Purpose
Loneliness is increasingly recognised as the next critical public health issue. A plausible reason for this concern may be related to emerging societal trends affecting the way we relate, ...communicate, and function in our social environment. In 2006, a prominent review of the clinical significance of loneliness was published. However, there has not been a comprehensive update on known and emerging risk factors and correlates of loneliness since then. Furthermore, there is no conceptual model that has been developed to better account for the complexity of loneliness and to inform the development of evidence-based solutions as we challenge the issues of the twenty-first century.
Methods
We reviewed the current literature to identify either known or emerging risk factors and correlates of loneliness since 2006. This includes new or known evidence on: (1) demography; (2) health, including physical health; mental health; cognitive health; brain, biology, and genetics; and (3) socio-environmental factors including digital communication and the workplace.
Results
We synthesized the literature according to a new proposed conceptual model of loneliness which showed the interplay between known and emerging correlates and risk factors from demography, health, to socio-environmental factors. In the conceptual model of loneliness, we illustrated how solutions can be delivered and tailored to an individual based on their life circumstances and preferences.
Conclusion
We concluded by making specific recommendations in advancing our scientific understanding of loneliness. Our knowledge can only be deepened if we increase scientific rigour via accounting for confounding variables and using longitudinal, multi-disciplinary, and multiple methodologies in research. We also call for the rigorous evaluation of programs targeting loneliness.
AbstractObjectivesTo identify data availability, gaps, and patterns for population level prevalence of loneliness globally, to summarise prevalence estimates within World Health Organization regions ...when feasible through meta-analysis, and to examine temporal trends of loneliness in countries where data exist.DesignSystematic review and meta-analysis.Data sourcesEmbase, Medline, PsycINFO, and Scopus for peer reviewed literature, and Google Scholar and Open Grey for grey literature, supplemented by backward reference searching (to 1 September 2021)Eligibility criteria for selecting studiesObservational studies based on nationally representative samples (n≥292), validated instruments, and prevalence data for 2000-19. Two researchers independently extracted data and assessed the risk of bias using the Joanna Briggs Institute checklist. Random effects meta-analysis was conducted in the subset of studies with relatively homogeneous research methods by measurement instrument, age group, and WHO region.ResultsPrevalence data were available for 113 countries or territories, according to official WHO nomenclature for regions, from 57 studies. Data were available for adolescents (12-17 years) in 77 countries or territories, young adults (18-29 years) in 30 countries, middle aged adults (30-59 years) in 32 countries, and older adults (≥60 years) in 40 countries. Data for all age groups except adolescents were lacking outside of Europe. Overall, 212 estimates for 106 countries from 24 studies were included in meta-analyses. The pooled prevalence of loneliness for adolescents ranged from 9.2% (95% confidence interval 6.8% to 12.4%) in South-East Asia to 14.4% (12.2% to 17.1%) in the Eastern Mediterranean region. For adults, meta-analysis was conducted for the European region only, and a consistent geographical pattern was shown for all adult age groups. The lowest prevalence of loneliness was consistently observed in northern European countries (2.9%, 1.8% to 4.5% for young adults; 2.7%, 2.4% to 3.0% for middle aged adults; and 5.2%, 4.2% to 6.5% for older adults) and the highest in eastern European countries (7.5%, 5.9% to 9.4% for young adults; 9.6%, 7.7% to 12.0% for middle aged adults; and 21.3%, 18.7% to 24.2% for older adults).ConclusionProblematic levels of loneliness are experienced by a substantial proportion of the population in many countries. The substantial difference in data coverage between high income countries (particularly Europe) and low and middle income countries raised an important equity issue. Evidence on the temporal trends of loneliness is insufficient. The findings of this meta-analysis are limited by data scarcity and methodological heterogeneity. Loneliness should be incorporated into general health surveillance with broader geographical and age coverage, using standardised and validated measurement tools.Systematic review registrationPROSPERO CRD42019131448.
