Research

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12 pages, 351 KiB

Open AccessArticle

Association of Loneliness and Mindfulness in Substance Use Treatment Retention

by Johnathan M. Herczyk, Keith J. Zullig, Stephen M. Davis, Jennifer Mallow, Gerald R. Hobbs, Danielle M. Davidov, Laura R. Lander and Laurie Theeke

Int. J. Environ. Res. Public Health 2023, 20(16), 6571; https://doi.org/10.3390/ijerph20166571 - 13 Aug 2023

Viewed by 1835

Abstract

Background: Elevated mental illness prevalence complicates efforts designed to address the opioid crisis in Appalachia. The recovery community acknowledges that loneliness impacts mood and engagement in care factors; however, the predictive relationship between loneliness and retention in medication-assisted outpatient treatment programs has not [...] Read more.

Background: Elevated mental illness prevalence complicates efforts designed to address the opioid crisis in Appalachia. The recovery community acknowledges that loneliness impacts mood and engagement in care factors; however, the predictive relationship between loneliness and retention in medication-assisted outpatient treatment programs has not been explored. Our objectives were to identify associations between mental health factors and retention in treatment and elucidate treatment retention odds. Data were collected from eighty participants (n = 57 retained, n = 23 not retained) of a mindfulness-based relapse prevention (MBRP) intervention for individuals receiving medication for opioid use disorder (MOUD) in Appalachia. Loneliness, depression, and anxiety did not differ between the retained and not retained, nor did they predict not being retained; however, mindfulness was significantly lower among those not retained in treatment compared to those retained (OR = 0.956, 95% CI (0.912–1.00), and p < 0.05). Preliminary findings provide evidence for mindfulness training integration as part of effective treatment, with aims to further elucidate the effectiveness of mindfulness therapies on symptom reduction in co-occurring mental health disorders, loneliness, and MOUD treatment retention. Full article

(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)

13 pages, 569 KiB

Open AccessArticle

Preventing Loneliness and Reducing Dropout: Results from the COMPLETE Intervention Study in Upper Secondary Schools in Norway

by Helga Bjørnøy Urke, Torill Bogsnes Larsen and Sara Madeleine Eriksen Kristensen

Int. J. Environ. Res. Public Health 2023, 20(13), 6299; https://doi.org/10.3390/ijerph20136299 - 04 Jul 2023

Viewed by 1504

Abstract

This study examines the impact of interventions aimed at improving psychosocial health on students’ perception of a caring school climate, their feelings of loneliness, and school completion in Norwegian upper secondary education. Two intervention conditions were tested: a universal single-tier intervention focused on [...] Read more.

This study examines the impact of interventions aimed at improving psychosocial health on students’ perception of a caring school climate, their feelings of loneliness, and school completion in Norwegian upper secondary education. Two intervention conditions were tested: a universal single-tier intervention focused on improving the psychosocial school climate: the Dream School Program, and a multi-tier intervention combining the Dream School Program with a targeted measure, the Mental Health Support Team. The direct and indirect effects of these interventions on school completion were analyzed using structural equation models (SEM), with data from 1508 students (mean age at Time 1: 17.02 (SD = 0.92); 60.7% girls; 72.1% Norwegian-born). The results indicated that loneliness levels did not differ significantly between the intervention conditions. However, students in the multi-tier intervention group reported a significantly higher perception of a caring school climate compared to those in the single-tier intervention group. The multi-tier intervention group had a lower rate of school completion compared to the control group and the single-tier intervention group. The SEM analysis revealed that the multi-tier intervention reduced loneliness in the second year of upper secondary school by promoting a caring school climate in the first school year. In contrast, the single-tier intervention was associated with increased loneliness due to a decrease in the perception of a caring school climate. The implications of these findings are discussed. Full article

(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)

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11 pages, 936 KiB

Open AccessArticle

Loneliness before and after COVID-19: Sense of Coherence and Hope as Coping Mechanisms

by Michal Einav and Malka Margalit

Int. J. Environ. Res. Public Health 2023, 20(10), 5840; https://doi.org/10.3390/ijerph20105840 - 17 May 2023

Cited by 4 | Viewed by 2087

Abstract

The COVID-19 pandemic posed a major threat to public health, with long-lasting consequences for the daily habits and practices of people around the world. The combination of hazardous health conditions and extensive changes to people’s daily routines due to lockdowns, social restrictions, and [...] Read more.

