Social Isolation Scores Research Articles

Driving Cessation and Social Isolation in Older Adults.

Objective: This study investigated the impact of driving cessation on social isolation in older adults. Method: Data were obtained from Rounds 1 through 6 of the National Health and Aging Trends Study. The study sample consisted of 6,916 Medicare beneficiaries aged 65 or above who were eligible drivers at baseline. Mixed-effects ordered logistic regression and piecewise regression were used to examine the impact of driving cessation on social isolation. Results: In multivariable mixed-effects ordered logistic regression, past-year nondrivers had a twofold increase in the odds of being in a higher social isolation category (odds ratio [OR] = 2.1, p < .001). Piecewise regression analysis showed that social isolation scores increased by 0.08 points (p = .024) following an incident of driving cessation. Discussion: Driving cessation is associated with a higher risk of social isolation in older adults. Interventions to reduce social isolation among older adults may improve public health by targeting older adults who have recently stopped driving.

미술치료가 고립아동의 자아존중감 및 또래관계에 미치는 영향에 관한 단일사례연구

The purpose of this study was to examine the effects of art therapy on the self-esteem and peer relationships of an isolated child. The study subject was a third-grade student attending C Community Child Center in Seoul. She was not confident and did not fit in with her peers. We performed twenty sessions with the child once a week for one hour. The results were as follows: First, art therapy had a positive impact on the self-esteem of the child. We observed that her self-esteem score increased in posttest compared to pretest, and there were also positive changes in her art diagnosis test. During the middle, late and terminal periods of art therapy, the child exhibited a sense of pride and accomplishment, expressed her acceptance of reality and hope for the future, and revealed an inner strength to overcome difficulties. Second, art therapy had positive impact on the peer relationships of the child. We observed a decrease in her social and emotional isolation scores, and both self-rated and teacher-rated friendship relations scores increased in posttest compared to pretest scores. During the late and terminal periods of art therapy, the child began to consider other people, and she recognized the necessity of friends and forming groups.

Civic Service as an Intervention to Promote Psychosocial Health and Implications for Mental Health in Post-9/11/01 Era Women Veterans.

Background: Women veterans experience significant morbidity with poorer health and mental health outcomes relative to nonveteran counterparts. Little is known about how to best promote health and well-being among reintegrating female veterans. Civic service has been shown to improve mental health in civilians, but its impact on female veterans is unknown. This study characterizes the physical and mental health and psychosocial functioning of female veterans and evaluates changes in these domains following completion of an intensive civic service program. Materials and Methods: Data were obtained from an observational, pre-post cohort study of post-9/11/01 era veterans who completed a 6-month, 20-hour per week civic service program. Of the 346 participants, 107 were women. Participants completed online pre- and post-program surveys. Nine measures of health, mental health, and psychosocial functioning were analyzed. Results: Before starting the program, 47% of women screened positive for a probable diagnosis of post-traumatic stress disorder (PTSD), 24% for depression, and 51% reported seeking assistance for mental health problems. Pre-post change scores indicated significant improvements on nine measures of health, mental health, and psychosocial functioning (p < 0.05). Perceived self-efficacy change scores predicted PTSD change scores, F(1, 93) = 8.00, p < 0.05. Seeking professional assistance for mental health problems and social isolation and loneliness change scores predicted depression change scores, F(2, 95) = 15.618, p < 0.05, explaining 23% of the variance. Conclusions: Civic service has the potential to promote and support the maintenance of psychosocial well-being for returning post-9/11/01 era women veterans with symptoms of PTSD or depression.

The association between use of online social networks sites and perceived social isolation among individuals in the second half of life: results based on a nationally representative sample in Germany

BackgroundTo date, little is known about the association between the use of online social network sites and social isolation among individuals in the second half of life. Therefore, the aim of the present study was to examine this association among older adults.MethodsCross-sectional data was drawn from a nationally representative sample of non-institutionalized individuals aged 40 and above (n = 7837) in Germany (German Ageing Survey). Online social network use was assessed using the frequency of social network use (e.g., Facebook) in the preceding 12 months (daily; several times a week; once a week; 1–3 times a month; less often; never). Perceived social isolation was measured using an established scale created by Bude and Lantermann.ResultsAdjusting for covariates, linear regressions revealed that daily online social network users reported lower social isolation scores compared with those with less frequent or no social media use.ConclusionsData suggest that daily users of online social networks aged 40 and over tend to feel less socially isolated than less frequent users or non-users. Future research should concentrate on identifying the direction of this association. Moreover, the reasons underlying this finding should be examined.

