Social isolation, depression, and anxiety among young adult cancer survivors: The mediating role of social connectedness.

BACKGROUND: Social isolation and social connectedness are health determinants and aspects of social well-being with strong associations with psychological distress. This study evaluated relationships among social isolation, social connectedness, and psychological distress (i.e., depression, anxiety) over 1 year in young adult (YA) cancer survivors 18-39 years old. METHODS: Participants were YAs in a large cohort study that completed questionnaires every 2 months for 1 year. Social isolation, aspects of social connectedness (i.e., companionship, emotional support, instrumental support, and informational support), depression, and anxiety were assessed with Patient-Reported Outcomes Measurement Information System short form measures. Mixed-effect models were used to evaluate changes over time. Confirmatory factor analysis and multilevel structural equation modeling were used to define social connectedness as a latent construct and determine whether relationships between social isolation and psychological distress were mediated by social connectedness. RESULTS: Participants (N = 304) were mean (M) = 33.5 years old (SD = 4.7) and M = 4.5 years (SD = 3.5) post-initial cancer diagnosis. Most participants were female (67.4%) and non-Hispanic White (68.4%). Average scores for social well-being and psychological distress were within normative ranges and did not change (p values >.05). However, large proportions of participants reported at least mild social isolation (27%-30%), depressive symptoms (36%-37%), and symptoms of anxiety (49%-51%) at each time point. Across participants, more social isolation was related to less social connectedness (p values <.001), more depressive symptoms (p < .001), and more symptoms of anxiety (p < .001). Social connectedness mediated the relationship between social isolation and depression (p = .004), but not anxiety (p > .05). CONCLUSIONS: Social isolation and connectedness could be intervention targets for reducing depression among YA cancer survivors.

The mediating effect of bullying on parental-peer support matching and NSSI behaviour among adolescents.

BACKGROUND: Being subjected to bullying is a significant risk factor for non-suicidal self-injury (NSSI) among adolescents. Parental support, peer support, and social connectedness play protective roles in mitigating NSSI in this population. However, the precise impact of the combined effects of parental and peer support on bullying and NSSI requires further investigation. METHODS: This study employed the Child and Adolescent Social Support Scale, Delaware Bullying Victimisation Scale, Social Connectedness Scale, and the Ottawa Self-Injury Inventory to survey 1277 Chinese adolescents. Polynomial regression analysis and response surface analysis were applied to examine the mediating role of bullying and social connectedness in the relationship between parental and peer support matching and NSSI. RESULTS: The results indicate that parental support (r = 0.287, P < 0.001), peer support (r = 0.288, P < 0.001), and social connectedness (r = 0.401, P < 0.001) were protective factors against NSSI in adolescents. Conversely, bullying (r = 0.425, P < 0.001) acts as a risk factor for NSSI in this population. Adolescents with low parental and peer support experienced more bullying than those with high parental and peer support, while those with low parental but high peer support experienced less bullying than those with high parental but low peer support (R^2 = 0.1371, P < 0.001). Social connectedness moderated the effect between bullying and NSSI in this model (ß = 0.006, P < 0.001). LIMITATIONS: Due to the under-representation of participants and lack of longitudinal data support, the explanatory power of causality between variables was limited. Future studies should include national samples and incorporate longitudinal studies to enhance the generalisability and robustness of the findings. CONCLUSION: This study reveals the influence mechanism of parental and peer support matching experienced by adolescents on bullying and NSSI and the moderating role of social connectedness. These findings enrich the developmental theory of adolescent NSSI and provide reference for the prevention and intervention of adolescent NSSI behaviour.

Connected for life: How social connectedness can help prevent suicide in American Indian and Alaska Native communities.

Enhancing social support and connectedness can reduce suicide risk, yet few studies have examined this effect in American Indian and Alaska Native (AI/AN) adults. We assessed suicidal ideation and behavior, thwarted belongingness, social support, enculturation, historical trauma, and traumatic life events in 709 AI/AN adults at high risk of suicide from five AI/AN communities. Suicidal ideation was associated with thwarted belongingness and protected against by social support and engaging in AI/AN ceremonies. Among those who made lifetime suicide attempts, traumatic life events, symptoms of depression/anxiety due to historical trauma, and thwarted belongingness were linked to more attempts. More engagement in cultural practices was associated with fewer suicide attempts. Higher levels of social support were associated with more suicide attempts, an observation potentially attributable to the cross-sectional nature of the study. Interventions should focus on protective factors and context-specific interventions emphasizing community history, values, and strengths.

