The examination of the relationships among digital addiction, loneliness, shyness, and social anxiety in adolescents / El examen de las relaciones entre adicción digital, soledad, timidez y ansiedad social en adolescentes

La adicción digital, que se determina como un problema común entre los adolescentes en los últimos años, afecta negativamente la vida de los adolescentes en muchos aspectos. El objetivo del estudio es examinar las relaciones entre la adicción digital, la soledad, la timidez y la ansiedad social de los adolescentes. Gate se reunió con adolescentes que completaron la Escala de adicción digital, la versión corta de la Escala de soledad de UCLA, la Escala de timidez y la Escala de gravedad del trastorno de ansiedad social DSM-5 - Formulario infantil. Las hipótesis sugeridas se han probado utilizando los datos recopilados de 991 adolescentes y un análisis de regresión jerárquica. Los resultados de la investigación encontraron una relación positiva y significativa entre la adicción digital, la soledad, la timidez y la ansiedad social entre los adolescentes. Además, los hallazgos muestran que la adicción digital, la soledad y la timidez predicen la ansiedad social. Los resultados obtenidos demuestran que la adicción digital, la soledad y la timidez tienen efecto sobre la ansiedad social. Según los hallazgos, se sugiere aplicar diversas intervenciones educativas por parte de profesionales de la salud mental a adolescentes que presenten signos de adicción digital, soledad, timidez y ansiedad social.(AU)

Digital addiction, which is determined as a common problem among adolescents in the last years, affects the lives of adolescents nega-tively in terms of many aspects. The aim of the study is to examine the re-lationships between adolescents' digital addiction, loneliness, shyness and social anxiety. Gate gathered from adolescents who completed Digital Ad-diction Scale, Short Form of UCLA Loneliness Scale, Shyness Scale, and DSM-5 Social Anxiety Disorder Severity Scale -Child Form. The suggest-ed hypotheses have been tested using the data gathered from 991 adoles-cents and hierarchical regression analysis. The research findings found a positive and significant relationship between digital addiction, loneliness, shyness and social anxiety among adolescents. Furthermore, the findings show that digital addiction, loneliness, and shyness predict social anxiety. The results obtained prove that digital addiction, loneliness and shyness have an effect on social anxiety. According to the findings, it is suggested to applyvarious educational interventions by mental health professionals to adolescents who show signs of digital addiction, loneliness, shyness, and social anxiety.(AU)

Chronic loneliness and chronic social isolation among older adults. A systematic review, meta-analysis and meta-regression.

OBJECTIVES: We performed a systematic review and meta-analysis to examine the prevalence and antecedents/consequences of chronic loneliness and social isolation (i.e. enduring or persistent experience that extends over a certain period of time) among older adults. Moreover, we conducted a meta-regression to explore sources of heterogeneity. METHOD: A search was conducted in four electronic databases. We included observational studies that reported prevalence and, where available, antecedents/consequences of chronic loneliness or chronic social isolation amongst older adults. Key characteristics of the studies were extracted. RESULTS: Across 17 studies included in the meta-analysis, the estimated prevalence of chronic loneliness was 20.8% (95% CI: 16.1-25.5%), including 21.7% among women (95% CI: 16.1-27.4%) and 16.3% among men (95% CI: 10.6-21.9%). One study reported chronic social isolation (13.4%) and found that chronic social isolation predicted higher depression scores. Meta-regressions indicated that loneliness was less prevalent when assessed with single-item measures. Regarding antecedents/consequences, spousal loss can contribute to chronic loneliness which in turn may contribute to adverse health-related outcomes. CONCLUSION: About one in five older adults experiences chronic loneliness reflecting the need to address chronic loneliness. More longitudinal research is needed on chronic loneliness and social isolation, particularly from low and middle-income countries.

Which Social Variables Predict Diabetes Onset? Robust Findings in Two National Surveys.

