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Social isolation and loneliness have been linked to adverse health outcomes such as depression in old age. However, limited data exist on the association of loneliness and social isolation with probable depression (PD) in low- and middle-income countries (LMICs), while psychosocial mediators are largely unknown. This study investigates the individual and joint associations of social isolation and loneliness with PD among older adults in Ghana. It quantifies the extent to which psychosocial factors mediate the associations. Cross-sectional data from the Aging, Health, Well-being, and Health-seeking Behaviour Study were analyzed. PD was defined as moderate to severe depressive symptoms with the Center for Epidemiologic Studies Depression (CES-D-9) scale. Loneliness and social isolation were assessed with the University of California, Los Angeles 3-item loneliness scale and the Berkman-Syme Social Network Index, respectively. Multivariable logistic models and PROCESS macro bootstrapping mediation analyses were performed. Among the 1,201 adults aged ≥50 years (Mage = 66.1 ± 11.9 years, 63.3% women), 29.5% PD cases were found. The prevalence of social isolation and loneliness was 27.3% and 17.7%, respectively. Loneliness (OR = 3.15, 95% CI = 3.26–5.28) and social isolation (OR = 1.24, 95% CI = 1.10–1.41) were independently associated with higher odds of PD. The loneliness and PD association was modified by spatial location (Pinteraction = 0.021); thus, the association was more pronounced in rural areas (OR = 7.06) than in urban areas (OR = 3.43). Psychosocial factors (e.g. sleep problems) mediated the loneliness/social isolation and PD association. Loneliness and social isolation were independently associated with a higher likelihood of PD, and psychosocial factors mediated the associations. Interventions to reduce PD in later life should also consider addressing loneliness and social isolation, as well as sleep problems.
Loneliness is a major health concern for immigrant older adults. This study explores social influences on loneliness in neighbourhoods among immigrant older adults across five major urban centres in Ontario and Alberta, Canada. Data were collected from 435 older immigrants who participated in the Inclusive Communities for Older Immigrants (ICOI) Project. Data were analysed using multiple linear regression (MLR) to identify the influences of neighbourhood factors, family support, duration of residency in Canada, English proficiency, and gender. Results indicate that increased engagement in ethnic enclaves, not being reliant on transportation for social interactions, and perceptions of neighbourhood cohesion are associated with a significant reduction in loneliness. These associations remain significant after accounting for family support and language proficiency. This calls for further research into the interconnections among interpersonal factors, neighbourhood-level factors, and family and community-level support to address key influences on loneliness in this population.
A significant number of people diagnosed with BPD experience emptiness. Service-users report that feelings of emptiness are intolerable, terrifying, and debilitating, and research shows that it is contributory to self-harming and suicidal behaviors including completion of suicide. Yet this criterion seems to be the least investigated of any of the nine criteria. This chapter examines what ‘emptiness’ is and whether current research reflects necessary and sufficient conditions for the concept. I describe prevailing thinking on the development of BPD and emptiness. The chapter then turns to experiences of emptiness that are found in other diagnoses, everyday life, and cross-culturally. I suggest that not all experiences of emptiness are signs of pathology. The second half of the chapter focuses on treatment possibilities, focusing on people diagnosed with BPD. I set out the main ideas in Dialectical Behavioral Therapy (DBT) and then work with one of the core methods in DBT for skill-building—mindfulness—to argue that some service-users may benefit from practicing Buddhist meditation. I conclude by discussing and responding to critics of such a position, after which I emphasize that Buddhist meditation is not for everyone and is only one option for treatment of feelings of emptiness.