Social Isolation and Mortality in US Black and White Men and Women

Social isolation is associated with higher mortality in studies comprising mostly white adults, yet associations among black adults are unclear. In this prospective cohort study, we evaluated whether associations of social isolation with all-cause, cardiovascular disease, and cancer mortality differed by race and sex. Adults enrolled in Cancer Prevention Study II in 1982/1983 were followed for mortality through 2012 (n = 580,182). Sex- and race-specific multivariable-adjusted hazard ratios and 95% confidence intervals were estimated for associations of a 5-point social isolation score with risk of death. Social isolation was associated with all-cause mortality in all subgroups (P for trend ≤ 0.005); for the most isolated versus the least isolated, the hazard ratios were 2.34 (95% confidence interval (CI): 1.58, 3.46) and 1.60 (95% CI: 1.41, 1.82) among black men and white men, respectively (P for interaction = 0.40) and 2.13 (95% CI: 1.44, 3.15) and 1.84 (95% CI: 1.68, 2.01) among black women and white women, respectively (P for interaction = 0.89). The association did not differ between black men and black women (P for interaction = 0.33) but was slightly stronger in white women than in white men (P for interaction = 0.01). Social isolation was associated with cardiovascular disease mortality in each subgroup (P for trend < 0.03) but with cancer mortality only among whites (P for trend < 0.0001). Subgroup differences in the influence of specific social isolation components were identified. Identifying and intervening with socially isolated adults could improve health outcomes.

Social isolation and loneliness as risk factors for the progression of frailty: the English Longitudinal Study of Ageing.

Backgroundloneliness and social isolation have been associated with mortality and with functional decline in older people. We investigated whether loneliness or social isolation are associated with progression of frailty.Methodsparticipants were 2,817 people aged ≥60 from the English Longitudinal Study of Ageing. Loneliness was assessed at Wave 2 using the Revised UCLA scale (short version). A social isolation score at Wave 2 was derived from data on living alone, frequency of contact with friends, family and children, and participation in social organisations. Frailty was assessed by the Fried phenotype of physical frailty at Waves 2 and 4, and by a frailty index at Waves 2–5.Resultshigh levels of loneliness were associated with an increased risk of becoming physically frail or pre-frail around 4 years later: relative risk ratios (95% CI), adjusted for age, sex, level of frailty and other potential confounding factors at baseline were 1.74 (1.29, 2.34) for pre-frailty, and 1.85 (1.14, 2.99) for frailty. High levels of loneliness were not associated with change in the frailty index—a broadly based measure of general condition—over a mean period of 6 years. In the sample as a whole, there was no association between social isolation and risk of becoming physically frail or pre-frail, but high social isolation was associated with increased risk of becoming physically frail in men. Social isolation was not associated with change in the frailty index.Conclusionolder people who experience high levels of loneliness are at increased risk of becoming physically frail.

Evaluation of Acceptance and Commitment Therapy (ACT) for Mothers of Children and Youth with Autism SpectrumDisorder

Mothers of children with autism spectrum disorder (ASD) often face high levels of stress. While there have been interventions for parents of children with ASD targeting their parenting skills, there have been fewer studies that aim to target the psychological or physical well-being of the mothers themselves. This study included mothers of children with ASD to cofacilitate acceptance and commitment therapy (ACT) to other mothers of children with ASD. The intervention consisted of one evening session and a full-day workshop, followed by a refresher session 1 month later. Of the 33 mothers that enrolled in the study, 29 attended all three sessions and completed the outcome measures. Significant changes were observed over time in terms of depression, stress, social isolation and physical health scores. Post hoc analyses showed reductions in stress and depression and improvements in physical health which were maintained at follow-up. Results suggest that a brief parent-facilitated ACT group intervention may be effective in improving the mental and physical health of mothers of children with ASD.

Role of Depression and Social Isolation at Time of Waitlisting for Survival 8Years After Heart Transplantation.