The COVID-19 pandemic posed a major threat to public health, with long-lasting consequences for the daily habits and practices of people around the world. The combination of hazardous health conditions and extensive changes to people’s daily routines due to lockdowns, social restrictions, and employment uncertainty have led to mental health challenges, reduced levels of subjective wellbeing, and increased maladaptive behaviors and emotional distress. Nevertheless, some studies have reported increased adaptive functioning and resilience after the pandemic, suggesting a more complex pattern of effects. The goals of the current study were to explore the role of two coping variables, sense of coherence and hope, in people’s emotional wellbeing and adaptation in dealing with loneliness before and after such a stressful period. In a cross-sectional study, 974 Israeli participants (sample 1: 540 participants before the pandemic; sample 2: 434 participants after the pandemic restrictions) answered online questionnaires about their loneliness, hope and sense of coherence levels before and after the pandemic. While the two groups did not differ in their levels of hope, the participants in the group before COVID-19 reported lower levels of loneliness and sense of coherence. However, the results also indicated that although the COVID-19 pandemic was related to increased levels of loneliness, the participants’ sense of coherence mediated this increase and their levels of hope moderated it. The theoretical contribution of these findings is discussed, as well as interventional implications and future directions. Full article

(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)

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10 pages, 336 KiB

Open AccessArticle

Too Close for Comfort: Stigma by Association in Family Members Who Live with Relatives with Mental Illness

by Joel O. Goldberg, Suzanne A. McKeag, Alison L. Rose, Heather Lumsden-Ruegg and Gordon L. Flett

Int. J. Environ. Res. Public Health 2023, 20(6), 5209; https://doi.org/10.3390/ijerph20065209 - 16 Mar 2023

Viewed by 3098

Abstract

Stigma by association is described in qualitative research of family members who have relatives diagnosed with mental illness, depicting their sense of public shame for having these relationship ties. However, there have been relatively few empirical studies thus far, in part due to [...] Read more.

Stigma by association is described in qualitative research of family members who have relatives diagnosed with mental illness, depicting their sense of public shame for having these relationship ties. However, there have been relatively few empirical studies thus far, in part due to the isolation of family members affecting research recruitment. In order to address this gap, an online survey was administered to 124 family members, comparing those who live in the same home with their ill relative (n = 81) and those who do not (n = 43). A remarkable incidence of one in three family members reported experiencing stigma by association. Those living with an ill relative reported comparatively higher levels of stigma by association using an adapted questionnaire measure. Both groups experienced loneliness (moderate levels), but importantly, the cohabiting relatives perceived themselves as lacking support from friends and other family members. Correlational analyses revealed that those with heightened stigma by association reported heightened anti-mattering: that is, feeling that other people treat them as if they are insignificant and invisible. Anti-mattering was also associated with more loneliness and reduced social support. Our discussion focuses on the theme that family members who actually live with mentally ill relatives experience heightened social isolation that is under-recognized due to public stigma concerns, compounded by feeling their own lives do not matter to others. Public health implications are considered for the stigmatized family members who appear to be particularly marginalized. Full article

(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)

12 pages, 754 KiB

Open AccessArticle

Association between Social Isolation and Loneliness with Estimated Atherosclerotic Cardiovascular Disease Risk in a UK Biobank Population-Based Study

by Alexandre Vallée

Int. J. Environ. Res. Public Health 2023, 20(4), 2869; https://doi.org/10.3390/ijerph20042869 - 06 Feb 2023

Cited by 4 | Viewed by 1655

Abstract

Objective: The association of cardiovascular (CV) risk with social isolation and loneliness remains poorly studied. The purpose of this cross-sectional study was to investigate the associations between social isolation and loneliness with estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk. Methods: Among 302,553 volunteers [...] Read more.