BACKGROUND AND OBJECTIVES: The role of social factors in diabetes onset has been obscured by wide variation in their conceptualization and operationalization. We apply three theoretical frameworks to categorize social relationship variables along several dimensions and identify which dimension(s) are robustly associated with incident diabetes in the older adult population. RESEARCH DESIGN AND METHODS: The National Social Life, Health, and Aging Project (n=2,365) and the Health and Retirement Study (n=11,824) provided longitudinal data from 57-90 year-old respondents over a 4- to 5-year period. Logistic regression models were used to test associations of 15 social variables measured identically in both datasets with diabetes onset measured as respondents' first report of a physician's diagnosis. RESULTS: In both studies, not being married, experiencing strain in a spousal relationship, and feeling lonely were associated with increased risk for diabetes onset at follow-up. Inconsistent or null findings were observed for social support, social activity, network size, number of friends and relatives, living alone, and closeness to network members. DISCUSSION AND IMPLICATIONS: Robust findings in two large-scale surveys support the importance of the valence dimension (i.e., positive and negative); specifically, alleviating negative aspects of social life might more effectively reduce risk for diabetes than augmenting positive ones. Findings were not aligned with social variables differing on the subjectivity dimension (i.e., structural, functional, and qualitative aspects of social connections). Future work needs consistent conceptualization and measurement of social factors to correctly identify and categorize risk factors for diabetes onset and other health conditions in older adults.

The Effect of Temporal Persistence of Loneliness on Dementia: A Longitudinal Analysis From the Hunter Community Study.

OBJECTIVES: Loneliness is common and becoming a public health concern. Although there is the clear evidence of the variable effect of temporal differences in loneliness (transient/situational and persistent/chronic) on health, their effect on dementia risk is unclear. This study aims to assess the effect of transient/situational and persistent/chronic loneliness on dementia risk. METHOD: Participants aged 55 years and older from the Hunter Community Study were recruited. Loneliness was measured using a single item measure. Dementia was defined as per International Classification of Disease-10 (ICD 10) codes. The Fine-Gray subdistribution hazard model was performed to calculate dementia risk. RESULTS: Of 1968 total participants with mean age of 66 years, (3%) 57 developed dementia and (7%) 135 died over the mean follow up of 10 years. Both persistent/chronic and transient/situational loneliness significantly increased the risk of all cause dementia in adjusted models (HR 2.74, 95% CI 1.11-6.88, p 0.03 and HR 2.35, 95% CI 1.21-4.55, p 0.01 respectively) with mean time to event of 9.7 years. Feeling lonely below the age of 70 years elevated the risk of dementia in later life (HR 4.01, 95% CI 1.40-11.50, p 0.01). CONCLUSIONS: Loneliness (both persistent/chronic and transient/situational) was associated with increased risk of all cause dementia, especially if loneliness was experienced before the age of 70 years. These results suggest that promoting coping strategies for loneliness especially in persons 70 years and younger may play a role in preventing dementia.

Addressing loneliness in older adults: predictors, protective factors, and implications for social work practice.

Loneliness significantly impacts the mental well-being of older adults, prompting an examination of psychological predictors and buffering factors associated with it in this demographic. A cross-sectional study involving 246 community-dwelling older adults was conducted. The UCLA Loneliness Scale identified predictors of loneliness, including negative mood, hopelessness (negative future expectations and loss of motivation), and despair. Buffering factors included ego-integrity, personal growth, and purpose in life. Regression analysis revealed that negative mood, negative future expectations, and despair increased loneliness, with negative mood showing a strong association. Conversely, ego-integrity, personal growth, and purpose in life reduced loneliness. The study underscores the complex interplay of psychological factors shaping loneliness in older adults, highlighting the importance of addressing both risk and protective factors. Social work practitioners in healthcare settings can play a pivotal role in addressing loneliness among older adults by leveraging these factors.

Interventions for loneliness in older adults: a systematic review of reviews.