BackgroundWe evaluated depression and social isolation assessed at time of waitlisting as predictors of survival in heart transplant (HTx) recipients.Methods and ResultsBetween 2005 and 2006, 318 adult HTx candidates were enrolled in the Waiting for a New Heart Study, and 164 received transplantation. Patients were followed until February 2013. Psychosocial characteristics were assessed by questionnaires. Eurotransplant provided medical data at waitlisting, transplantation dates, and donor characteristics; hospitals reported medical data at HTx and date of death after HTx. During a median follow‐up of 70 months (<1–93 months post‐HTx), 56 (38%) of 148 transplanted patients with complete data died. Depression scores were unrelated to social isolation, and neither correlated with disease severity. Higher depression scores increased the risk of dying (hazard ratio=1.07, 95% confidence interval, 1.01, 1.15, P=0.032), which was moderated by social isolation scores (significant interaction term; hazard ratio = 0.985, 95% confidence interval, 0.973, 0.998; P=0.022). These findings were maintained in multivariate models controlling for covariates (P values 0.020–0.039). Actuarial 1‐year/5‐year survival was best for patients with low depression who were not socially isolated at waitlisting (86% after 1 year, 79% after 5 years). Survival of those who were either depressed, or socially isolated or both, was lower, especially 5 years posttransplant (56%, 60%, and 62%, respectively).ConclusionsLow depression in conjunction with social integration at time of waitlisting is related to enhanced chances for survival after HTx. Both factors should be considered for inclusion in standardized assessments and interventions for HTx candidates.

Potential biological pathways linking Type-D personality and poor health: A cross-sectional investigation.

BackgroundType-D personality, defined as a combination of high negative affect and high social isolation, has been associated with poor health outcomes. However, pathways underlying this association are largely unknown. We investigated the relationship between Type-D personality and several biological and behavioral pathways including the autonomic nervous system, the immune system, glucose regulation and sleep in a large, apparently healthy sample.MethodsData from a total of 646 respondents (age 41.6±11.5, 12,2% women) were available for analysis. Persons with Type-D (negative affect and social isolation score ≥10) were contrasted with those without Type-D. Measures of plasma fibrinogen levels, white blood cell count, high sensitivity C-reactive protein, fasting plasma glucose (FPG), cholesterol, high-density and low-density lipoprotein, glycated hemoglobin (HbA1c), creatinine, triglycerides, and albumin were derived from fasting blood samples. Urine norepinephrine and free cortisol were determined by high-performance liquid chromatography. Time-domain heart rate variability (HRV) measures were calculated for the 24hr recording period and for nighttime separately.ResultsPersons with Type-D had higher HbA1c, FPG, and fibrinogen, and lower nighttime HRV than those without Type-D, suggesting worse glycemic control, systemic inflammation and poorer autonomic nervous system modulation in Type-D persons. In addition, those with Type-D reported less social support and greater sleep difficulties while no group differences were observed for alcohol and cigarette consumption, physical activity and body mass index.ConclusionsFindings provide some of the first evidence for multiple possible biological and behavioral pathways between Type-D personality and increased morbidity and mortality.

Early maladaptive schema domains in the first day of menses and 15 days after the menses in healthy volunteers

IntroductionPremenstrual syndrome (PMS) symptoms may affect the physical, psychological and social lives of many women of the reproductive age group. Most women report being extra-sensitive and have difficulties with emotional regulation and some patients report worsening of their psychiatric symptoms during the premenstrual period. Early maladaptive schemas (EMS) are developed early in childhood and may remain dormant until they are activated by situations relevant to the particular schema.ObjectiveWe hypothesized that some of the psychological symptoms of PMS may be related to EMS activation and that this activation is due to the hormonal changes of the menstrual cycle.AimsOur aim was to measure any changes regarding the EMS domains between the first day of menses and 15 days later.MethodsOne hundred and ten women from an architectural and engineering firm were enrolled in the study. After ruling-out psychopathology with Symptom check-list-90-R, remaining women (n = 65) filled out young schema scale short form (YSS-SF) on the first day of menses and 15 days after menses. The time of probable ovulation was defined as 15 days after the first day of menses.ResultsYSS-SF scores regarding the schemas of defectiveness, insufficient self-control, failure to achieve, vulnerability to harm or illness were significantly decreased by the 15th day of menses (P &lt; 0.05). Abandonment, social isolation, dependency, enmeshment and self-sacrifice schema scores remained similar on the first and 15th days.ConclusionsEMS activation may contribute to the PMS symptoms, therefore schema therapy may be an option for those women suffering from PMS.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Quality of Life and Psychosocial Implications in Patients with Hidradenitis Suppurativa