This study examines the impact of organizational gossip on workplace outcomes, including affective organizational commitment, loneliness, and turnover intention, with a focus on differences between the public and private sectors. Using a mixed-methods approach, the research combines qualitative and quantitative data from surveys conducted with Turkish citizen partners and in-depth interviews with employees in both sectors. The findings reveal that positive gossip enhances social bonds and commitment, while negative gossip leads to loneliness and increased turnover intention, especially in the private sector where job insecurity is higher. The study introduces an integrated framework linking gossip dynamics to organizational processes. Practical implications suggest that managers should address negative gossip while promoting positive gossip to strengthen workplace relationships. This study highlights the dual role of gossip in shaping employee experiences and retention strategies.
Loneliness and social isolation pose significant public health concerns globally, with adverse effects on mental health and well-being. Although the terms are often used interchangeably, loneliness refers to the subjective feeling of lacking social connections, whereas social isolation is the objective absence of social support or networks.
Aims
To investigate the prevalence of loneliness and social isolation and their associations with psychiatric disorders.
Method
This study used data from the Republic of Korea National Mental Health Survey 2021, a nationally representative survey. A total of 5511 adults aged 18–79 residing in South Korea participated in the survey. Loneliness and social isolation were assessed using the Loneliness and Social Isolation Scale, whereas psychiatric disorders were evaluated using the Korean version of the Composite International Diagnostic Interview. Multivariate logistic regressions were performed after adjustment for sociodemographic variables.
Results
Among the participants, 11.8% reported experiencing loneliness, 4.3% reported social isolation and 3.4% reported both. Co-occurrence of loneliness and social isolation was significantly associated with psychiatric disorders (adjusted odds ratio (AOR) 7.59, 95% CI: 5.48–10.52). Loneliness alone was associated with greater prevalence and higher probability of psychiatric disorders (AOR 3.12, 95% CI: 2.63–3.71), whereas social isolation did not show any significant association (AOR 0.88, 95% CI: 0.64–1.22).
Conclusion
The co-occurrence of loneliness and social isolation is particularly detrimental to mental health. This finding emphasises the need for targeted interventions to promote social connection and reduce feelings of isolation.
Statins are among the most prescribed medications worldwide. Both beneficial (e.g. antidepressant and pro-cognitive) and adverse (e.g. depressogenic and cognitive-impairing) mental health outcomes have been described in clinical studies. The underlying neuropsychological mechanisms, whether positive or negative, are, however, not established. Clarifying such activities has implications for the safe prescribing and repurposing potential of these drugs, especially in people with depression.
Methods
In this double-blind, randomized, placebo-controlled experimental medicine study, we investigated the effects of simvastatin on emotional processing, reward learning, working memory, and waking salivary cortisol (WSC) in 101 people at-risk for depression due to reported high loneliness scores (mean 7.3 ± 1.2 on the UCLA scale). This trial was largely conducted during periods of social distancing due to the COVID-19 pandemic (July 2021–February 2023), and we employed a fully remote design within a UK-wide sample.
Results
High retention rates, minimal outlier data, and typical main effects of task condition (e.g. emotion) were seen in all cognitive tasks, indicating this approach was comparable to in-person testing. After 28 days, we found no statistically significant differences (F’s < 3.0, p’s > 0.20) for any of the measures of emotional processing, reward learning, working memory, and WSC.
Conclusions
Study results do not substantiate concerns regarding adverse neuropsychiatric events due to statins and support the safety of their prescribing in at-risk populations. Although other unmeasured cognitive processes may be involved, our null findings are also in line with more recent clinical evidence suggesting statins do not show antidepressant or pro-cognitive efficacy.
Edited by
Richard Pinder, Imperial College of Science, Technology and Medicine, London,Christopher-James Harvey, Imperial College of Science, Technology and Medicine, London,Ellen Fallows, British Society of Lifestyle Medicine
Healthy relationships are interpersonal connections that are mutually beneficial, supportive, and respectful, with an emphasis on open communication and trust. Social isolation and loneliness can negatively impact the development and quality of healthy relationships and are associated with poor physical and mental health outcomes. Social isolation and loneliness are influenced by various risk factors, such as disability, bereavement, family structure, urbanisation, and technology use, and affect different groups of people differently.