Examining bi-directional links between loneliness, social connectedness and sleep from a trait and state perspective.

Greater loneliness as well as a lack of social connectedness have often been associated with poorer sleep. However, the temporal dynamics and direction of these associations remain unclear. Aim of the current study was to examine bi-directional associations between loneliness/social connectedness and sleep in 48 stress-exposed medical students during their first medical internship, considered a period of heightened stress. We obtained trait-level questionnaire data on loneliness and global sleep completed before and during the internship as well as state-level diary- and wearable-based data on daily changes in social connectedness and sleep collected twice over the period of seven consecutive days, once before and once during the internship. Bi-directional associations among greater loneliness and higher daytime dysfunction on trait-level were identified. In addition, several uni-directional associations between loneliness/social connectedness and sleep were found on trait- and state-level. In sum, findings of this study point at a bi-directional relation among loneliness/social connectedness and sleep, in which variables seem to reciprocally influence each other across longer-term periods as well as on a day-to-day basis.

An Empowerment-Based Physical Activity Intervention for Older People with Advanced Age-Related Macular Degeneration: An Exploratory Qualitative Case Study Design.

Background: Age-related macular degeneration (AMD) is the most common cause of incurable visual impairment and impacts daily life. There are benefits of physical activity for people who are affected with AMD; however, living with AMD is associated with lower levels of physical activity and social isolation. The aim of this study was to explore how older people with AMD in Sweden experienced participation in a 6-month empowerment-based physical activity intervention and how it influenced their physical abilities. Methods: The participants were nine individuals with AMD aged 70-87 years. The intervention comprised physical and social activities in a group twice a week and individual health coaching on three occasions. The study was based on an exploratory qualitative case study design. Results: The findings showed two themes: created meaningfulness in life and creative and playful ways to develop body movements. The findings also showed improved muscle strength after the intervention. Conclusions: The findings showed that participants had increased social connectedness, improved physical self-efficacy and physical ability, as well as improved muscle strength. The empowerment process of the intervention was appreciated by the participants and challenged them to participate in physical activity offered by the municipality for older individuals.

Social connectedness and loneliness in school for autistic and allistic children.

LAY ABSTRACT: Many previous studies reported that autistic children have fewer social connections. Yet, recent studies also show that autistic children more often feel lonely in school than allistic (i.e. non-autistic) children. This outcome seems to go against the traditional view that autistic children do not desire to have social connections. Therefore, this study aimed to find out how autistic and allistic children feel about their social connections. We included 47 autistic and 52 neurodiverse-allistic children from two special education primary schools (aged 8-13 years). We tested their social connections and loneliness in school, through a new approach. This new approach includes questionnaires, and sensors for tracking social contacts on playgrounds during school breaks. We found that allistic children felt more loneliness when they spent little time in social contacts during school breaks. Yet, autistic children felt more loneliness when their peers did not like to play with them. For these autistic children, feelings of loneliness may go beyond face-to-face contacts. Being liked as part of a peer group was key. Understanding differences in children's needs can lead to a more effective design for a welcoming school climate.

Reducing Loneliness through the Power of Practicing Together: A Randomized Controlled Trial of Online Dyadic Socio-Emotional vs. Mindfulness-Based Training.

Loneliness has become a pressing topic, especially among young adults and during the COVID-19 pandemic. In a randomized controlled trial with 253 healthy adults, we evaluated the differential efficacy of two 10-week app-delivered mental training programs: one based on classic mindfulness and one on an innovative partner-based socio-emotional practice (Affect Dyad). We show that the partner-based training resulted in greater reductions in loneliness than the mindfulness-based training. This effect was shown on three measures of loneliness: general loneliness assessed with the 20-item UCLA Loneliness Scale, state loneliness queried over an 8-day ecological momentary assessment in participants' daily lives, and loneliness ratings required before and after daily practice. Our study provides evidence for the higher efficacy of a mental training approach based on a 12 min practice conducted with a partner in reducing loneliness and provides a novel, scalable online approach to reduce the increasing problem of loneliness in society.

