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      Social isolation, loneliness and their relationships with depressive symptoms: A population-based study

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      PLoS ONE
      Public Library of Science

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          Abstract

          Objectives

          To assess the relationship between various social isolation indicators and loneliness, and to examine the differential associations that social isolation indicators, loneliness have with depressive symptoms.

          Methods

          Baseline data for 1,919 adults (aged 21 years and above) from a representative health survey in the Central region of Singapore was used for this study. The association between social isolation indicators (marital status, living arrangement, social connectedness with relatives and friends) and loneliness (the three-item UCLA Loneliness) were assessed, and their differential associations with depressive symptoms (the Patient Health Questionnaire-9) were examined using multiple linear regression, controling for relevant covariates.

          Results

          There was significant overlap between loneliness and social isolation. Social connectedness with relatives and friends were mildly correlated with loneliness score (|r| = 0.14~0.16). Social isolation in terms of weak connectedness with relatives and with friends and loneliness were associated with depressive symptoms even after controling for age, gender, employment status and other covariates. The association of loneliness with depressive symptoms (β = 0.33) was independent of and stronger than that of any social isolation indicators (|β| = 0.00~0.07).

          Conclusions

          The results of the study establishes a significant and unique association of different social isolation indicators and loneliness with depressive symptoms in community-dwelling adults aged 21 and above.

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          Most cited references36

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          The PHQ-9

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            A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies.

            Most studies of social relationships in later life focus on the amount of social contact, not on individuals' perceptions of social isolation. However, loneliness is likely to be an important aspect of aging. A major limiting factor in studying loneliness has been the lack of a measure suitable for large-scale social surveys. This article describes a short loneliness scale developed specifically for use on a telephone survey. The scale has three items and a simplified set of response categories but appears to measure overall loneliness quite well. The authors also document the relationship between loneliness and several commonly used measures of objective social isolation. As expected, they find that objective and subjective isolation are related. However, the relationship is relatively modest, indicating that the quantitative and qualitative aspects of social relationships are distinct. This result suggests the importance of studying both dimensions of social relationships in the aging process.
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              Loneliness matters: a theoretical and empirical review of consequences and mechanisms.

              As a social species, humans rely on a safe, secure social surround to survive and thrive. Perceptions of social isolation, or loneliness, increase vigilance for threat and heighten feelings of vulnerability while also raising the desire to reconnect. Implicit hypervigilance for social threat alters psychological processes that influence physiological functioning, diminish sleep quality, and increase morbidity and mortality. The purpose of this paper is to review the features and consequences of loneliness within a comprehensive theoretical framework that informs interventions to reduce loneliness. We review physical and mental health consequences of loneliness, mechanisms for its effects, and effectiveness of extant interventions. Features of a loneliness regulatory loop are employed to explain cognitive, behavioral, and physiological consequences of loneliness and to discuss interventions to reduce loneliness. Loneliness is not simply being alone. Interventions to reduce loneliness and its health consequences may need to take into account its attentional, confirmatory, and memorial biases as well as its social and behavioral effects.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Project administrationRole: SoftwareRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Project administrationRole: Writing – review & editing
                Role: Funding acquisitionRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                23 August 2017
                2017
                : 12
                : 8
                : e0182145
                Affiliations
                [001]Health Services and Outcomes Research, National Healthcare Group Pte Ltd, Singapore, Singapore
                University of West London, UNITED KINGDOM
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0001-8080-7020
                Article
                PONE-D-17-18474
                10.1371/journal.pone.0182145
                5568112
                28832594
                51dad9e1-da5d-43dd-88f6-de9e57830e0a
                © 2017 Ge et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 13 May 2017
                : 12 July 2017
                Page count
                Figures: 1, Tables: 4, Pages: 13
                Funding
                The author(s) received no specific funding for this work.
                Categories
                Research Article
                Biology and Life Sciences
                Psychology
                Collective Human Behavior
                Interpersonal Relationships
                Social Sciences
                Psychology
                Collective Human Behavior
                Interpersonal Relationships
                Biology and Life Sciences
                Nutrition
                Diet
                Alcohol Consumption
                Medicine and Health Sciences
                Nutrition
                Diet
                Alcohol Consumption
                People and Places
                Geographical Locations
                Asia
                Singapore
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Regression Analysis
                Linear Regression Analysis
                Physical Sciences
                Mathematics
                Statistics (Mathematics)
                Statistical Methods
                Regression Analysis
                Linear Regression Analysis
                Social Sciences
                Sociology
                Social Research
                People and Places
                Population Groupings
                Ethnicities
                People and places
                Population groupings
                Ethnicities
                Ethnic Malays
                Computer and Information Sciences
                Network Analysis
                Social Networks
                Social Sciences
                Sociology
                Social Networks
                Custom metadata
                According to the Data Protection Act Commission Singapore - Advisory Guidelines for the Healthcare Sector, all the individual data collected for the Population Health Index study are protected under the Act. Data are from the Population Health Index study whose authors may be contacted at Health Services and Outcomes Research, National Healthcare Group Pte Ltd. (Dr. Yap Chun Wei, Chun_Wei_YAP@ 123456nhg.com.sg ). Minimal dataset underlying the findings in the manuscript are available upon request. There is no designated contact person other than the authors or URL through which requests to access data may be submitted. The authors can be contacted for data request. The minimal dataset is ready for sharing upon the publication with request.

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                Uncategorized

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