Higher Levels Of Loneliness Research Articles

Managing Uncertainty and Loneliness: Protective and Risk Factors Impacting on Older People’s Mental Health in Hong Kong

ABSTRACT This study investigated the roles of loneliness and prospective intolerance of uncertainty (IU-P) on mental health, and identified the sources of stress and joy during the COVID-19 in Hong Kong. Two thousand two hundred and fifty-eight older adults completed the survey. Older adults who had higher levels of loneliness and IU-P were more likely to have poor mental health. IU-P was found to partially and positively mediate the relationship between loneliness and mental health. Top stressors were contracting the virus, uncertainty about the future, and loneliness; while family/friends, peace of mind, and hobbies were identified as protective factors.

Cyberbullying Among Adolescents in Norway: Time Trends and Factors Associated with Perpetration and Victimization

There is limited knowledge about time trends in cyberbullying involvement, and whereas previous studies have often focused on various mental health outcomes, possible outcomes of cyberbullying may concern a wide range of areas. A better understanding of cyberbullying development over time, as well as of the possible consequences, is needed for effective prevention and intervention efforts. The aims of this study were (i) to gain knowledge of time trends in cyberbullying among Norwegian adolescents, and (ii) to better understand how different forms of cyberbullying involvement is related to a variety of outcomes. Data from the Norwegian Ungdata surveys (2014–2016) were used to assess involvement in cyberbullying over time. Associations with cyberbullying involvement and four outcome variables (belief in a good and happy life, loneliness, school thriving, and depressive symptoms) were assessed using logistic regression analyses. Across years of study, the prevalence rates for cyberbullying involvement were 1.5% for perpetration, 3% for victimization, and 1% for perpetration-victimization. Compared with non-involvement, involvement in cyberbullying in any role was associated with poorer outcomes on all variables. Cyber-victims who were also perpetrators were less likely to have high levels of loneliness and depressive symptoms, compared to cyber-victims only. The prevalence of cyberbullying involvement among adolescents in Norway was relatively unchanged between 2014 and 2016. Cyberbullying involvement is associated with negative outcomes related to mental health, loneliness, school thriving, and beliefs in one’s personal future, and victims of cyberbullying appear to be the most vulnerable group.

Relationship Between Social Isolation, Loneliness and Psychological Well-Being in Inflammatory Bowel Disease Patients: The Mediating Role of Disease Activity Social Isolation in Inflammatory Bowel Disease.

To evaluate the relationship between social isolation, loneliness and psychological well-being in patients with inflammatory bowel disease (IBD). Additionally, we examined the mediating effect of disease activity on the relationships between social isolation, loneliness and psychological well-being. Cross-sectional descriptive study. A total of 218 participants were recruited from outpatient clinic at a university hospital in Turkey and from the community membership of the patient support group. Participants provided their socio-demographic and disease-related information and completed (online and paper based) the Turkish Lubben Social Network Scale-6, the Turkish UCLA Loneliness Scale Short Form and the Turkish Psychological Well-being Scale. The data were analysed using univariate linear regression analysis. This study adhered to the STROBE checklist for reporting. The majority of the participants (72%) were socially isolated, and over half (54.1%) reported moderate to high levels of loneliness. Participants also had low psychological well-being. Linear regression analysis revealed that high loneliness level and social isolation were negative predictors of psychological well-being. The results revealed that the effect of social isolation and loneliness on psychological well-being was mediated by disease activity. In line with the findings, it can be recommended to enhance social support and networks, along with regular psychological evaluation, should be integrated into the holistic care approach for IBD patients. The findings of this study hold significant implications for the management and support of patients with IBD, particularly within clinical settings in Turkey. Patients were invited to complete questionnaires. The investigators explained the study's content and purpose, and addressed any concerns during the data collection process.