Loneliness in older persons is a major risk factor for adverse health outcomes. Before the COVID-19 pandemic led to unprecedented isolation and hampered programs aimed at preventing or reducing loneliness, many interventions were developed and evaluated. However, previous reviews provide limited or conflicting summaries of intervention effectiveness. This systematic review aimed to assess previous review quality and bias, as well as to summarize key findings into an overarching narrative on intervention efficacy. The authors searched nine electronic databases and indices to identify systematic reviews of interventions to reduce loneliness in older people prior to the COVID-19 pandemic; 6,925 records were found initially. Of these, 19 reviews met inclusion criteria; these encompassed 101 unique primary intervention studies that varied in research design, sample size, intervention setting, and measures of loneliness across 21 nations. While 42% of reviews had minimal risk of bias, only 8% of primary studies appraised similarly. Among the 101 unique articles reviewed, 63% of tested interventions were deemed by article author(s) as effective or partially effective. Generally, interventions that included animals, psychological therapies, and skill-building activities were more successful than interventions focused on social facilitation or health promotion. However, interventions that targeted multiple objectives aimed at reducing loneliness (e.g., improving social skills, enhancing social support, increasing social opportunities, and changing maladaptive social cognition) were more effective than single-objective interventions. Future programs should incorporate multiple approaches, and these interventions should be rigorously tested.

A community-academic partnered approach to designing a Virtual Village to address the needs of older adults living with HIV.

ABSTRACTMany older adults living with HIV face unique challenges, including comorbidities, loneliness, and isolation. This community-academic partnered study elicited viewpoints from older adults living with HIV about the characteristics of a digital environment ("Virtual Village") to combat against loneliness and isolation. We utilized Choice-Based Conjoint Analyses to determine preferred attributes of a Virtual Village. We also conducted focus groups and interviews with older adults living with HIV and used an iterative, data-driven approach to systematically identify emergent themes. Participants (N = 82) were aged 50-82 years and racially/ethnically diverse. The majority were men (78%), gay (66%), and lived with HIV for ≥15 years (83%). Cost was the factor that most drove participants' preference for joining a Virtual Village. Thematic concerns included lack of technological confidence, internet access, potential for harassment in digital environments, privacy, and preference for in-person interactions. Praises centered on convenience and making connections across geographic distances. Participants emphasized the need for purposive strategies to form a cohesive and supportive community for older adults living with HIV. A moderated environment was recommneded to create a safe, structured, and comfortable digital environment for older adults living with HIV. A Virtual Village should be viewed as a bridge to in-person interactions.

Ambiguity potentiates effects of loneliness on feelings of rejection.

For social species, having strong and high-quality social relationships is an important safety cue. Loneliness occurs when an individual perceives they have insufficient relationships resulting in feelings of lack of safety. States of perceived unsafety are linked to an increased tendency to construe ambiguous information - information lacking a unique clear interpretation - as threatening. Here, we explore whether the ambiguity of social cues of interpersonal rejection moderates effects of loneliness on feelings of rejection while undergoing social exclusion. Data were collected in 2021; 144 adults completed a progressive social exclusion paradigm where they were randomly assigned to be equally included, excluded, or over-included. Social exclusion/inclusion cues became more pronounced over the course of multiple rounds of a ball-tossing game (Cyberball) resulting in a scenario where ambiguity was highest in earlier rounds and decreased over time. Participants reported feelings of loneliness prior to the task and feelings of rejection throughout the task. Results demonstrated that higher loneliness predicted increased feelings of rejection regardless of exclusion condition. Notably, this positive relationship was strongest during earlier rounds when social cues were most ambiguous. These findings contribute to our understanding of how loneliness modulates social perception to enable organisms to adequately adapt to changing circumstances.

Silence between words: Is solitude important for relatedness?

Chronic loneliness is a risk factor for physical and health problems, in part due to dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system. In contrast, temporary moments of positive solitude (passing good times alone and not feeling lonely) appear to have positive effects on mental health, social life, and creativity, and seems to be a buffer against loneliness. Herein, three ways of how solitude may have positive effects on health and relatedness are discussed, namely effects on enhancement of mind-wandering, interoceptive awareness, and spirituality. Solitude may facilitate (1) activation of the default mode network (DMN) underlying mind-wandering including daydreaming about other people; (2) activation of brain areas supporting interoceptive awareness; (3) deactivation of prefrontal cortex, or deactivation and decreased connectivity of the DMN, giving raise to susceptibility to spiritual experiences. The capacity to handle and enjoy solitude is a developmental process that may be difficult for many persons. Craving for social connections and external stimulation with digital technologies (e.g., internet, smartphones, social media) might be interfering with the development of the capacity for solitude and thereby increasing loneliness; this might be partly due to impaired interoceptive awareness and impaired functional mind-wandering (common in solitude). Congruently, overuse of digital technologies was associated with reduced activity, and reduced gray matter volume and density, in brain areas supporting interoceptive awareness, as well as with decreased connectivity of the DMN supporting creative insights. Solitude has been a relatively dismissed topic in neuroscience and health sciences, but a growing number of studies is highlighting its importance for well-being.