Interventions to enhance healthy relationships can include improving social skills, enhancing social support, increasing opportunities for social contact, addressing maladaptive social cognition, and facilitating community engagement and volunteering. The relationship between clinician and patient is also a key factor for health outcomes, and can be improved by continuity of care, empathy, and trust. Clinicians can apply a Lifestyle Medicine approach to identify and address the impact of relationships on health, and support people to develop and maintain healthy relationships.
Loneliness, while a common human experience, is something to which people often respond quite differently. Here, I examine how an individual’s social position, as well as his socialization into a particular cultural milieu, can shape his response to the fact of his loneliness (as well as the features of human existence that loneliness makes salient). Specifically, I argue that in cases where the individual experiencing loneliness has been socialized to disvalue the features of existence that loneliness makes salient (e.g., our dependence on and vulnerability to others) and/or to feel entitled to the social goods that they are, or perceive themselves to be, lacking (e.g., recognition or intimate connection), loneliness may catalyze the vicious, extremist attitude of ressentiment. This analysis allows us to see how loneliness may play a role in catalyzing vicious, extremist attitudes—though I contend that loneliness never warrants such attitudes.
Creating conditions that facilitate sociality and friendship is an important way to address loneliness. But it is not sufficient in itself, as shown by philosopher Anca Gheaus in a recent article. After highlighting the need for alternative ways to address chronic loneliness, Gheaus offers a promising approach: “[c]reating favourable conditions for the appreciation of solitude […]” (Gheaus, 2022, p. 242). In this article, I first expand Gheaus’ account by articulating different dimensions of solitude experiences. Second, I show how cultivation of philosophic contemplation could enhance one’s ability to appreciate solitude.
A systematic review and meta-analysis was conducted to investigate the prevalence and antecedents/outcomes of loneliness and social isolation among individuals with severe mental disorders (SMD), such as schizophrenia, schizoaffective disorder, bipolar disorder or major depressive disorder.
Methods
Five well-known electronic databases (PubMed, PsycINFO, CINAHL, Web of Science and Scopus) were searched (plus a hand search). Observational studies that report the prevalence and, if available, antecedents and consequences of loneliness/isolation among individuals with SMD were included. Key characteristics were extracted, and a meta-analysis was performed. Our systematic review was preregistered on PROSPERO (ID: CRD42024559043). The PRISMA guidelines were followed. The Joanna Briggs Institute (JBI) standardized critical appraisal tool developed for prevalence studies was applied to assess the quality of the included studies.
Results
The initial search yielded 4506 records, and after duplicate removal and screening, a total of 10 studies were finally included. The studies included used data from Europe, Asia, North America, and Oceania. Two studies employed a longitudinal design, while all other studies had a cross-sectional design. Most of the studies included between 100 and 500 individuals with SMD. All studies involved both male and female participants, with women typically comprising about 40% of the sample. The average age of participants often ranged from approximately 30 to 40 years. The estimated prevalence of loneliness was 59.1% (95% CI: 39.6% to 78.6%, I2 = 99.3, P < .001) among individuals with any diagnosis of SMD. Furthermore, the estimated prevalence of objective social isolation was 63.0% (95% CI: 58.6% to 67.4%) among individuals with schizophrenia or schizophrenia spectrum disorder. The quality of the studies was moderate to good. Subjective well-being and depressive symptoms in particular were found to contribute to loneliness in the included studies.
Conclusions
The present systematic review with meta-analysis identified high levels of loneliness and objective social isolation among those with SMD. These findings stress the importance of monitoring and addressing social needs in this vulnerable group, which may have a positive effect on the life quality of individuals with SMD. Future research in neglected regions (e.g. South America and Africa) is recommended. Different diagnoses within severe mental disorders should be distinguished in future studies. Furthermore, additional longitudinal studies are required to explore the antecedents and consequences of loneliness and social isolation among individuals with SMD.