Background: Hidradenitis suppurativa (HS) is a long-term skin disorder associated with high levels of psychological distress and significant life impact. Objective: To evaluate the quality of life, depression, anxiety, loneliness, and self-esteem in patients with HS. Methods: Ninety-four patients with HS were enrolled in the study. The quality of life, depression, anxiety, loneliness, and self-esteem of the patients were assessed using the Dermatology Life Quality Index (DLQI), the Hospital Anxiety and Depression Scale (HADS), the UCLA Loneliness Scale (UCLA-Version 3), and the Rosenberg Self-Esteem Scale (RSES), respectively. Results: The DLQI mean score was 11.43 ± 6.61 in patients with HS. The patients with HS presented statistically significantly higher anxiety (6.41 ± 3.31 vs. 5.00 ± 1.59, p < 0.001), depression (5.45 ± 2.79 vs. 4.16 ± 1.54, p < 0.001), and loneliness and social isolation scores (42.86 ± 8.63 vs. 35.57 ± 6.17, p < 0.001) and lower self-esteem scores (18.91 ± 1.79 vs. 19.77 ± 2.53, p = 0.008) than the healthy controls. Conclusions: HS is a distressing, recurrent disease that impairs quality of life. We can suggest services that allow an integrated approach, which includes psychosocial support, offering the patients relief from isolation and an opportunity to share common experiences.

Is disability measured by FIM a predictor for successful self-intermittent catheterization in neurological patients?

Self-clean intermittent catheterization (CIC) is a part of the arsenal of treatment strategies of neurogenic bladder (1). The acquisition of this technique depends on environment and parameters related to the patients, that can be measured by the FIM score (Functional Independence Measure), validated in various neurological populations (2). The objective of this study is to determine whether disability, as measured by the FIM, is predictive of the acquisition and the retention of CIC. All neurological patients consulting for learning self-CIC between 2011 and 2015 with disability evaluated by FIM were included retrospectively. Demographic and medical characteristics together with the successful acquisition of self-CIC were collected at the end of the learning session, as well as retention at 1 month and between 6 and 12 months. Association between motor (FIMmot), cognitive (FIMcog) scores and success for self-CIC was tested by uni- and multivariate logistic regression models. Of 460 patients (mean age 52.0 ± 14.3 years; women: 62.4%), 54.8% were diagnosed with multiple sclerosis, 16.5% of “medical” spinal cord condition, 4.6% of spinal cord injury, 14.3% of peripheral neuropathy, 3.7% of neurodegenerative disorders and 3.0% of brain condition. The mean FIMmot and FIMcog scores were 185.1 ± 27.5 and 4.1 ± 31.6. The success rate was 89.6%, with 75.5% holding at 1 month and 60.1% at 6–12 months. FIMmot and FIMcog scores were associated with success in self-CIC ( P < 0.001) and retention at 1 month ( P < 0.05). Between 6 and 12 months, only FIMcog remained associated ( P = 0.003). After adjustment for age, BMI, pathology and social isolation, FIMmot and FIM cog scores as well as male gender were associated with success (OR [CI 95] respectively: 1.02 [1.01–1.03], 1.18 [1.07–1.29], 0.25 [0.09–0.57]). These variables were also associated with retention at 1 month and between 6 and 12 months ( P < 0.001). FIMmot and FIMcog scores are independent predictors of successful self-CIC acquisition and retention among neurological patients. A significant clinical threshold is to be defined in order to select the best candidates for self-CIC and to propose tailored protocols of CIC acquisition.