Frailty and related factors among community-dwelling older adults in Türkiye

Abstract Background Frailty in elderly can lead to complex challenges in the follow-up and management of health services. Ensuring comprehensive primary care services and social support can avert, reverse, or mitigate frailty in old age. We aimed to evaluate frailty and its associated factors in individuals aged ≥65 years. Methods We conducted a cross-sectional study in patients applying to primary care centres in 2024, in a city where 10% of the population is elderly. The centres were divided into clusters based on the socioeconomic status of the regions they serve, and nine were randomly selected by weight. A total of 1154 elderly who consecutively presented were included. A questionnaire including sociodemographic characteristics, Edmonton Frailty Scale, Loneliness Scale for the Elderly (LSE), Charlson Comorbidity Index (CCI), International Falls Effectiveness Scale (FES-I) was applied to the elderly. Results The mean age was 71.3±5.3 years, and 50.8% were male. In the study, 20.1% were frail, and 19.6% were apparently vulnerable. It was found that those aged 70-79 and ≥80 years, women, deceased/separated from their spouses, those with low education, those whose occupation was housewife, those earning below minimum wage, those who lived alone, non-exercisers, those taking >8 medications/day, and those who had ≥2 falls/last year were more frail. In multivariate logistic regression analysis, illiteracy (Odds ratio-OR:15.2, 95%CI:1.7-135.5), taking >8 medications/day (OR:4.1, 1.7-9.9), falling ≥2 times/last year (OR:3.4, 1.8-6.4) and ≥4 points on the CCI (OR:1.9, 1.0-3.4) were found to be predictors of frailty. Each score on the FES-I and LSE increased the risk of frailty by 1.08 (1.05-1.11) and 1.13 (1.08-1.17) times, respectively. Conclusions One in five people was found to be frail. Low education level, >8 medications/day, ≥2 falls in the last year, severity of comorbidity, fear of falling, and high levels of loneliness were found to be predictive factors for frailty. Key messages • Encouraging a healthy lifestyle to prevent comorbid diseases and early interventions to avoid falls can reduce frailty. • Providing social activities in primary care and promoting the elderly to participate in these activities can help prevent loneliness, which is a risk factor of frailty.

Forecasting Psychological Distress Across Waves Of The COVID-19 Pandemic: A Multi-country Longitudinal Study

Abstract The current study used a longitudinal multi-country cohort survey (N = 8013 at baseline; age (M) = 40.3, SD = 15; female 76%) to investigate whether psychological distress assessed at five waves (May-June 2020; September-October 2020; December 2020-January 2021; March-April 2021 and March-May 2022) during the COVID-19 outbreak can be forecasted by a variety of socio-demographic and psychological- and COVID-related factors assessed at baseline. Psychological distress was defined by elevated depression and/or anxiety scores (PHQ-9 and GAD-7 > = 10). Predictors included demographic characteristics (e.g., gender, age, education), infections with COVID-19, loss of income, substance abuse, domestic violence, contamination fear, basic value orientations, social support and coping strategies. A Random Forest (RF) prediction model within a machine learning context was used to estimate the association between the independent variables and the presence of psychological distress among respondents completing all waves (N = 1052). Preliminary RF results showed that psychological distress at multiple waves, both during the initial phases (2020) as well as the more protracted phases (2021 and 2022), was adequately forecasted by scores on a number of basic value orientations (e.g., lower tradition and conformity, higher security and predictability), by demographic characteristics (e.g., younger age), by the fear of being contaminated, and by lower levels of social support and higher levels of loneliness. It is concluded that during a pandemic, certain personal values may elicit more vulnerability for psychological distress than others. Effective psychological intervention strategies should encompass personal traits and values and factors such as low social support levels and feelings of loneliness to mitigate distress. These insights can help in accurately pinpointing high-risk groups for heightened distress in future public health crises.

Loneliness Trajectories in U.S. Military Veterans: A 3-Year Longitudinal Study of Risk and Protective Factors.