Navigating the digital landscape: Relationship between type of internet use and well-being among students-A mediation and moderation analysis.

Background: The amount and frequency of internet use are often used to forecast its pros and cons, with mixed findings. After COVID-19, technological advances and sociological upheavals have shown the internet's ability to support numerous activities, necessitating a change in internet use. Beyond internet use frequency, it has been advised to examine why people use it and how it affects their well-being. Hence, we aimed to investigate the various mediators and moderators in the relationship between the quality of internet use (type of activity) and well-being. Further, we investigated whether user attributes such as initial age and frequency of internet use moderate the influence of internet use quality on problematic internet use, loneliness, and well-being. Methods: 131 students in Manipur who were 18 years old were included in this cross-sectional study. Self-rated measures of the Adult Internet Usage questionnaire, Internet Addiction Test, and Mental Health Continuum-Short Form assessed internet use, dependence, and well-being. Results: Loneliness mediates the association between well-being and internet behaviors related to personal use-self-actualization (BootSE = .53, BootLLCI = .10, BootULCI = 2.18), cultural use-belonging (BootSE =.57, BootLLCI = -2.23, BootULCI = -.02). Average online hours moderate economic use-education, loneliness, and well-being (BootSE =.13, BootLLCI = -.55, BootULCI = -.04). Conclusion: To conclude, the effectiveness of internet use affects well-being differently depending on the type of activity. After a certain point, even seemingly good internet activities may have diminishing returns.

Predicting hostility towards women: incel-related factors in a general sample of men.

Hostility towards women is a type of prejudice that can have adverse effects on women and society, but research on predictors of men's hostility towards women is limited. The present study primarily introduced predictors associated with misogynist involuntary celibates (incels), and then investigated whether loneliness, rejection, attractiveness, number of romantic and sexual partners, right-wing authoritarianism, and gaming predicted hostility towards women among a more general sample of men. A total of 473 men (aged 18-35, single, heterosexual, UK residents) recruited via Prolific answered the hostile sexism subscale, the misogyny scale, the self-perceived sexual attractiveness scale, the right-wing authoritarianism scale, the game addiction scale for adolescents, the adult rejection-sensitivity scale, the UCLA loneliness scale, and self-developed questions regarding number of sexual and romantic partners, and time spent gaming. We found a strong positive relationship between right-wing authoritarianism and hostility towards women, as well as a strong convex curvilinear relationship between attractiveness and hostility towards women. The number of sexual partners showed a moderate concave relationship with hostility towards women. We did not find sufficient support for a relationship between gaming and hostility towards women, and there was no support that loneliness, rejection, or romantic partners predicted hostility towards women among a general sample of men. Our study supports right-wing authoritarianism and self-perceived attractiveness as potential strong predictors in understanding men's hostility towards women in the wider community. Pre-registration: https://osf.io/ms3a4.

[Loneliness in Bavaria before and during the COVID-19 pandemic]. / Einsamkeit in Bayern vor und während der COVID-19-Pandemie.

BACKGROUND: Loneliness represents a significant health risk and is associated with numerous mental and physical conditions. The aim of this paper was to describe the prevalence of loneliness in Bavaria before and during the COVID-19 pandemic with respect to socio-demographic attributes. METHODS: Data sources were the German Ageing Survey (DEAS) and the Socio-Economic Panel (SOEP). Univariate statistical analyses were carried out for different socio-demographic attributes, such as age, gender, type of household, education, and financial resources. RESULTS: According to the SOEP, the proportion of adults who are often or very often lonely increased from 2.3% in 2017 to 16.2% in 2021. In 2021, women had a higher prevalence of loneliness than men (21.0% vs. 11.3%), and younger adults had the highest prevalence of loneliness (18 to 25 years: 31.7%) compared to the other age groups. DISCUSSION AND CONCLUSIONS: During the COVID-19 pandemic, loneliness increased in almost every population subgroup in Bavaria. Further studies are needed to examine whether this development is temporary or represents a long-term effect even after the measures to prevent the spread of COVID-19 have been lifted.