The Fusarium graminearum virus China 9 (FgV-ch9) is a member of the genus Betachrysovirus in the Chrysoviridae family and causes hypovirulence in its host, Fusarium graminearum, the causal agent of ...Fusarium head blight. Although insights into viral biology of FgV-ch9 have expanded in recent years, questions regarding the function of virus-encoded proteins, cis-acting elements, and virus transmission are yet to be answered. Therefore, we developed a tool for the establishment of an artificial 6th segment of FgV-ch9, which encodes a GFP gene flanked by the non-translated regions of FgV-ch9 segment 1. Subsequently, we have proved successful encapsidation of this artificial segment into virus particles as well as its horizontal transmission. Expression of GFP was further verified via immunoassay and life cell imaging. Thus far, we were able to establish for the first time a mini-replicon system for segmented dsRNA viruses replicating in fungi.
Morality is an important social construct necessary for understanding what is right and wrong. Neuroimaging studies investigating morality have used a wide variety of paradigms and implicated many ...different brain areas. Yet, it remains unclear whether differences amongst morality tasks are the cause for such heterogeneous findings. Therefore, in the present study, a series of activation likelihood estimation (ALE) meta-analyses were conducted on 123 datasets (inclusive of 1963 participants) to address this question. The ALE meta-analyses revealed a series of common brain areas associated with all moral tasks, including medial prefrontal cortex, lateral orbitofrontal cortex, amygdala, temporoparietal junction, and precuneus. However, individual and contrast analyses also revealed unique networks associated with each moral modality, suggesting that different moral tasks recruit specialised brain regions.
Loneliness is an emerging issue for young people, but yet many interventions to address loneliness in this group focus on providing social opportunities. While these sorts of interventions may appear ...to increase social connections, loneliness is more related to quality rather than quantity of social relationships. Thus, interventions addressing loneliness should focus on maximizing the quality of current relationships. Together with youth consumers both with mental ill health and those without, we developed a digital smartphone application (app) called +Connect. The 6-week program delivers positive psychology content designed to improve relationship quality. We tested the acceptability, feasibility, and safety of the program in lonely young people with or without a mental health diagnosis of social anxiety disorder. We used a mixed method study design to triangulate pilot quantitative and qualitative data in young people with and without social anxiety disorder (SAD).
Nine participants with a diagnosis of social anxiety disorder (
= 21.00;
= 1.41) and 11 participants with no mental health conditions (
= 20.36;
= 2.16) completed the +Connect digital intervention.
Those with social anxiety disorder reported less acceptable ratings on outcomes. Feasibility ratings, measured by uptake and app completion, met
threshold criteria in both groups. Those with social anxiety disorder yielded more attrition, with almost double the attrition rate compared with those without the disorder. There were no safety issues elicited during the pilot study. In terms of outcomes, exploratory analyses indicated that the app itself is likely to be beneficial rather than cause harm. Our qualitative data indicated both groups reported no negative outcomes and noted that positive outcomes were driven by three processes: reflection, learning, and real-life application. Further exploratory data on usability indicated room for improvement in terms of giving more support for different components of the app (i.e., challenges).
The pilot findings of this proof-of-concept app indicates some promise in terms of a second iterative version of +Connect.
Objective: Individuals with social anxiety disorder (SAD) are more likely to feel lonely compared with those without the disorder (NOSAD). Loneliness is also associated with increased emotion ...regulation deficits. In this study, we examined the relationships among different emotion regulation processes and loneliness in individuals with and without a diagnosis of SAD.
Method: We recruited demographically matched groups comprising 42 participants with a primary diagnosis of SAD, and 42 participants from the broader community who acted as the NOSAD sample.
Results: In line with predictions, loneliness severity and difficulties with regulating emotions differed between a SAD and NOSAD sample. We also found that loneliness in those with SAD was positively associated with the clarity and awareness subscales of the Difficulties with Emotion Regulation Scale.
Conclusion: Overall, those with SAD reported more difficulties regulating emotions and higher loneliness compared with the sample with NOSAD. Results are discussed in line with theoretical and clinical implications.
KEY POINTS
What is already known about this topic:
(1) Loneliness is associated with poor mental health.
(2) Social anxiety symptoms predict higher loneliness over time and vice versa.
(3) Emotion regulation capacity is related to both social anxiety and loneliness.
What this topic adds:
(1) Compares loneliness and emotion regulation across clinical and NOSAD samples.
(2) Difficulties in emotion regulation ability are uniquely associated with loneliness in the sample with social anxiety disorder compared to those without social anxiety disorder.
(3) Provides a rationale to target emotion regulation deficits.