Loneliness is a significant public health concern associated with adverse mental and physical health outcomes in older adults. This study examined the nature and correlates of predominant loneliness trajectories in a nationally representative sample of older U.S. military veterans. Participants included 2,441 veterans (mean age = 63, 8% female, 80% white) from the National Health and Resilience in Veterans Study, a 3-year longitudinal cohort study. Growth mixture modeling (GMM) was used to identify distinct trajectory classes of loneliness based on self-reported ratings. Multinomial logistic three-step regression analyses examined potential psychosocial risk and protective factors associated with loneliness trajectories. GMM revealed three distinct loneliness trajectories: Low-decreasing loneliness (61.2%), moderate-increasing loneliness (31.6%), and high-increasing loneliness (7.2%). Being married/partnered and perceiving greater purpose in life emerged as protective factors against elevated levels of loneliness. Worse cognitive functioning was a risk factor for the moderate-increasing loneliness trajectory, while greater psychological distress and more adverse childhood experiences were risk factors for the high-increasing loneliness trajectory. Nearly 40% of older U.S. veterans exhibited trajectories characterized by moderate to high levels of loneliness, with both groups showing increases over time. Targeted interventions that promote social connectedness, enhance purpose in life, and address mental health concerns and early life adversities may help mitigate the negative health consequences associated with chronic loneliness in this vulnerable population.

Relationship between qualitative and quantitative loneliness and suicidal ideation by occupational classification in the working-age population: a nationally-representative survey

BackgroundRising digitalization and individualism in the workplace after the COVID-19 pandemic have increased loneliness and related problems in the working-age population. The potential effects of various forms of loneliness on suicidal ideation may differ depending on employment status.MethodThis is a cross-sectional study based on a national survey of mental health in the general Korean population. We classified occupations as “employed,” “self-employed,” or “unemployed.” Loneliness was assessed using the UCLA Loneliness Scale, which measures both qualitative and quantitative aspects of loneliness. Suicidal ideation was evaluated using the Patient Health Questionnaire-9.ResultsA total of 1770 participants aged 30–65 years (mean age: 47.7 years) were included. The mean loneliness score was 43.9 (SD = 10.4), and 28% of the participants experienced a high level of loneliness. The prevalence ratio for suicidal ideation in the group with high levels of loneliness was 3.06 (95% CI 2.57, 3.63) compared to the group with low levels of loneliness. In our subgroup analysis, we consistently observed an association between loneliness and suicidal ideation across the employed group; however, the employed was more related with qualitative loneliness, the self-employed and the unemployed were more related with quantitative loneliness.ConclusionsLoneliness was associated with suicidal ideation. According to employment status, the associations were consistent, but there were interactions between type of loneliness and employment status. These findings suggest that interventions to reduce loneliness and prevent suicidal ideation should be tailored to specific employment groups, focusing on qualitative aspects for employed individuals and quantitative aspects for self-employed and unemployed individuals.

Mediation of expressive suppression and emotional well-being in the relationship between loneliness and mobile phone addiction among Chinese adolescents

The relationship between adolescent loneliness and mobile phone addiction has been well-documented; however, little is known about its underlying mechanisms. This study aimed to explore the mediation of expressive suppression and emotional well-being in the loneliness-mobile phone addiction link among Chinese adolescents. A total of 906 adolescents completed the related questionnaires in a cross-sectional study. Results have shown that higher levels of loneliness are associated with higher levels of mobile phone addiction. Meanwhile, the link between loneliness and mobile phone addiction could be independently mediated by expressive suppression and emotional well-being. The serial mediation effect of expressive suppression and emotional well-being could also explain the link between loneliness and mobile phone addiction. These findings highlight potential intervention directions targeting these factors to decrease mobile phone addiction.

Examining psychosocial vulnerability in caregivers of individuals with a chronic haematological malignancy. A cross sectional survey.

ObjectiveTo investigate psychosocial vulnerability in informal caregivers of chronic haematological cancer patients and determine the level of psychosocial vulnerability among carers of people living with a CHM. MethodsAn international cross – sectional study including caregivers of individuals with a chronic haematological cancer (n=64) from Ireland (n=29), Australia (n=21), the UK (n=4), the USA (n=4), and India (n=6). Caregivers completed scales for loneliness, resilience, stress and caregiver strain using the UCLA scale, BRS scale, PSS scale and MCSI scale. Descriptive statistics and non-parametric techniques were used. ResultsThe results show that younger carers (aged between 18-40) report higher levels of loneliness, stress and caregiver strain. Carers who have left their paid employment due to caregiving and are in receipt of carers’ allowance or social welfare report high levels of loneliness and caregiver strain. Lower stress levels were reported in those who received paid professional caring support. Finally, higher levels of loneliness in carers were associated with the patient currently being on some form of treatment and higher levels of caregiver strain were associated with caring for someone for more than 8 hours per day and having all social, mental, and financial areas of life affected ConclusionCaregivers of patients with chronic haematological cancers experience psychosocial vulnerability, which is associated with their age, socioeconomic status, gender and health and wellbeing.