The impact of social isolation on smartphone addiction among college students: the multiple mediating effects of loneliness and COVID-19 anxiety.

Background: The widespread use of smartphones has significantly increased smartphone addiction among college students, especially during the COVID-19 pandemic. Since the COVID-19 outbreak, university campuses in mainland China have strictly followed the Chinese government's strict quarantine policy, including closed campus management, prohibitions against gatherings, and social distancing, increasing student loneliness and anxiety and thus increasing the risk of smartphone addiction. Extant Studies have revealed that social isolation is a prominent predictor of smartphone addiction but have failed to systematically explore the complex relationship between social isolation and smartphone addiction in the context of COVID-19; therefore, the underlying mechanisms of these factors in the post-pandemic era are unclear. Objective: This study is the first attempt to consider loneliness, COVID-19 anxiety and social isolation as a whole and to clarify the underlying mechanisms of social isolation and smartphone addiction by constructing a multiple mediating model. Method: This study included students enrolled at eight higher education institutions in Conghua District (Guangzhou city). Quota proportional sampling was adopted, 900 self-report questionnaires were distributed through the WeChat groups of these universities from December 10 to December 15, 2022, and 868 valid questionnaires (620 females, 248 males) were ultimately obtained. Results: The direct effect of social isolation on smartphone addiction was significant, and loneliness and COVID-19 anxiety mediated the association between social isolation and smartphone addiction in both parallel and sequential ways. Moreover, a reverse mediation model with COVID-19 anxiety as the first mediator and loneliness as the second mediator was found. Conclusion: College students who experience social isolation are at greater risk for smartphone addiction, and the core factor leading to their smartphone addiction is the subjective psychological state triggered by campus isolation and social distancing, such as loneliness and anxiety. These risky behaviors of people should receive extra attention, and psychological factors such as loneliness and COVID-19 anxiety should be considered in future therapies aimed at reducing addiction.

Emotional loneliness, perceived stress, and academic burnout of medical students after the COVID-19 pandemic.

Introduction: In recent times, emotional loneliness has been increasing among young people, despite their intense social interaction via virtual platforms and in real life. Their social-emotional development seems to be interrupted due to high levels of psychological stress, and it probably results in significant academic problems. This study aimed to investigate the relationships between loneliness, perceived stress, and academic burnout among medical students after the COVID-19 pandemic. Methods: Datasets were collected from 630 medical students (51.7% women, with the mean age of 21.31 and the standard deviation of 2.14) by using scales for emotional and social loneliness, psychological stress, and academic burnout in January 2023. After verifying normality, a t-test and ANOVA were used to compare groups. Pearson's correlation coefficient and path analyses were also utilized for data analysis. Results: In terms of loneliness, there were significant differences between genders in preclinical and clinical term groups, and stress levels were also significantly different between the two term groups. Men were found to be more emotionally lonely than women. No significant difference was observed for academic burnout across gender and term groups. Perceived stress played a mediator role between emotional loneliness and academic burnout, while social loneliness had almost no effect on either stress or academic burnout. Stress increased significantly as educational levels increased. Conclusions: According to the results, emotional loneliness and stress increase academic burnout. To alleviate burnout, emotional loneliness and stress should be decreased through various psychosocial interventions, such as group therapies. Addressing the psychological issues and improving the psychological resilience of medical students can also help.

Relationship between adolescent internet addiction and adolescent non-suicidal self-injury: a moderated mediation model.