Social restrictions and government-mandated lockdowns implemented worldwide to kerb the SARS-CoV-2 virus disrupted our social interactions, behaviours, and routines. While many studies have examined ...how the pandemic influenced loneliness and poor mental health, such as depression, almost none have focussed on social anxiety. Further, how the change in social restrictions affected change in mental-health and well-being has not yet been explored.
This is a longitudinal cohort study in community dwellers who were surveyed across three timepoints in the first six months of the pandemic. We measured loneliness, social anxiety, depression, and social restrictions severity that were objectively coded in a sample from Australia, United States, and United Kingdom (
= 1562) at each time point. Longitudinal data were analysed using a multivariate latent growth curve model.
Loneliness reduced, depression marginally reduced, and social anxiety symptoms increased as social restrictions eased. Specific demographic factors (e.g., younger age, unemployment, lower wealth, and living alone) all influenced loneliness, depression, and social anxiety at baseline. No demographic factors influenced changes for loneliness; we found that those aged over 25 years reduced faster on depression, while those younger than 25 years and unemployed increased faster on social anxiety over time.
We found evidence that easing social restrictions brought about additional burden to people who experienced higher social anxiety symptoms. As country-mandated lockdown and social restrictions eased, people are more likely report higher social anxiety as they readjust into their social environment. Mental health practitioners are likely to see higher levels of social anxiety in vulnerable communities even as social restrictions ease.
Young people are vulnerable to experiencing problematic levels of loneliness which can lead to poor mental health outcomes. Loneliness is a malleable treatment target and preliminary evidence has ...shown that it can be addressed with digital platforms. Peer Tree is a strength-based digital smartphone application aimed at reducing loneliness. The study aim is to reduce loneliness and assess the acceptability, usability, and feasibility of Peer Tree in young people enrolled at university.
This will be a pilot randomised controlled trial (RCT) comparing a strength-based digital smartphone application (Peer Tree) with a control condition. Forty-two young people enrolled at university will be recruited for this pilot RCT. Participants with suicidal ideation or behaviours, acute psychiatric symptoms in the past month, or a current diagnosis of a mood or social anxiety disorder will be excluded. Allocation will be made on a 1:1 ratio and will occur after the initial baseline assessment. Assessments are completed at baseline, at post-intervention, and at follow-up. Participants in the control condition complete the same three assessment sessions. The primary outcome of the study will be loneliness. Depression, social anxiety, quality of life, acceptability, usability, feasibility, and safety of Peer Tree will also be measured as secondary outcomes.
This trial will report the findings of implementing Peer Tree, a smartphone application aimed at reducing loneliness in university students. Findings from this trial will highlight the initial efficacy, acceptability, and feasibility of using digital positive psychology interventions to reduce subthreshold mental health concerns. Findings from this trial will also describe the safety of Peer Tree as a digital tool. Results will contribute evidence for positive psychology interventions to address mental ill-health.
Australian New Zealand Clinical Trial Registry ACTRN12619000350123. Registered on 6 March 2020.
Objective: The aim of the current study was to investigate cardiovascular responses to a brief social exclusion stressor, the Cyberball task, and to determine whether individual differences in ...depression, anxiety, and perceived social isolation moderate physiological stress responses. Methods: Sixty-four participants engaged in the Cyberball task while heart rate, blood pressure, and respiratory rate were continuously measured. Results: Systolic (M = 121.61, SD = 13.34) and diastolic (M = 77.34, SD = 7.56) blood pressure increased significantly during the exclusion condition compared with the rest condition (M = 117.81, SD = 12.71, M = 75.63, SD = 7.39, respectively). Significant correlations were also found between social anxiety (r = −0.25) and depression (r = −0.25) scores with systolic blood pressure from the exclusion condition. Further, participants who reported high depression scores had attenuated cardiovascular responses to social exclusion. Conclusions: Overall, cardiovascular activity were elevated after a brief social stressor, but those with clinically relevant cut off scores on the CES-D had attenuated cardiovascular responses These findings support the growing body of literature surrounding cardiovascular stress reactivity to stress induced from social exclusion.
Meaningful social relationships lie at the core of social wellbeing. Loneliness, defined as the discrepancy between one’s desired and actual social relationships, has been linked to a range of health ...outcomes such as cardiovascular disease,1 cognitive impairment,2 and early death.3
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