Coping with COVID-19: a prospective cohort study on young Australians' anxiety and depression symptoms from 2020–2021

BackgroundStudies have shown that the coronavirus (COVID-19) pandemic negatively impacted the mental health of young Australians. However, there is limited longitudinal research exploring how individual factors and COVID-19 related public-health restrictions influenced mental health in young people over the acute phase of the COVID-19 pandemic. This study aimed to identify risk and protective factors associated with changes in individual symptoms of anxiety and depression among young Australians during the COVID-19 pandemic.MethodsThis prospective cohort study collected data on anxiety and depression symptoms of young Australians aged 15–29 years old using the Depression, Anxiety and Stress Scale short form (DASS-21). We delivered four online questionnaires from April 2020 to August 2021 at intervals of 3, 6, and 12 months after the initial survey. We implemented linear mixed-effects regression models to determine the association among demographic, socioeconomic, lifestyle and COVID–19 public health restrictions related factors and the severity of anxiety and depression symptoms over time.ResultsAnalyses included 1936 young Australians eligible at baseline. There was a slight increase in DASS-21 anxiety mean scores from timepoint 3 to timepoint 4. DASS-21 depression scores showed slight fluctuations across timepoints with the highest mean score observed in timepoint 2. Factors associated with increases in anxiety and depression severity symptoms included LGBTQIA + identity, financial insecurity both before and during the pandemic, higher levels of loneliness, withdrawal or deferral of studies, spending more time on social media, and difficulties to sleep. Risk factors for only depression symptoms include unemployment during COVID-19 pandemic and being in lockdown. Living with someone was a protective factor for both anxiety and depression symptoms, pre-COVID-19 unemployment for depression symptoms, and older age and unemployment during the pandemic for anxiety symptoms.ConclusionThese findings indicate that during the first year of the pandemic in Australia, there were significant changes in young people’s mental health which were associated with multiple demographic, socioeconomic, lifestyle, and lockdown factors. Hence, in future public health crises, we suggest more inclusive guidelines that involve young people in their development and implementation ensuring that their unique perspectives and needs are adequately considered.

Abstract B134: Socioeconomic, social, and clinical factors associated with loneliness among African American breast cancer survivors

Abstract Importance: Social connections are an important driver of cancer risk and outcomes and animal studies have shown that social isolation is important to breast cancer initiation and progression. However, limited empirical data are available on perceived loneliness among patient groups who are at increased risk for breast cancer morbidity and mortality. Objectives: The purpose of this study was to characterize the nature and distribution of loneliness in a sample of African American breast cancer patients and identify clinical and social factors having significant independent associations with perceived loneliness among these survivors. Methods: The study included African American breast cancer patients (n=110) who provided self-reported data on loneliness as part of a participating in a prospective observational study and randomized trial that examined stress reactivity using the Trier Social Stress Test. Loneliness was measured using a short form of the Loneliness Scale; scores were dichotomized using the median split to characterize patients as experiencing high versus low levels of loneliness. Multivariate logistic regression analysis was used to identify factors having significant associations with loneliness. Results: Over half (51.82%) of patients reported experiencing high levels of loneliness. Clinical and social factors that had significant independent associations with loneliness included marital status (OR=2.853, CI=1.066, 7.635, p=0.037), financial strain (OR=3.240, CI=1.114, 9.422, p=0.031), and the number of co-morbidities. Compared to patients who did not have any co- morbidities, those who had one, two, or three or more comorbidities had seven (CI=1.066, 40.645; p=0.029), eleven (CI=1.858, 66.716, p=0.008), and eleven (CI=1.757, 65.244; p=0.010) times the odds, respectively, of experiencing loneliness. Conclusions and Relevance: Many African American breast cancer patients in this study reported high levels of loneliness. Greater efforts are needed to identify patients who may benefit from interventions that enhance social connections, especially if they are married, experiencing financial strain, and have co-morbid conditions. Citation Format: Kelsie Campbell, Fatimata Sanogo, Trista Beard, Melanie Jefferson, Bodhour Sahlia, Chanita Hughes Halbert. Socioeconomic, social, and clinical factors associated with loneliness among African American breast cancer survivors [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B134.