Mapping of technological strategies for reducing social isolation in homebound older adults: A scoping review.

BACKGROUND: Homebound older adults (HOAs) are particularly vulnerable to social isolation and loneliness, which engender a poorer physical and mental health, and greater cognitive decline. The purpose of this review is to map the literature to identify potential technological strategies that reduce social isolation in HOAs, and to understand facilitators and barriers for adoption and implementation. METHODS: Six databases including PubMed (MEDLINE), Google Scholar, Cochrane Database, EBSCOHost, National Library ProQuest, Web of Science, and the Journal of Medical Internet Research were searched for relevant articles. Peer-reviewed literature published in English from Jan 2014 to Feb 2024 that employed technological strategies applicable to HOAs and assessed social isolation or connectedness as an outcome measure were included. RESULTS: 107 studies were reviewed and classified into different technological categories based on their functions and features. A social technology framework encompassing delivery, hardware, software, content, training, and support was conceptualized with core characteristics identified from the reviewed technological strategies. Cost and complexity of technology, and resource commitment were identified as barriers while user-friendliness, content curation and a supportive ecosystem may facilitate the adoption of a technological strategy to address social isolation in HOAs. CONCLUSION: There is a need for early and concerted effort to identify HOAs, provide technology training, and empower them to tap on the digital world to complement and/or supplement social interactions. Development of cost-effective and rapid-to-implement technology is vital for HOAs who are at highest risk to social isolation.

Understanding the Effect of External and Internal Assets on Hazardous/Harmful Drinking Among Chinese College Students: A Serial Mediation Model.

Hazardous/harmful drinking among college students is increasingly becoming a global health concern. Previous studies have mostly paid more attention to the prevalence and risk factors of alcohol use disorder based on the public health approach, and less is understood about psychological mechanisms and protective factors of problem drinking behavior. Grounded in the framework of developmental assets, this study explored the predictive effect of external assets (i.e., social connectedness) and internal assets (i.e., self-concept clarity and drinking refusal self-efficacy) on hazardous/harmful drinking among Chinese college students. Participants were 598 college students with a mean age of 19.41 (SD = 1.21) years. The results of structural equation modeling showed that social connectedness negatively predicted college students' hazardous/harmful drinking. Moreover, our path analyses revealed a serial mediation among these variables: students with high social connectedness tended to report high self-concept clarity, which in turn increased drinking refusal self-efficacy, and consequently decreased the level of hazardous/harmful drinking. This study revealed the mechanisms underlying how external and internal assets predict risky drinking among college students. These findings made significant contributions to prevention and precision interventions for college-aged youth with drinking problems.

Ethnicity, social connectedness, and the rural-urban food continuum: Food security among urban informal settlement dwellers in Kenya.

Rapid urbanization in developing countries is increasingly becoming an important development issue due to its negative effects on poverty and food insecurity in cities. This study investigated the determinants of the food insecurity gap among urban households living in informal settlements in Nairobi, Kenya, and the role of social connectedness and the rural-urban food continuum. Using panel data collected from 385 households using a two-stage cluster sample design, the study applied panel data regression and decomposition models to understand the factors affecting food insecurity access scores and weekly household food consumption expenditure. Descriptive results showed a score of 8.00 for the pooled sample on the household food access scale, with households from other regions having a lower score (7.94) than those from the Western region (8.32). 43 % of households from Western Kenya engaged in farming in rural areas (43 %) and had higher social connectedness (45 %) than households from other regions. The results indicate that dependency ratio, income, savings, social connectedness, rural visits, and dietary knowledge are significant factors impacting food security. Decomposition of levels and change in food insecurity revealed that endowments from the random effects model contributed to reducing the food insecurity gap between households originating from the Western region and those from other regions. The study highlights the importance of considering regional factors and promoting social connectedness and rural-urban linkages in addressing food insecurity in informal urban settlements.

Fostering belonging and social connectedness in nursing: Evidence-based strategies: A discussion paper for nurse students, faculty, leaders, and clinical nurses.