Background: Both Internet addiction (IA) and non-suicidal self-injury (NSSI) are major public health concerns among adolescents, association between internet addiction and non-suicidal self-injury have been observed among adolescents. However, it is unclear how, and under what conditions, internet addiction relates to non-suicidal self-injury. According to our hypothesis, there is a positive relationship between IA and NSSI among Chinese adolescents, but this relationship is affected by the mediating role of loneliness and the moderating role of cognitive reappraisal. Method: A cross-sectional survey was conducted on 1046 Chinese adolescents from 3 middle schools. Measurements: Adolescent Self-Harm Scale; Young's Internet Addiction Test (IAT); University of California at Los Angels (UCLA) Loneliness Scale; Emotional Regulation Questionnaire (ERQ), They were asked to complete self-report questionnaires. Results: In our sample, the detection rate of NSSI was 12.3%. IA was positively associated with NSSI, and loneliness partially mediated the association between them. In addition, cognitive reappraisal moderated the first half path of the mediation model. Specifically, the higher the level of cognitive reappraisal, the weaker the positive effect of IA on NSSI through loneliness. Conclusion: Interventions targeted to reduce loneliness and increase cognitive reappraisal strategies may reduce the risk of NSSI in adolescents with Internet addiction.

Loneliness and social isolation are associated with an increased risk of glaucoma: a UK Biobank cohort study.

BACKGROUND: Loneliness and social isolation have been found to be associated with various health-related outcomes. Our study aimed to evaluate the association of loneliness and social isolation with the risk of glaucoma. METHODS: A total of 373,330 participants from the UK Biobank without glaucoma at recruitment were included in this study. Self-reported questionnaires were used to define loneliness and social isolation. Incident glaucoma events were identified by hospital inpatient admissions and self-reported data. COX proportional hazards models adjusted for sociodemographic, lifestyle, and health-related factors were used to estimate hazard ratios (HRs) and 95% CIs. RESULTS: During a median follow-up of 13.1 (interquartile range: 12.3-13.9) years, 6,489 participants developed glaucoma. After adjusting for confounding factors, loneliness (yes vs. no: adjusted HR: 1.16; 95% CI: 1.04-1.30; P = 0.009) and social isolation (yes vs. no: adjusted HR: 1.08; 95% CI: 1.01-1.16; P = 0.033) were associated with an increased risk of glaucoma. CONCLUSIONS: In this population-based prospective cohort study, loneliness and social isolation were associated with a higher risk of glaucoma.

[Migration background and loneliness among middle-aged and older adults in Germany]. / Migrationshintergrund und Einsamkeit im mittleren und hohen Alter in Deutschland.

BACKGROUND: Currently, there is limited knowledge about the association between a migration background and loneliness among middle-aged and older individuals in Germany. The aim was therefore to examine the association between migration background and loneliness in this group. METHODS: Data were taken from the German Ageing Survey (Wave 7, November 2020 to March 2021), a representative sample of middle-aged and older individuals. The sample comprised 4145 individuals, and the mean age was 63.8 years. Of the respondents, 93.2% had no migration background, approximately 5.9% had a migration background with personal migration experience, and 0.9% had a migration background but no personal migration experience. The De Jong Gierveld tool was used to quantify loneliness. RESULTS: Multiple linear regressions showed that individuals with a migration background and their own migration experience have significantly higher levels of loneliness (ß = 0.15, 95% confidence interval (CI): 0.004 to 0.30, p < 0.05) compared to individuals without a migration background, whereas individuals with a migration background without their own migration experience have significantly lower levels of loneliness (ß = -0.27, 95% CI: -0.52 to -0.02 p < 0.05). CONCLUSIONS: Individuals with a migration background and their own migration experience appear to represent a risk group for high loneliness among middle-aged and older adults in Germany. In this respect, this group should be given special consideration in corresponding measures. Against the background of current (and potential future) migration movements, the results are of great importance as these groups in particular could be affected by loneliness.

COVID-19 Posttraumatic Effects on Perinatal Psychological Distress: A Cross-Sectional Study at the End of the Pandemic Health Emergency.