Objective: The association of cardiovascular (CV) risk with social isolation and loneliness remains poorly studied. The purpose of this cross-sectional study was to investigate the associations between social isolation and loneliness with estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk. Methods: Among 302,553 volunteers of the UK Biobank population, social isolation and loneliness were assessed with a questionnaire. Associations between social isolation and loneliness with ASCVD risk were estimated using multiple gender regressions. Results: Men presented a higher estimated 10-year ASCVD risk (8.63% vs. 2.65%, p < 0.001) and higher proportions of social isolation (9.13% vs. 8.45%, p < 0.001) and loneliness (6.16% vs. 5.57%, p < 0.001) than women. In all covariate-adjusted models, social isolation was associated with an increased ASCVD risk in men (B = 0.21 (0.16; 0.26), p < 0.001) and women (B = 0.12 (0.10; 0.14), p < 0.001). Loneliness was associated with an increased ASCVD risk in men (B = 0.08 (0.03; 0.14), p = 0.001) but not in women (p = 0.217). A significant interaction was observed between social isolation and loneliness with ASCVD risk in men (p = 0.009) and women (p = 0.016). After adjustment for all covariates, both social isolation and loneliness were significantly associated with ASCVD risk in men (B = 0.44 (0.28; 0.61), p < 0.001) and women (B = 0.20 (0.12; 0.29), p < 0.001). Conclusion: Social isolation was associated with a higher estimated 10-year ASCVD risk in both genders but only loneliness among men. Social isolation and loneliness can be considered potential added risk factors for CV risk. Health policies should address these notions in prevention campaigns, in addition to traditional risk factors. Full article

(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)

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11 pages, 349 KiB

Open AccessArticle

Relationships between Interpersonal Goals and Loneliness in Older Adults: A Cross-Sectional Study

by Francesca C. Ezeokonkwo, Kathleen L. Sekula, Jeffrey E. Stokes, Laurie A. Theeke, Rick Zoucha, Meredith Troutman-Jordan and Dinesh Sharma

Int. J. Environ. Res. Public Health 2023, 20(3), 1914; https://doi.org/10.3390/ijerph20031914 - 20 Jan 2023

Viewed by 1608

Abstract

Loneliness is linked to many physiological and psychological issues and disproportionately affects older adults. Interpersonal goals (compassion and self-image) are essential to interpersonal relationships; however, how they relate to loneliness in older adults is unknown. We investigated the impact of interpersonal goals on [...] Read more.

Loneliness is linked to many physiological and psychological issues and disproportionately affects older adults. Interpersonal goals (compassion and self-image) are essential to interpersonal relationships; however, how they relate to loneliness in older adults is unknown. We investigated the impact of interpersonal goals on loneliness using the Ecosystem–Egosystem Theory of Social Motivation. This study, adopting a descriptive cross-sectional correlational design, used data from the 2016 Health and Retirement Study. Participants (n = 3212) included people aged >65 years (mean age: 75; female: 60.1%). We performed exploratory factor analysis with principal axis factoring and varimax rotation to examine the suitability of compassionate and self-image goals as separate factors. The complex samples general linear model was used to assess the relationship between loneliness and interpersonal goals. Interpersonal goals were significantly negatively associated with loneliness. Respondents with higher compassion and self-image goals reported lower loneliness levels. Our results contribute to understanding how interpersonal goals relate to loneliness in older adults. These initial findings warrant further investigation. Full article

(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)

10 pages, 997 KiB

Open AccessArticle

Impact of COVID-19-Related Social Isolation on Behavioral Outcomes in Young Adults Residing in Northern Italy

by Alessandra Patrono, Azzurra Invernizzi, Donatella Placidi, Giuseppa Cagna, Stefano Calza, Manuela Oppini, Elza Rechtman, Demetrios M. Papazaharias, Abraham Reichenberg, Roberto G. Lucchini, Maurizio Memo, Elisa Ongaro, Matteo Rota, Robert O. Wright, Stefano Renzetti and Megan K. Horton

Int. J. Environ. Res. Public Health 2022, 19(24), 16496; https://doi.org/10.3390/ijerph192416496 - 08 Dec 2022

Cited by 3 | Viewed by 1268

Abstract

Social isolation affects our emotions, behavior and interactions. Worldwide, individuals experienced prolonged periods of isolation during the first wave of the COVID-19 pandemic when authorities-imposed restrictions to reduce the spread of the virus. In this study, we investigated the effects of social isolation [...] Read more.