BACKGROUND: The phenomenon of loneliness among healthcare providers, particularly nurses, has garnered increasing attention due to its detrimental effects on individual well-being and professional retention. The isolation experienced by nurses has been linked to heightened turnover rates and intentions to leave the profession, posing significant challenges to healthcare systems globally. Recognizing loneliness as an epidemic in 2023, the U.S. Surgeon General highlighted the urgency of addressing this issue within the healthcare workforce. PURPOSE: This paper explores evidence-based strategies to mitigate loneliness and promote social connectedness among nurses, drawing insights from various stakeholders. It aims to offer actionable recommendations to enhance the nursing experience and retain professionals in the field. DISCUSSION: Strategies include peer support programs, mentorship initiatives, wellness activities, and fostering open communication. Leveraging technology for virtual connections is also highlighted, especially in remote work scenarios. CONCLUSION: A holistic approach is vital, combining individual, interpersonal, and systemic interventions to combat nurse loneliness. Prioritizing social connectedness fosters a supportive work environment, benefiting both nurses and patient care quality.

The Resettlement Journey: Understanding The Role of Social Connectedness on Well-being and Life Satisfaction among (Im)migrants and Refugees: A Systematic Review.

In the context of rising global migration and/or forced displacement, there is a pressing need to consider the well-being and life satisfaction of (im)migrants and refugees during resettlement. Research highlights the importance of social connectedness for (im)migrants and refugees during the resettlement phase. Yet, a critical gap remains in our understanding of the key characteristics through which social connections exert their influence on well-being and life satisfaction. This systematic review provides a comprehensive overview of the existing international literature on social connectedness and its impact on the well-being and life satisfaction of (im)migrants and refugees in post-migration contexts. Our analysis of 43 studies finds that social connectedness, in the form of social support and social networks, is beneficial for well-being and life satisfaction during resettlement. In addition to social support from individual network ties, community engagement can also enhance well-being by facilitating a sense of belonging. All 43 studies focused on psychological well-being and 69.8% relied on cross-sectional data. The findings of this review emphasise the need for longitudinal studies and standardised measurement tools to capture the dynamic interplay between social connectedness and well-being across various domains (psychological, physical, general/subjective) in migrant populations. We draw on the findings to propose a new conceptual model of the dynamic association between social connectedness and well-being/life satisfaction that seeks to explore these relationships in future empirical studies.

Perceived Social Support and Connectedness in Non-Suicidal Self-Injury Engagement.

Perceived social support has been posited as an important factor in non-suicidal self-injury (NSSI) cessation. Although, previous research suggests that social connectedness is the mechanism through which perceived social support influences psychological wellbeing. Thus, the present study investigated whether social connectedness is the mechanism through which perceived social support functions to influence NSSI engagement. Fifty-six women with (Mage = 20.18, SD = 2.07) and 84 without (Mage = 20.24, SD = 1.98) a history of NSSI completed online measures of perceived social support and social connectedness. A mediation model was conducted with social connectedness in the relation between perceived social support from family, friends, and significant others and NSSI engagement. Findings revealed that social connectedness fully explained the relation between perceived social support from all sources and NSSI engagement. The results suggest that the relation between perceived social support and NSSI engagement is fully explained by the degree to which individuals report feeling connected to others. Implications for future research and practice will be discussed.

The association between social connectedness and euthanasia and assisted suicide and related constructs: systematic review.

BACKGROUND: Euthanasia and assisted suicide (EAS) requests are common in countries where they are legal. Loneliness and social isolation are modifiable risk factors for mental illness and suicidal behaviour and are common in terminal illness. Our objective was to summarise available literature to clarify whether these and related measures of social connectedness might contribute to requests for EAS. METHODS: We conducted a pre-registered (PROSPERO CRD42019160508) systematic review and narrative synthesis of quantitative literature investigating associations between social connectedness and a) requested/actual EAS, b) attitudes towards EAS, and c) a desire for hastened death (DHD) by searching six databases (PsycINFO, MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar) from inception to November 2022, rating eligible peer-reviewed, empirical studies using the QATSO quality assessment tool. RESULTS: We identified 37 eligible studies that investigated associations with a) requested/actual EAS (n = 9), b) attitudes to EAS (n = 16), and c) DHD (n = 14), with limited overlap, including 17,359 participants. The majority (62%) were rated at medium/high risk of bias. Focussing our narrative synthesis on the more methodologically sound studies, we found no evidence to support an association between different constructs of social connectedness and requested or actual EAS, and very little evidence to support an association with attitudes to EAS or an association with DHD. CONCLUSIONS: Our findings for all age groups are consistent with a those of a previous systematic review focussed on older adults and suggest that poor social connectedness is not a clear risk factor for EAS or for measures more distally related to EAS. However, we acknowledge low study quality in some studies in relation to sampling, unvalidated exposure/outcome measures, cross-sectional design, unadjusted analyses, and multiple testing. Clinical assessment should focus on modifying established risk factors for suicide and EAS, such as hopelessness and depression, as well as improving any distressing aspects of social disconnectedness to improve quality of life. FUNDING: UKRI, NIHR.