INTRODUCTION: Psychological distress in pregnant and postpartum women increased during the COVID-19 pandemic. However, the impact of the pandemic in perinatal women at the end of the health emergency has been rarely studied. This study is aimed at investigating the psychological health of pregnant and postpartum women at the end of the COVID-19 public health emergency, hypothesizing that the COVID-19-related fears influence perinatal psychological distress via the mediation of the COVID-19-related posttraumatic impact and loneliness. METHODS: A total of 200 women in the perinatal period, of which 125 were pregnant and 75 were postpartum, participated in an online survey at the end of the COVID-19 public health emergency in Italy. Depression, anxiety, stress, loneliness, posttraumatic impact of COVID-19 pandemic and COVID-19-related fears were assessed. To test the hypotheses, robust serial mediation analyses were performed. RESULTS: Increased levels of COVID-19-related fears were associated with an increase in perinatal depression, anxiety and stress indirectly through the serial mediation of COVID-19 posttraumatic impact and loneliness. Loneliness played a stronger role in mediating the relationship between COVID-19-related fears and depression than anxiety and stress outcomes. CONCLUSIONS: This study should be considered exploratory for its methodological characteristics and nonreplicability of the pandemic condition. However, this study suggests the importance of assessing posttraumatic reactions to 'collective' crises in pregnant and postpartum women for research and clinical practice. In addition, it sustains the role of loneliness as a transversal construct that should be greatly considered in targeting psychological interventions for women in the perinatal period.

[Loneliness as health risk: a narrative review]. / Einsamkeit als Gesundheitsrisiko: Eine narrative Übersichtsarbeit.

Loneliness is increasingly recognized as a significant health risk. This review provides an overview of current research on the impact of loneliness on mental and physical health. The findings indicate that loneliness is a significant risk factor of both mental and physical health. Previous reviews focusing on mental health effects reveal that loneliness is associated with the onset of depression, social anxiety, and cognitive decline. Furthermore, loneliness can impede recovery from mental disorders in general, which can be partly attributed to the bidirectional interplay between loneliness and mental health. Regarding physical health, consequences of loneliness have been mostly studied in relation to cardiovascular diseases. Loneliness predicts the onset of cardiovascular diseases and impedes recovery from them. Reviews also highlight that loneliness enhances the likelihood of suicidality and mortality. However, this article also points out the shortage of longitudinal studies, complicating the investigation into how loneliness causally affects future health problems. The health implications of loneliness outlined in this review, some of which are irreversible and can induce suffering and impairment, underscore the importance of interventions aimed at alleviating loneliness as a preventive strategy against both mental and physical illnesses.

Effectiveness of a Virtual Reality Open-Air Bath Program in Reducing Loneliness and Improving Brain Function for Dementia Prevention in Older Adults: Protocol for a Prospective Randomized Crossover Study.

BACKGROUND: Older adults often face loneliness due to chronic illness or loss of close ones, a situation worsened by the COVID-19 pandemic. Increased loneliness heightens the risk of diseases, especially dementia, necessitating urgent action. OBJECTIVE: This study aims to assess the impact of a virtual reality (VR)-based open-air bath program on depression and loneliness in older individuals with subjective cognitive decline/mild cognitive impairment attending the Dementia Medical Center in Kyoto, Japan. We further aim to evaluate the feasibility of the program (participant recruitment and adherence) and to measure program enjoyment and satisfaction. METHODS: The study design is a crossover trial with a 1:1 ratio, wherein 12 participants will be randomly assigned to groups 1 and 2, with group 2 serving as a waitlist control and group 1 receiving the VR program from the onset for 6 months; the VR program will be conducted 6 times (monthly). Program completion for group 1 will be followed by an observation period from months 7 to 12. Group 2 will participate in the VR program from months 7 to 12, with an observation period from months 1 to 6. Cognitive tests, psychiatric assessments, and the University of California, Los Angeles Loneliness Scale will be conducted before the study, at 6 months, and at 12 months. Results will be analyzed using repeated-measures ANOVA. Head magnetic resonance imaging and single-photon emission computed tomography scans will be performed before and after the VR program to evaluate changes and effects on brain regions. RESULTS: Recruitment began in September 2023 and data collection is expected to be completed by March 2025. Complete study results will be published by September 2025. CONCLUSIONS: This study examines the preliminary effects of VR on loneliness in older adults with predementia through open-air bath simulations. VR experiences could benefit this population, particularly those with limited outdoor activities. Quantifying VR's impact will aid in determining the size for a larger clinical trial. Qualitative results will inform participation mechanisms and guide the implementation and design of future trials. TRIAL REGISTRATION: University hospital Medical Information Network UMIN000052667; https://tinyurl.com/3yaccay5. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/57101.