealand

BACKGROUND

Loneliness has many negative physical and mental health ramifications and is most prevalent among vulnerable social groups. However, little is known about how loneliness is grouped within the population and the characteristics of those groups.

METHODS

We conducted a Latent Profile Analysis on 18,264 participants from the fifth wave of the New Zealand Attitudes and Values Study to identify the number of distinct loneliness profiles in the population. Secondary analyses then determined the representation of various demographic and psychosocial characteristics of participants within each profile.

RESULTS

Analyses identified four distinct loneliness profiles: 'high-loneliness' (5.7%), 'low-loneliness' (57.9%), 'appreciated outsiders' (29.1%; who received acceptance from others but felt like social outsiders) and 'superficially connected' (7.2%; who showed the opposite pattern). 'High-loneliness' were the most introverted, emotionally unstable and poorest in wellbeing. 'Appreciated outsiders' and 'superficially connected' had moderate wellbeing, but 'appreciated outsiders' were relatively higher in wellbeing despite greater introversion and neuroticism.

CONCLUSION

This research provides a typology of loneliness in New Zealand and identifies groups more likely to experience loneliness. The 'appreciated outsiders' and 'superficially connected' profiles provide fresh insight into how loneliness may manifest and the relative influences of quality and quantity of social contacts on wellbeing.

Social discomfort moderates the relationship between drinking in response to negative affect and solitary drinking in underage drinkers

OBJECTIVE

Research shows that solitary drinking is associated with negative reinforcement motives (i.e., relieving negative affect). An untested hypothesis proposes that this association may be especially strong for individuals who experience social discomfort. This study aimed to 1) replicate findings linking solitary drinking to social discomfort (i.e., loneliness, social anxiety, and lack of perceived social support), alcohol problems, and drinking in response to negative affect (i.e., drinking to cope motives and inability to resist alcohol during negative affect), and 2) investigate whether greater social discomfort moderates the relationship between drinking in response to negative affect and solitary drinking in underage drinkers.

METHOD

Current alcohol drinkers ages 18 to 20 (N=664) recruited from a TurkPrime panel reported the percentage of time they drank solitarily and completed measures assessing social discomfort, drinking in response to negative affect, and alcohol involvement. Structural equation modeling was used to test the moderation model.

RESULTS

Results replicated prior literature supporting the first aim. For the second aim, analyses indicated a positive association between solitary drinking and drinking in response to negative affect across all individuals, but contrary to prediction, this relationship was stronger for individuals with lower, rather than higher, social discomfort.

CONCLUSION

Underage drinkers with lower, rather than higher, social discomfort appear to be at greater risk for drinking alone. These findings may inform our understanding of individuals at greatest risk for drinking alone and promote new avenues for intervention.

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.