Liberatore-Maguire E, Devlin A, Fisher S, Ramsey F, Grunwald H, Brownstein K, Morrison M F
Temple University Health System, Department of Psychiatry, Temple University Hospital, Episcopal Campus, 100 E. Lehigh Avenue MAB Suite 305B, Philadelphia, PA, 19125, USA.
Lewis Katz School of Medicine, Department of Clinical Sciences, Temple University, 3440 North Broad Street, Kresge East Room 211, Philadelphia, PA, 19140, USA.
Womens Midlife Health. 2022 Oct 27;8(1):11. doi: 10.1186/s40695-022-00080-z.
Connectedness and attachment are vital parts of humanity. Loneliness, a state of distress in reaction to perceived detachment and isolation, is reported by over one-third of U.S. adults and is associated with numerous physical and mental health consequences. What contributes to loneliness, especially in women and minority populations, is poorly understood, but this population is also at greater risk for abuse and trauma. Our study aimed to further understand loneliness in urban midlife women and to explore the relationship that may exist with trauma(s).
To identify primacies for mental health care, female midlife participants (N=50) of a long-standing urban community-based cohort focused on health improvement completed a one-time audiotaped interview with both quantitative assessments and a qualitative interview. Loneliness was assessed by the UCLA 3-item Loneliness Scale. Using semi-structured interviews, open-ended questions facilitated a discussion regarding mental health needs and experiences. Interview transcripts were coded and analyzed following a grounded theory methodology. Themes around loneliness and trauma emerged. The transcripts were coded using the same methodology and coders as the individual interviews. Twenty women participated in two optional focus groups.
Participants had a mean age of 50, with the majority identifying as Black/African American (N=37) and unemployed (N=33). Three themes emerged regarding perceived causes of loneliness: trauma, the burden of responsibilities for others, and secondary to unhealthy relationships. Loneliness associated with trauma will be explored here; other themes are beyond the scope of this paper and will be discussed in subsequent analyses. Quantitative results suggest that physical abuse (loneliness scores 5.4 vs. 4.0, p=0.003), as well as emotional abuse and neglect (loneliness scores 5.6 vs. 4.4, p=0.01), were associated with greater loneliness.
In urban midlife low-income women, lifetime physical abuse and emotional abuse/neglect are associated with increased feelings of loneliness. Qualitative data provide insight into how participants viewed their traumatic histories, ways in which the trauma has ongoing influence, and how they experience loneliness. Though further investigation is needed, trauma-informed approaches should be considered in both primary care and mental health settings with a focus on mitigating loneliness and providing appropriate support and trauma treatment.
人际关系和情感依恋是人类至关重要的组成部分。孤独是一种因感知到的疏离和孤立而产生的痛苦状态，超过三分之一的美国成年人报告有孤独感，且孤独与众多身心健康问题相关。对于孤独的成因，尤其是女性和少数族裔群体中孤独的成因，人们了解甚少，但这一群体遭受虐待和创伤的风险也更高。我们的研究旨在进一步了解城市中年女性的孤独感，并探索其与创伤之间可能存在的关系。
为了确定心理健康护理的重点，一个长期关注健康改善的城市社区队列中的50名中年女性参与者完成了一次包含定量评估和定性访谈的录音采访。孤独感通过加州大学洛杉矶分校孤独感量表的3个项目进行评估。通过半结构化访谈，开放式问题促进了关于心理健康需求和经历的讨论。访谈记录按照扎根理论方法进行编码和分析。围绕孤独和创伤的主题浮现出来。这些记录使用与个人访谈相同的方法和编码员进行编码。20名女性参加了两个可选的焦点小组。
参与者的平均年龄为50岁，大多数人认定为黑人/非裔美国人（37人）且失业（33人）。关于孤独感的感知成因出现了三个主题：创伤、对他人的责任负担以及不健康关系导致的结果。本文将探讨与创伤相关的孤独感；其他主题超出了本文的范围，将在后续分析中讨论。定量结果表明，身体虐待（孤独感得分5.4对4.0，p = 0.003）以及情感虐待和忽视（孤独感得分5.6对4.4，p = 0.01）与更高的孤独感相关。
在城市中年低收入女性中，一生遭受的身体虐待和情感虐待/忽视与孤独感增加有关。定性数据提供了关于参与者如何看待其创伤经历、创伤持续产生影响的方式以及她们如何体验孤独感的见解。尽管还需要进一步研究，但在初级保健和心理健康环境中应考虑采用创伤知情方法，重点是减轻孤独感并提供适当的支持和创伤治疗。