Social isolation affects our emotions, behavior and interactions. Worldwide, individuals experienced prolonged periods of isolation during the first wave of the COVID-19 pandemic when authorities-imposed restrictions to reduce the spread of the virus. In this study, we investigated the effects of social isolation on emotional and behavioral outcomes in young adults from Lombardy, Italy, a global hotspot of COVID-19. We leveraged baseline (pre-social isolation) and follow-up (mid- or post-isolation) data collected from young adults enrolled in the ongoing, longitudinal Public Health Impact of Metals Exposure (PHIME) study. At baseline, 167 participants completed the ASEBA questionnaires (ASR/YSR) by web link or in person; 65 completed the ASR 12–18 weeks after the onset of restrictions. Using the sign test and multiple linear regression models, we examined differences in ASR scores between baseline and follow-up adjusting for sex, age, pre-pandemic IQ and time with social restrictions (weeks). Further, we examined interactions between sex and time in social isolation. Participants completed the ASR after spending an average of 14 weeks in social isolation (range 12–18 weeks). Thought problems increased between baseline and follow-up (median difference 1.0; 1st, 3rd quartile: −1.0, 4.0; p = 0.049). Among males, a longer time in social isolation (≥14 weeks) was associated with increased rule-breaking behaviors of 2.8 points. These results suggest the social isolation related to COVID-19 adversely impacted mental health. In particular, males seem to externalize their condition. These findings might help future interventions and treatment to minimize the consequences of social isolation experience in young adults. Full article

(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)

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14 pages, 346 KiB

Open AccessArticle

Loneliness in Young Adult Workers

by Sarah L. Wright and Anthony G. Silard

Int. J. Environ. Res. Public Health 2022, 19(21), 14462; https://doi.org/10.3390/ijerph192114462 - 04 Nov 2022

Cited by 3 | Viewed by 2286

Abstract

Loneliness is commonly associated with older people with the majority of research and interventions focusing on loneliness in aged and aging populations. However, loneliness seems to be on the rise for young adults more so than the elderly. Our research focusses on the [...] Read more.

Loneliness is commonly associated with older people with the majority of research and interventions focusing on loneliness in aged and aging populations. However, loneliness seems to be on the rise for young adults more so than the elderly. Our research focusses on the experiences of young workers who report feeling lonely at work. We explore individual and organisational factors that may be contributing to loneliness, and comment on the consequences of feeling lonely at work. Qualitative data from 37 young adults from Western Europe suggest that these workers feel invisible at work, have a thwarted sense of belonging to their employing organisation, and often experience relational deficiencies due to automation and individualisation of work practices. Full article

(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)

12 pages, 925 KiB

Open AccessArticle

Assessing Loneliness among Adults Receiving Outpatient Treatment with Medication for Opioid Use Disorder (MOUD)

by Rosalina Mills, Keith J. Zullig, Laurie A. Theeke, Laura R. Lander, Gerry R. Hobbs, Johnathan Herczyk and Stephen M. Davis

Int. J. Environ. Res. Public Health 2022, 19(20), 13481; https://doi.org/10.3390/ijerph192013481 - 18 Oct 2022

Cited by 3 | Viewed by 2042

Abstract

Loneliness is a significant risk factor for substance use, however, impacts of treatments on loneliness are relatively unexplored. Living in a rural location is a greater risk factor for loneliness. This study examined data from a quasi-experimental study in rural Appalachia, comparing the [...] Read more.

Loneliness is a significant risk factor for substance use, however, impacts of treatments on loneliness are relatively unexplored. Living in a rural location is a greater risk factor for loneliness. This study examined data from a quasi-experimental study in rural Appalachia, comparing the effectiveness of Mindfulness-Based Relapse Prevention (MBRP) versus Treatment as Usual (TAU) among adults receiving MOUD in outpatient therapy. Our objective was to determine whether observed reductions in self-reported craving, anxiety, depression, and increased perceived mindfulness would also improve loneliness reports. Eighty participants (n = 35 MBRP; n = 45 TAU) were included in the analysis from a group-based Comprehensive Opioid Addiction Treatment program. Outcomes tracked included craving, anxiety, depression, mindfulness, and loneliness as measured by the Revised UCLA Loneliness Scale (R-UCLA). A linear mixed model ANOVA determined the significance of the treatments on changes in loneliness scores at baseline, 12 weeks, 24 weeks, and 36 weeks post-recruitment. Both groups reported significantly reduced loneliness over the course of the study (F = 16.07, p < 0.01), however there were no significant differences between groups. Loneliness was also significantly positively (p < 0.01) correlated with anxiety (0.66), depression (0.59), and craving (0.38), and significantly (p < 0.01) inversely correlated (−0.52) with mindfulness. Results suggest that participation in MOUD group-based outpatient therapy has the potential to diminish loneliness and associated poor psychological outcomes. Thus, it is possible that a more targeted intervention for loneliness would further diminish loneliness, which is important as loneliness is linked to risk for relapse. Full article