Relationship-centred mealtimes can support care home residents, who are at high risk for loneliness. However, care home staff do not consistently promote relationship-centred mealtimes. This secondary analysis examined the impact of factors (selected based on the Theory of Planned Behaviour) upon care home staff interest in making mealtimes more relationship-centred. Data were from a cross-sectional, quantitative survey of 670 care home staff from North America. We used multivariable logistic regression to test hypotheses. The model was statistically significant, and explained 13 per cent of the variance in staff members’ interest in making mealtimes more relationship-centred. Respondents who were more satisfied with current mealtime practices, had used collaborative change strategies in the past, and who perceived organizational support for relationship-centred care were more likely to have interest in making mealtimes more relationship-centred. These are modifiable factors to target in interventions designed to promote care home staff interest in making mealtimes more relationship-centred.
Loneliness can be found in many life experiences, such as loss, rejection, illness, failure, as well as in success, creativity, or meditation. This chapter is unique because it includes loneliness as part of the social and emotional intelligences. The author helps readers shift their perception of loneliness from something to be avoided or defended against to a necessary exploration of their solitude in the universe. Solitude is argued as a necessary experience for developing social and emotional intelligences. This chapter explores the benefits of solitude for wellbeing and growth across the lifespan.
Essentials of the Social and Emotional Intelligences explores the foundations of social and emotional intelligences from a multicultural humanistic psychology perspective. Delving into the spectrum of abilities associated with holistic emotional processes, this book unravels the intricacies of developing self-awareness, regulating emotional states, fostering social awareness and empathy, exercising freedom of choice, and building diverse relationships. Offering a unique theoretical synthesis of humanistic psychology and multicultural education, the text provides diverse perspectives on complex phenomena within social and emotional intelligences, including empathy, spirituality, loneliness, self-awareness, and cultural humility. Through a fusion of empirical research studies and multicultural insights, this book equips readers with the knowledge to cultivate these essential skills within themselves and foster meaningful connections with others. This concise guide is ideal for students, professionals, educators and laypersons hoping to build their fundamental knowledge in utilizing social and emotional intelligences.
Loneliness may lead individuals to spend more time on the internet and increase the likelihood of experiencing internet-use disorders. Similarly, individuals with internet-use disorders may feel lonelier. In the present systematic review and meta-analysis, pre-registered in PROSPERO (CRD42023390483), we quantified associations between internet-use-disorder symptoms (e.g. internet gaming disorder and online gambling disorder) and loneliness. We searched PubMed, Web of Science, and an institutional database aggregator for references that compared degrees of loneliness in groups of individuals with and without symptoms of internet-use disorder. Means and standard deviations of loneliness, or alternatively, odds ratios, were transformed into Cohen’s d for statistical pooling through a random-effects model. After screening 2,369 reports, we extracted data from 23 studies. The total number of individuals across the studies was 36,484. Participants were between 13 and 30 years of age (median 20). The pooled difference between those with and without internet-use-disorder symptoms yielded a standardized effect (Cohen’s d) of 0.53 (95% CI 0.35–0.7). While heterogeneity was high, there was no indication of publication or small sample biases. Similar effect sizes were found when limiting to specific types of internet-use disorder symptoms. Moreover, meta-regressions did not show an effect of age, sex, or sample size. Individuals with symptoms of internet-use disorders scored 49.35 (43.84–54.85) points on the UCLA-Loneliness scale on average, compared to 43.78 (37.47–50.08) in individuals without symptoms of internet-use disorders (Standardized Mean Difference: 5.18, 95% CI = 2.05–8.34). Individuals with internet-use-disorder symptoms experience greater loneliness. The effect appears moderately sized.