'We Were an Afterthought': Corona Virus Disease 2019 (COVID-19) Pandemic in Culturally and Linguistically Diverse (CALD) Communities in New South Wales, Australia.

This paper investigates the impact on Culturally and Linguistically Diverse (CALD) communities in Australia of government and community responses to the coronavirus pandemic of 2019 in the domains of education, employment, housing, social connectedness, and public health communication. Most of the examples are drawn from the state of New South Wales. In Australia, CALD refers to people from countries not classified as main English speaking. Most CALD communities reported in this article are from refugee backgrounds, are recently arrived migrants or do not use English in most of their communication. Inadequate, and in some instances, inappropriate or absent support, adversely impacts CALD communities. We used a multidisciplinary bricolage approach that draws on media, government, and community support publications and concluded that CALD communities experienced heightened pressures due to lower resource availability and poor communication. This led to disruption of support services, exposing gaps and vulnerability. The results reported here challenge Australian government, schools, community agencies, researchers to include proactively CALD community perspectives when planning and responding to such crises in future. Improving communication, pandemic response planning, addressing needs and ensuring participation are key considerations.

Sources of Social Support and Trauma Recovery: Evidence for Bidirectional Associations from a Recently Trauma-Exposed Community Sample.

Although the association between post-traumatic stress disorder (PTSD) and social support is well documented, few studies have tested the causal pathways explaining this association at several points in the acute post-trauma recovery period or examined whether the association varies for different sources of social support. To address these gaps, 151 community individuals (mean age = 37.20 years, 69.5% women) exposed to trauma within the previous 6 months were recruited to complete measures of PTSD and social support from intimate partners, friends, and relatives four times in 1 year. In line with recent recommendations for research on social support and PTSD symptoms, random intercept cross-lagged panel modeling (RI-CLPM) was used to examine dynamic changes between PTSD severity and social support over time. The pattern of RI-CLPM cross-lagged coefficients indicated that positive deviations from one's expected stable level of total social support (across all sources) sped up the recovery of PTSD symptoms at the end of the post-trauma year, and more severe PTSD symptoms than expected based on one's expected stable level of PTSD started eroding social support midway through the assessment year. When specific sources of social support were analyzed separately, the association between within-person increases in social support from friends at any given time point accelerated the recovery from PTSD across the entire year. Among participants with intimate partners (n = 53), intimate partner support did not predict PTSD symptoms, but more severe PTSD symptoms at any given time point predicted less support at the following time point. Results from this longitudinal study provide additional support for the bidirectional relationship between PTSD and social support over time and suggest that perceived social support from friends may be especially helpful during trauma recovery.

Men's Social Connectedness in Later Life: A Qualitative Study with Older Men.

This qualitative study aimed to understand men's social connectedness in later life in Portugal focusing on their perceptions, obstacles, strategies, and impact on well-being. The sample included 104 older Portuguese men over 65 years of age (Mage = 70.76 years). The qualitative data were the direct transcriptions of the answers given by participants to the electronic interview using thematic analysis. Findings revealed six overarching themes encompassing 18 subcategories: definitions of social connectedness (social support, community identity, mental health promotion, use of community structures), difficulties/obstacles in maintaining social connectedness (ageism, lack of initiative, physical limitations, psychological traits, resources), strategies/actions or resources to establish social connections (use of technology, use of community groups, leisure and sport activities, church/religion), negative impact of difficulties in establishing relevant social connections (mental health, physical health, relationships), positive actions from being socially connected (positive prescriptions to promote social connectedness), and concerns from being socially disconnected (health risks). These findings indicate that the lack of social connectedness creates social vulnerability in later life, and social support is needed to ensure safer aging among older men.