The association of material deprivation with major depressive disorder and the role of loneliness and social support: A cross-sectional study

BackgroundExisting research has highlighted the positive association of material deprivation, loneliness, and poor social support with major depressive disorder (MDD). However, there is limited information on the complex interplay between these risk factors. In this study, we investigated (1) whether loneliness and social support moderate the relationship between material deprivation and MDD and (2) whether social support moderates the association between material deprivation and loneliness. MethodsWe conducted a cross-sectional study analyzing responses from a representative sample of the Spanish adult population, comprising 2790 individuals who were interviewed between 2019 and 2021. The 12-month prevalence of MDD was assessed using the Composite International Diagnostic Interview (CIDI). Loneliness was measured using the three-item UCLA Loneliness Scale, and social support was evaluated with the Oslo social support scale. Material deprivation was measured using an instrument developed by the Spanish National Institute of Statistics (INE). Regression models were constructed to investigate moderating effects. ResultsAbout 25 % of participants experienced material deprivation and 2.8 % had MDD. Among those with lower levels of loneliness, the probability of MDD was almost 0.10 and no significant differences were found in relation to material deprivation. Conversely, differences depending on material deprivation ranged from 0.10 (95 % CI 0.03, 0.18) to 0.44 (95 % CI 0.24, 0.65) among those with higher levels of loneliness. Social support effectively moderated the association between material deprivation and loneliness. LimitationThe cross-sectional nature limits causal inferences. ConclusionSocial support has the potential to improve loneliness and mental health in individuals with economic difficulties.

Perceived loneliness: Why are Syrian refugees more lonely than other newly arrived migrants in Germany?

Migration often impacts the mental and emotional health of those needing to move from their home countries. Studies have focused on migrants’ levels of distress or well-being, and recent research looks at older migrants’ experience with loneliness. What has yet to be researched is how different migrant groups experience loneliness, and how these feelings are affected by the contexts of leaving one country and reception in another. Drawing on the theoretical framework of integration, this article asks whether newly arrived refugees in Germany differ in their perception of loneliness from other newly arrived migrants. It examines these perceptions as related to social contacts and the context—and interplay—of exit and reception. Using OLS regressions with data from the Recent Immigration Processes and Early Integration Trajectories in Germany (ENTRA) project, we find that Syrian refugees have higher levels of loneliness than migrant groups from Poland, Italy, and Turkey. The difference is largely attributable to Syrians not having local German contacts, surviving traumatic experiences at home, and migrating specifically for physical safety. We also find that discrimination and not being in the labor force are determinants of loneliness across all four groups, and that even when considering migrant origins and other effects, having local social contacts lowers levels of loneliness. Our results point to migration policies, such as those related to family reunification and labor market access, for producing inequalities in loneliness between Syrian refugees and other migrants in Germany.

Attributional style in Borderline personality disorder is associated with self-esteem and loneliness

BackgroundAttributions are the processes by which individuals explain the causes of positive and negative events. A maladaptive attributional style has been associated with reduced self-esteem, psychosocial functioning, and mental health. Although many psychosocial interventions target an individual’s attributional style in mental disorders, studies of its alterations in Borderline Personality Disorder (BPD) are sparse. This study aimed to investigate the attributional style in patients with BPD in comparison to healthy control individuals (HC) and its association with self-esteem and psychosocial functioning.MethodsThe participants (32 patients with a diagnosis of BPD, 32 HC, groups were balanced for sex, age and education) assessed their attributional style in regard to locus of control, stability and globality for positive and negative scenarios. Attributional style was compared between groups and linked to self-reports of self-esteem, loneliness and psychosocial functioning in different social domains while controlling for BPD and depressive symptom severity.ResultsIndividuals diagnosed with BPD reported a maladaptive attributional style for both positive and negative events. This was found to be strongly related with lower self-esteem and higher levels of loneliness, but not with psychosocial dysfunctions assessed in different social domains. The severity of BPD and depressive symptoms did not fully explain the association of attributional style with self-esteem and loneliness. In contrast, correcting for acute psychopathology actually strengthened the relationship between self-esteem and maladaptive inferring causality for positive events.ConclusionThe differential association of attributional style for positive and negative events with self-esteem and psychosocial functioning highlights the importance of considering the different facets of inferring causality during psychosocial interventions. Our findings suggest that the significance of cognitive alterations may change with remission of acute BPD and depressive psychopathology, depending on the valence of an event.