Comprehending resilience in the face of mental health issues is important, especially for young people who deal with a variety of psychological pressures. This study aims to investigate the co-occurrence of several mental health conditions and the role of resilience as a potential intervention in youth 14–25 years in the Nairobi metropolitan area. We recruited 1,972 youths. The following self-administered instruments were used: resilience (ARM-R), hopelessness (BHS), depression (BDI, PHQ-9), PTSD (HTQ), loneliness (UCLA Loneliness Scale) and suicidality (C-SSRS). Descriptive statistics, Pearson correlation and hierarchical multiple regression analyses were conducted on the data. The key findings are that depression and hopelessness showed a strong negative association with resilience. PTSD and recent suicidal ideation and behavior showed less negative association with resilience. Building resilience is an important intervention for the conditions reported in our study among the youth. This study contributes novel insights into the intersection of multiple psychological stressors and resilience, paving the way for more targeted, integrative mental health interventions.
A systematic review/meta-analysis synthesising the existing evidence regarding the prevalence of loneliness and social isolation among individuals with mild cognitive impairment (MCI) or dementia is lacking.
Aims
A systematic review and meta-analysis was conducted to investigate the prevalence and factors associated with loneliness and social isolation among individuals with MCI or dementia.
Method
A search was conducted in five established electronic databases. Observational studies reporting prevalence and, where available, factors associated with loneliness/isolation among individuals with MCI and individuals with dementia, were included. Important characteristics of the studies were extracted.
Results
Out of 7427 records, ten studies were included. The estimated prevalence of loneliness was 38.6% (95% CI 3.7–73.5%, I2 = 99.6, P < 0.001) among individuals with MCI. Moreover, the estimated prevalence of loneliness was 42.7% (95% CI 33.8–51.5%, I² = 90.4, P < 0.001) among individuals with dementia. The estimated prevalence of social isolation was 64.3% (95% CI 39.1–89.6%, I² = 99.6, P < 0.001) among individuals with cognitive impairment. Study quality was reasonably high. It has been found that living alone and more depressive symptoms are associated with a higher risk of loneliness among individuals with dementia.
Conclusions
Social isolation, and in particular loneliness, are significant challenges for individuals with MCI and dementia. This knowledge can contribute to supporting successful ageing among such individuals. Future research in regions beyond Asia and Europe are clearly required. In addition, challenges such as chronic loneliness and chronic social isolation should be examined among individuals with MCI or dementia.
Loneliness is a risk factor for late-life dementia. There is less consistent evidence of its association with cognitive performance. This study examined the replicability of the association between loneliness and overall and domain-specific cognitive function and informant-rated cognitive decline in cohorts from seven countries: the United States, England, India, China, South Africa, Mexico, and Chile.
Methods
Data were from the Harmonized Cognitive Assessment Protocol administered in seven population-based studies (total N > 20,000). Participants reported their loneliness, completed a battery of cognitive tests, and nominated a knowledgeable informant to rate their cognitive decline. Random-effect meta-analyses were used to summarize the associations from each cohort.
Results
Loneliness was associated with poor overall cognitive performance and informant-rated cognitive decline controlling for sociodemographic factors (meta-analytic correlation for overall cognition = −.10 [95% CI = −.13, −.06] and informant-rated decline = .16 [95% CI = .14, .17]). Despite some heterogeneity, the associations were significant across samples from Africa, Asia, Europe, North, Central, and South America. The meta-analysis also indicated an association with specific cognitive domains: episodic memory, speed-attention, visuospatial abilities, numeric reasoning, and verbal fluency. The associations were attenuated but persisted when depressive symptoms were added as a covariate. Depression, cognitive impairment, and sociodemographic factors did not consistently moderate the associations across samples.
Conclusions
Loneliness is associated with poor performance across multiple domains of cognition and observer-rated cognitive decline, associations that replicated across diverse world regions and cultures.
Loneliness has emerged as a pervasive public health challenge. Understanding loneliness and its associated risk factors is crucial for developing interventions to address this issue effectively. This study aimed to investigate loneliness among adults living in Australia, comparing different age cohorts.