The impact of COVID-19 on the peer relationships of adolescents around the world: A rapid systematic review.

The main objective of this rapid systematic review was to examine how the COVID-19 pandemic impacted peer relationships for adolescents (10-25 years of age) around the globe. We focused on four indices of peer relationships: (1) loneliness, (2) social connectedness, (3) social support, and (4) social media use. In addition, we examined gender and age differences. Four databases (APA PsychInfo, PubMed, Scopus, and Web of Science) were searched for articles published from January 2020 to November 2022. A total of 96 studies (cross-sectional: n = 66, longitudinal: n = 30, quantitative: n = 67, qualitative: n = 12, mixed-methods: n = 17) met our inclusion criteria (empirical observational studies with data on at least one of the indices of interest, cross-sectional data on COVID-19-related experiences or longitudinal data collected during the pandemic, age range of 10-25 years, typically developing adolescents). We extracted data and conducted a narrative synthesis. Findings suggest that COVID-19 disruptions negatively impacted peer relationships for youth. Most studies reported either an increase in loneliness over the course of the pandemic or a positive association between loneliness and COVID-19-related experiences. Similar findings were observed for increased social media use as a means of continued communication and connection. Fewer studies focused on social support but those that did reported a decrease or negative association with COVID-19-related experiences. Lastly, findings suggest a mixed impact on social connectedness, which might be due to the strengthening of closer ties and weakening of more distant relationships. Results for gender differences were mixed, and a systematic comparison of differences across ages was not possible. The heterogeneity in measures of COVID-19-related experiences as well as timing of data collection prevented a more nuanced examination of short and more long-term impacts.

Mental and social wellbeing trajectory during the pandemic for vulnerable populations.

Objectives: We investigated changes over time in mental and social wellbeing indicators for vulnerable population subgroups during the pandemic. These groups were younger people, people with disabilities, low-income groups, unemployed, culturally, and linguistically diverse communities (CaLD), and Aboriginal and Torres Strait Islander peoples. Methods: A series of four repeated population representative surveys were conducted in June 2020, September 2020, January 2022, and June 2022. Questions included items on psychological distress, financial hardship, social connection, and life satisfaction. Results: For most groups, social connection and life satisfaction improved in 2022 relative to 2020. Psychological distress and financial hardship showed the opposite pattern, with some groups having worse results in 2022 relative to 2020. People without any vulnerability had better mental health and social wellbeing outcomes at each time point relative to the vulnerable population subgroups. Conclusion: Pandemic-related policies had differential effects over time and for different population groups. Future policies and research need to closely monitor how they impact population subgroups, and the overall results clearly demonstrate the inequity in mental health and social wellbeing outcomes for vulnerable population cohorts.

Factors associated with loneliness among individuals aged 80 years and over: Findings derived from the nationally representative "Old Age in Germany (D80+)" study.

OBJECTIVES: To clarify the factors associated with loneliness in individuals aged 80 years and older in Germany (also stratified by sex). METHODS: Data from the nationally representative "Old Age in Germany (D80+)" were employed. The analytic sample equaled 10,031 individuals. The D80+ study included community-dwelling and institutionalized individuals ≥ 80 years in Germany. Multiple linear regressions were used (with sociodemographic and health-related explanatory factors). The collection of data occurred between November 2020 and April 2021 (written questionnaire). RESULTS: Higher loneliness was significantly associated with not being married (e.g., widowed compared to being married, ß=0.37, p<.001), being institutionalized (ß=0.33, p<.001), low education (high education compared to low education, ß=-0.07, p<.01), a higher number of chronic conditions (ß=0.02, p<.001), poor self-rated health (ß=-0.19, p<.001) and greater functional impairment (ß=0.15, p<.001). Sex-stratified regressions produced comparable results. However, low education was only associated with higher loneliness among men, but not women (with significant interaction: education x sex). CONCLUSION: Several sociodemographic and health-related factors can contribute to loneliness among the oldest old in Germany, with sex-specific associations between education and loneliness. Overall, such knowledge can aid to address individuals with higher loneliness levels.