Frailty Assessment and Its Impact on Loneliness among Older Adults Receiving Home-Based Healthcare during the COVID-19 Pandemic.

The purpose of this study was to identify the effect of frailty on loneliness among older adults receiving home care, in correlation to their socioeconomic and homebound statuses. This cross-sectional study recruited 218 individuals aged ≥65 years receiving home-based health services from the "Help at Home" program in the Region of Evrytania, Greece through an open invitation from the municipality authorities from March to June 2022. The Tilburg Frailty Indicator (TFI) was used for the evaluation of frailty, the UCLA Loneliness Scale version 3 was used for loneliness, and social isolation was accessed through five questions (living alone, frequency of interaction with children, relatives, friends, and participation in social organizations). The mean age of the participants was 81.48 ± 9.06, 61.9% were female, 54.1% experienced high levels of loneliness (UCLA-3 mean 45.76 ± 11.10 [range 20-68]), and 46.3% of the participants were found to be socially isolated. Also, 58.3% of the individuals were identified as frail (TFI mean 5.95 ± 3.07) [TFI range 0-13], with 57.3% experiencing physical frailty, 43.6% experiencing psychological frailty, and 27.1% experiencing social frailty. An analysis of covariance (ANCOVA) using UCLA-3 as the dependent variable revealed that loneliness across all domains of TFI was significantly higher in participants with frailty (total frailty [Yes] 49.27 vs. [No] 40,87 p < 0.001) (physical frailty [Yes] = 48.99 vs. [No] = 41.42, p < 0.001, psychological: 48.60 vs. 43.57 p < 0.001, and social: 53.38 vs. 42.94 p < 0.001), particularly compared to non-frail individuals, even after adjusting for potential confounding effects (covariates: gender, age, marital status, family status, living status, educational level, annual income, chronic diseases, homebound status, and social isolation). Our findings indicate that frail older adults experienced higher levels of loneliness, suggesting that frailty and loneliness are independently associated among older adults who receive home-based healthcare.

Quietly Crowded: The Moderating Role of Positive Relationship Quality in Cyberspace on Loneliness and Subjective Well-Being in Urban Communities

Loneliness is commonly experienced by individuals in urban communities because of the difficulties in establishing close relationships in urban settings. One way to deal with loneliness in the real world is to find virtual friends in cyberspace. In other words, high level of loneliness can cause social relationship in the virtual world to increase and social relationship in the real world to decrease. The social compensation model hypothesized that higher quality interaction with virtual friends could reduce loneliness levels and ultimately increase one's subjective well-being because this interaction is considered a safe relationship and a preference for those who feel isolated. By utilizing the Social and Emotional Loneliness Scale for Adults - Short Version (SELSA-S), the Positive Negative Relationship Quality (PN-RQ) Scale, and the Satisfaction With Life Scale (SWLS), this study found that positive relationship quality in cyberspace (with virtual friends) significantly moderated the association between loneliness levels and subjective well-being (N = 300). Therefore, this study’s results show that not all online interactions are detrimental to individual’s mental health. Also, individuals in urban communities should considering focusing more on increasing the quality of interactions, instead of increasing the quantity or number of friendships.

Associations of social engagement, and loneliness with the progression and reversal of frailty: longitudinal investigations of two prospective cohorts from the UK and the USA.