(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)

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15 pages, 1690 KiB

Open AccessArticle

Loneliness in Intimate Relationships Scale (LIRS): Development and Validation

by Ami Rokach, Ami Sha’ked and Elisheva Ben-Artzi

Int. J. Environ. Res. Public Health 2022, 19(19), 12970; https://doi.org/10.3390/ijerph191912970 - 10 Oct 2022

Cited by 3 | Viewed by 2421

Abstract

Intimate relationships have been shown to be loneliness positively related to self-esteem. Happiness and well-being and have also been regarded as a buffer against loneliness. Nevertheless, substantive research indicates that intimate relationships and marriage can produce or result in loneliness and thus seriously [...] Read more.

Intimate relationships have been shown to be loneliness positively related to self-esteem. Happiness and well-being and have also been regarded as a buffer against loneliness. Nevertheless, substantive research indicates that intimate relationships and marriage can produce or result in loneliness and thus seriously affect the person’s physical, emotional and spiritual well-being. Loneliness in intimate relationships may damage the relationship if it goes on, and thus, this newly developed scale has been introduced to aid clinicians and researchers in discovering loneliness in an intimate union so it can be addressed before it negatively affects the union. Since none of the measures of loneliness tap loneliness as experienced in intimate relationships, a new rating scale, the Loneliness in Intimate Relationships Scale (LIRS), was developed and tested psychometrically. The generation of items followed a qualitative approach based on a semi-structured questionnaire administered to 108 volunteers from the general Israeli population, theoretical and empirical literature, and assessments of expert psychologists. In a second study (N = 215), a self-report scale assessing loneliness in intimate relationships was developed. This was followed by psychometric and construct validity evaluations with a new sample of 306 participants. Analyses revealed that loneliness in intimate relationships is experienced mainly in terms of three aspects: detachment, hurt, and guilt. Exploratory and confirmatory factor analyses and validity tests indicate that the final 14-item Loneliness in Intimate Relationship Scale is a well-structured, reliable, and valid scale tapping emotional, behavioral, and cognitive manifestations of loneliness in intimate relationships. Full article

(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)

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Review

Jump to: Research

19 pages, 411 KiB

Open AccessReview

Love and Infidelity: Causes and Consequences

by Ami Rokach and Sybil H. Chan

Int. J. Environ. Res. Public Health 2023, 20(5), 3904; https://doi.org/10.3390/ijerph20053904 - 22 Feb 2023

Cited by 3 | Viewed by 10498

Abstract

This is a narrative review addressing the topic of romantic infidelity, its causes and its consequences. Love is commonly a source of much pleasure and fulfillment. However, as this review points out, it can also cause stress, heartache and may even be traumatic [...] Read more.

This is a narrative review addressing the topic of romantic infidelity, its causes and its consequences. Love is commonly a source of much pleasure and fulfillment. However, as this review points out, it can also cause stress, heartache and may even be traumatic in some circumstances. Infidelity, which is relatively common in Western culture, can damage a loving, romantic relationship to the point of its demise. However, by highlighting this phenomenon, its causes and its consequences, we hope to provide useful insight for both researchers and clinicians who may be assisting couples facing these issues. We begin by defining infidelity and illustrating the various ways in which one may become unfaithful to their partner. We explore the personal and relational factors that enhance an individual’s tendency to betray their partner, the various reactions related to a discovered affair and the challenges related to the nosological categorization of infidelity-based trauma, and conclude by reviewing the effects of COVID-19 on unfaithful behavior, as well as clinical implications related to infidelity-based treatment. Ultimately, we hope to provide a road map, for academicians and clinicians alike, of what some couples may experience in their relationships and how can they be helped. Full article

(This article belongs to the Special Issue Public Health Consequences of Social Isolation and Loneliness)

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