Developing “Family Integrated Treatment” for Autistic Disorders and Comparing its Efficacy on Decreasing Parenting Stress of Parents of Autistic Children with “Little Bird” Method

Introduction: Autism is one of the most famous neuro-developmental disorders and increases parental stresses. On the other hand, decrease of parental stress has positive effect on child response to treatment. So, the main goal of this study was to develop a family education program for parents of children with autism, which is effective on decreasing their parental stress. Materials and Methods: The first part of the study was a qualitative research of three categories of information resulted from deep interviews with 11 specialists, semi-structured interviews with 30 parents and review of 101 articles. The second part was an experimental research on two intervention, and one control groups, with three examination stages: before, after and one-month fallow-up. To fulfill this goal, 42 parents were selected from the parents of autistic children who received services in Tehran Autism Center, Iran, during the study period, and then, were divided randomly to tree groups. The material used for this section of study was Parental Stress Index (PSI). The results were analyzed using covariate analysis and analysis of variance techniques via SPSS 20 software. Results: Our family integrated treatment method for autistic disorders was more efficient on decreasing reinforcing (P = 0.032), mood (P = 0.010), acceptability (P = 0.013), and adaptability (P = 0.004), and total score of child stress (P = 0.004). In addition, it showed significant effect on competence (P = 0.002), depression (P = 0.001), social isolation (P = 0.002), attachment (P < 0.001), role restriction (P =0.001), parental health (P = 0.003), and total score of parental stress (P < 0.001), and also on PSI-total score (P < 0.001), in comparison with 2 other groups. Conclusion: In comparison with previous parental training programs like little bird program which mostly focuses on stress of child domain, family integrated treatment method pays attention to special needs of every single family and its comprehensiveness; and is effective on decreasing parental domain of stress as well.

Motivational engagement in first-time hearing aid users: A feasibility study

Objective: To assess (1) the feasibility of incorporating the Ida Institute’s Motivation Tools into a UK audiology service, (2) the potential benefits of motivational engagement in first-time hearing aid users, and (3) predictors of hearing aid and general health outcome measures.Design: A feasibility study using a single-centre, prospective, quasi-randomized controlled design with two arms. The Ida Institute’s Motivation Tools formed the basis for motivational engagement. Study sample: First-time hearing aid users were recruited at the initial hearing assessment appointment. The intervention arm underwent motivational engagement (M+, n = 32), and a control arm (M-, n = 36) received standard care only. Results: The M+ group showed greater self-efficacy, reduced anxiety, and greater engagement with the audiologist at assessment and fitting appointments. However, there were no significant between-group differences 10-weeks post-fitting. Hearing-related communication scores predicted anxiety, and social isolation scores predicted depression for the M+ group. Readiness to address hearing difficulties predicted hearing aid outcomes for the M- group. Hearing sensitivity was not a predictor of outcomes. Conclusions: There were some positive results from motivational engagement early in the patient journey. Future research should consider using qualitative methods to explore whether there are longer-term benefits of motivational engagement in hearing aid users.

Social networks and links to isolation and loneliness among elderly HCBS clients

Objectives: The purpose of this study was to explore the network types of HCBS clients based on the structural characteristics of their social networks. We also examined how the network types were associated with social isolation, relationship quality and loneliness.Method: Forty personal interviews were carried out with HCBS clients to assess the structure of their social networks as indicated by frequency of contact with children, friends, family and participation in religious and community organizations. Hierarchical cluster analysis was conducted to identify network types.Results: Four network types were found including: family (n = 16), diverse (n = 8), restricted (n = 8) and religious (n = 7). Family members comprised almost half of participants’ social networks, and friends comprised less than one-third. Clients embedded in family, diverse and religious networks had significantly more positive relationships than clients embedded in restricted networks. Clients embedded in restricted networks had significantly higher social isolation scores and were lonelier than clients in diverse and family networks.Discussion: The findings suggest that HCBS clients’ isolation and loneliness are linked to the types of social networks in which they are embedded. The findings also suggest that clients embedded in restricted networks are at high risk for negative outcomes.

The effect of acceptance of illness on the quality of life in patients with chronic heart failure.