Social connections may impact the dynamic trajectory of frailty. Using data from the British Regional Heart Study (BRHS) in the UK (n = 715), and the US Health, Aging and Body Composition (Health ABC) Study (n = 1256), we conducted multinominal regression analyses to examine the association of baseline and change in social engagement and loneliness with progression to pre-frailty and frailty, as well as their association with reversal to pre-frailty and robust status among older adults. A higher level of social engagement at baseline (BRHS: relative risk ratio (RRR) 0.69 [95%CI 0.55-0.85]; Health ABC: 0.56 [0.45-0.70]), as well as increase in social engagement (BRHS: 0.73, [0.59-0.90]; Health ABC: 0.51 [0.41-0.63]), were associated with a lower risk of developing frailty. In BRHS, a higher level of loneliness at baseline (1.42 [1.10-1.83]) and an increase in loneliness (1.50 [1.18-1.90]), increased the risk of developing frailty. For reversal of frailty, higher social engagement at baseline (Health ABC: 1.63 [1.08-2.47]) and an increase in social engagement (BRHS:1.74[1.18-2.50]; Health ABC: 1.79[1.17-.274]) were beneficial. Social connections maybe potentially important and modifiable factors in both preventing and reversing progression of frailty in older adults.

Loneliness and Its Impact: An Overlooked Epidemic

Approximately half of U.S. adults report experiencing measurable levels of loneliness.1 Loneliness is the feeling of being alone, irrespective of social contact, while social isolation is a lack of social connections. Therefore, social isolation may lead to loneliness for some, while others can feel lonely without being socially isolated. Both loneliness and social isolation are increasing exponentially. The U.S. Surgeon General, Dr. Vivek Murthy, recently declared loneliness and isolation as an underappreciated public health crisis, equating its impact on physical health to that of smoking 15 cigarettes per day.2 The primary method for measuring loneliness uses self-report surveys, where individuals evaluate their loneliness and social isolation by responding to statements about social interactions and emotions, indicating their agreement or frequency of these experiences. The UCLA Loneliness Scale is one of the most widely used tools which has 20 items, allowing individuals to subjectively assess their feelings on a scale from 1 to 4, covering aspects such as feeling excluded or having companionship. Scores ranging from 20 to 34 indicate a low level of loneliness, 35 to 49 indicate a moderate level, 50 to 64 reflect a moderately high level, and 65 to 80 indicate a high level of loneliness.3 Loneliness is inherently subjective, and individuals' perceptions of what constitutes loneliness can vary widely.

Socially isolated, but not lonely in lockdown: Exploring the role of reflective functioning as a protective factor in the early days of the COVID-19 pandemic in Germany

IntroductionLoneliness is a pressing public mental health issue. So far, there has been a paucity of investigations focused on the individual differences modulating this subjective feeling in the face of difficult circumstances, e.g., the COVID-19 pandemic. As such, the present study aimed to investigate the role of mentalization; given that the construct comprises reflection abilities that might be particularly relevant to the pandemic's interpersonal challenges. MethodsA survey representative of the German population was conducted from May to June 2020 (N = 2503). We examined mentalization, operationalized as reflective functioning (RF) and measured using the Mentalization Questionnaire (MZQ), both as a protective factor against loneliness on its own and as a moderator of the association of social isolation with loneliness. ResultsOf the overall sample, 822 (32.8 %) individuals reported social isolation. Worse RF was moderately associated with higher levels of loneliness (r = 0.433, p < .001). A linear regression model (controlling for sociodemographic characteristics and general personality pathology) confirmed this positive association, but also indicated an interaction effect of RF and social isolation in the statistical prediction of loneliness. Stratified models showed that RF was a comparatively weaker statistical predictor of loneliness among the socially isolated. DiscussionThis representative population study expanded our knowledge about the factors shaping loneliness in the population. RF emerged as a potentially modifiable protective influence. Further research needs to clarify the mechanisms through which it mitigates loneliness. LimitationsThe cross-sectional design does not give insight into the temporal association of RF and loneliness.

Loneliness in the Digital World: protocol for a co-produced ecological momentary assessment study in adolescents

IntroductionLoneliness has been identified as an important public health issue, peaking during adolescence. Previous research has suggested that social interaction is a key factor in loneliness, and positive social interaction...