Method:
This study used 10,815, 11,234, 14,670 and 15,049 records with loneliness measurements taken at 2006, 2010, 2014 and 2018, respectively, from the Household, Income and Labour Dynamics in Australia (HILDA) survey. A supervised machine learning algorithm, CatBoost, was employed to predict loneliness. Model predictions were explained using SHapley Additive exPlanations (SHAP) and partial dependence plots across five age-based subgroups to capture life stage variations.
Results:
Mental well-being, having a life partner, social connectedness and social fulfilment were the most important predictors of loneliness at the whole-population level. Among young adults, the level of friendship fulfilment, financial satisfaction and health status were relatively strong predictors of loneliness, while loneliness in older adults was more strongly associated with spare time fulfilment, community satisfaction and the loss of loved ones. Youth who reported that they did not have a lot of friends were predicted to have a 46.5% (95% CI: 45.9%–47.2%) chance of experiencing loneliness. Seniors have a 44.9% (95% CI: 43.9%–45.8%) chance of experiencing loneliness if they were almost always not fulfilled in their spare time.
Implications:
This study underscores the need to recognise the heterogeneity of loneliness across the lifecourse and the importance of both targeted strategies and efforts to improve broader social cohesion.
Loneliness has become a major public health issue of the recent decades due to its severe impact on health and mortality. Little is known about the relation between loneliness and social anxiety. This study aimed (1) to explore levels of loneliness and social anxiety in the general population, and (2) to assess whether and how loneliness affects symptoms of social anxiety and vice versa over a period of five years.
Methods
The study combined data from the baseline assessment and the five-year follow-up of the population-based Gutenberg Health Study. Data of N = 15 010 participants at baseline (Mage = 55.01, s.d.age = 11.10) were analyzed. Multiple regression analyses with loneliness and symptoms of social anxiety at follow-up including sociodemographic, physical illnesses, and mental health indicators at baseline were used to test relevant covariates. Effects of loneliness on symptoms of social anxiety over five years and vice versa were analyzed by autoregressive cross-lagged structural equation models.
Results
At baseline, 1076 participants (7.41%) showed symptoms of social anxiety and 1537 (10.48%) participants reported feelings of loneliness. Controlling for relevant covariates, symptoms of social anxiety had a small significant effect on loneliness five years later (standardized estimate of 0.164, p < 0.001). Vice versa, there was no significant effect of loneliness on symptoms of social anxiety taking relevant covariates into account.
Conclusions
Findings provided evidence that symptoms of social anxiety are predictive for loneliness. Thus, prevention and intervention efforts for loneliness need to address symptoms of social anxiety.
The COVID-19 pandemic posed an unprecedented global challenge, with past evidence suggesting negative psychological effects with the additional concern that social and physical restrictions might disproportionately affect adolescents.
Aims
To explore mental health and its wider determinants in young people in the UK during 1 year of the COVID-19 pandemic (August 2020–August 2021).
Method
A representative sample of 11 898 participants (48.7% female) aged between 13 and 19 years (mean = 16.1) participated in five waves of data collection. Using validated self-reported questionnaires for loneliness, anxiety and depression, this survey measured the extent and nature of the mental health impacts of the coronavirus pandemic and help-seeking behaviours, and changes over time.
Results
Young people experienced higher levels of anxiety during the summer and fall 2020, followed by higher levels of depression during the winter 2020–2021, with loneliness gradually increasing then peaking during the spring and summer of 2021. Young people who were older, female, with pre-existing mental-health issues and experiencing financial difficulties were at higher risk of anxiety, depression and loneliness. Help-seeking behaviours reduced the risk of depression and loneliness.
Conclusions
The COVID-19 pandemic had substantial impact on young people, whether on their mental health, their social contacts and interactions or their perspective on what the future holds for them. Young people strongly advocated for better teacher training, and a better integration of mental health services, particularly within their schools.