Although important, a relationship between acceptance of illness and quality of life has not been studied extensively in individuals with chronic heart failure. The aim of this study was to analyse an association between these two variables in a large group of individuals with at least a six-month history of heart failure. The study included 100 patients (68 men and 32 women, mean age 63.2±12.2 years) with at least six months' clinical evidence of heart failure corresponding to New York Heart Association class II, III or IV. All the patients were examined with the Nottingham Health Profile (NHP) questionnaire and Acceptance of Illness Scale (AIS). The patients presenting with low levels of acceptance of illness (8-18 points) scored significantly higher on the energy, pain, emotional reaction, sleep, social isolation and mobility domains of the NHP. Multivariate analysis showed that acceptance of illness was the only independent predictor of quality of life in all the NHP domains: energy (β= -0.653, p<0.001), pain (β= -1.464, p<0.001), emotional reactions (β -1.738, p<0.001), sleep (β= -0.820, p<0.001), social isolation (β= -0.638, p<0.001) and mobility (β= -1.739, p<0.001). Male gender proved to be an independent predictor of lower pain scores (β= -1.320, p= 0.001) and divorce was associated with higher social isolation scores (β=1.948, p<0.001). The extent a patient accepts their chronic heart failure diagnosis has been shown to impact on their quality of life.

The Concurrent Validity of Brief Screening Questions for Anxiety, Depression, Social Isolation, Catastrophization, and Fear of Movement in People With Low Back Pain

The aim of this study was to (1) test the concurrent validity of brief screening questions for 5 psychosocial constructs (anxiety, depression, social isolation, catastrophization, and fear of movement) and (2) translate into Danish and validate those screening questions. Data were collected from 5 cross-sectional samples (total n=1105) of people seeking care for low back pain in Australian primary care settings and a Danish secondary care hospital. The responses to English and Danish-translated versions of 1-item or 2-item screening questions were compared with those of validated full-length questionnaires. Compared with anxiety, depression, and social isolation scores from full-length questionnaires, screening questionnaire responses demonstrated: a correlation of 0.62 to 0.83, overall accuracy of 78% to 91%, sensitivity of 70% to 82%, specificity of 75% to 95%, positive likelihood ratios of 3.3 to 13.9, and negative likelihood ratios of 0.21 to 0.33. For catastrophization and fear of movement, the results demonstrated: correlation of 0.89 to 0.95, overall accuracy of 88% to 93%, sensitivity of 78% to 88%, specificity of 91% to 96%, positive likelihood ratios of 9.5 to 20.8, and negative likelihood ratios of 0.13 to 0.23. The concurrent validity of these screening questions was comparable to, or better than, alternate questions previously reported, and stable across age, sex, pain intensity, pain duration, and counties. On the basis of the observed likelihood ratios, all of the screening questions provided moderate or strong evidence to rule in or out an extreme score on each psychosocial construct. Given the ease of administration of these brief screening questions, their prognostic and treatment implications should be investigated.

The Association between Hearing Loss and Social Isolation in Older Adults

To determine if age-related hearing loss is associated with social isolation and whether factors such as age, gender, income, race, or hearing aid use moderated the association. Cross-sectional. Randomly sampled United States communities. Cross-sectional data on adults 60 to 84 years old from the 1999 to 2006 cycles of the National Health and Nutrition Examination Survey were analyzed. The dependent variable was social isolation, which was defined using the social isolation score (SIS), a 4-point composite index consisting of items pertaining to strength of social network and support. SIS scores ≥2 were considered indicative of social isolation. The independent (predictor) variable was the pure tone average of speech frequency (0.5-4 kHz) hearing thresholds in the better-hearing ear. Covariates included potential medical, demographic, and otologic confounders. We used multivariate logistic regression to evaluate the association between hearing loss and the odds of having social isolation. An exploratory analysis was performed to assess the strength of associations between hearing loss and individual items of the SIS scale. Greater hearing loss was associated with increased odds of social isolation in women aged 60 to 69 years (odds ratio [OR], 3.49 per 25-dB of hearing loss; 95% confidence interval, 1.91, 6.39; P < .001). Effect modification by gender was significant in this age group (P = .003). Hearing loss was not significantly associated with social isolation in other age and gender groups. Greater hearing loss is associated with increased odds of being social isolated in a nationally representative sample of women aged 60 to 69 years.

Does Social Isolation Predict Hospitalization and Mortality Among HIV+ and Uninfected Older Veterans?

To compare levels of social isolation in aging veterans with and without the human immunodeficiency virus (HIV) and determine associations with hospital admission and mortality. Longitudinal data analysis. The Veterans Aging Cohort Study (VACS), at eight VA Medical Centers nationally. Veterans aged 55 and older enrolled in VACS from 2002 to 2008 (N = 1,836). A Social Isolation Score (SIS) was created using baseline survey responses about relationship status; number of friends and family and frequency of visits; and involvement in volunteer work, religious or self-help groups, and other community activities. Scores were compared according to age and HIV status, and multivariable regression was used to assess effects of SIS on hospital admission and all-cause mortality. Mean SIS was higher for HIV-positive (HIV+) individuals, with increasing difference according to age (P = .01 for trend). Social isolation was also more prevalent for HIV+ (59%) than uninfected participants (51%, P < .001). In multivariable regression analysis of HIV+ and uninfected groups combined, adjusted for demographic and clinical features, isolation was independently associated with greater risk of incident hospitalization (hazard rate (HR) = 1.25, 95% confidence interval (CI) = 1.09-1.42) and risk of all-cause mortality (HR=1.28, 95% CI = 1.06-1.54). Risk estimates calculated for HIV+ and uninfected groups separately were not significantly different. Social isolation is associated with greater risk of hospitalization and death in HIV+ and uninfected older veterans. Despite similar effects in both groups, the population-level effect of social isolation may be greater in those who are HIV+ because of the higher prevalence of social isolation, particularly in the oldest individuals.

대학생의 인터넷 중독위험 정도에 따른 사회 심리적 건강

본 연구는 749명의 대학생을 대상으로 인터넷 중독위험 정도에 따른 사회 심리적 건강상태를 파악하고 중독위험에 영향을 미치는 요인을 규명하기 위하여 시행되었다. 인터넷 중독위험 정도는 The 6th Korea Youth Risk Behavior Web-based Survey의 인터넷 중독 자가진단 척도로 측정하여 중독위험 사용자군, 정상 사용자군으로 분류하였고 각 군의 사회 심리적 건강상태는 절망감, 자살생각, 자살시도, 생활스트레스, 사회적 고립감, 정신건강 점수를 측정하여 비교하였다. 인터넷 정상 사용자군 및 중독위험 사용자군의 일반적 특성과 인터넷 중독위험 정도, 사회 심리적 건강은 t-test와 <TEX>$x^2$</TEX>-test로 비교 분석하였고, 인터넷 중독위험에 영향을 미치는 요인은 logistic regression analysis로 확인하였다. 연구결과 중독위험 사용자군은 82명(10.9%), 정상 사용자군은 667명(89.1%)이었고 절망감, 자살시도 경험, 생활스트레스, 사회적 고립감, 정신건강 점수에서 중독위험 사용자 군이 정상사용자군에 비해 빈도 및 점수가 유의하게 높아 사회 심리적 건강상태가 불량한 것으로 나타났다. 이상의 결과는 인터넷 중독사용 고위험 군을 조기선별하고 인터넷 중독 발생을 예방하며 나아가 이들을 위한 심리사회적 건강을 증진시키기 위한 프로그램 개발의 기초자료로 활용될 것을 기대한다. This study aimed to compare Psycho-social Well-being depending on level of internet addiction and investigate the factors inducing internet addiction among 749 college students. The Internet Addiction Diagnosis Criterion Inventory was used to classify participants into two groups, Internet overuse and Internet normal use. The psychosocial well-being of each group was measured by hopelessness, idea of suicide, suicide attempt, stress, social isolation, and mental health. Data were analyzed using the t-test and <TEX>$x^2$</TEX>-test to compare general characteristics, level of internet addiction and psycho-social well-being between two groups(the overuse and normal use group). Moreover, logistic regression analysis was used to examine the factors inducing internet addiction. The results placed 82 people (10.9%) in the internet overuse group and 667 people(89.1%) in the internet normal use group. The internet overuse group showed higher level of hopelessness, idea of suicide, suicide attempt, stress, social isolation, and mental health scores than the internet normal use group. Therefore, people in the internet overuse group were more likely to have worse Psycho-social well-being. The results of this study recommend that the Internet overuse should be screened early because it can be useful in developing addiction prevention programs and then finally improving the psycho-social well-being.