Research School of Psychology, The Australian National University, Canberra, Australia.
School of Psychology, The University of Queensland, Brisbane, Australia.
Psychother Res. 2023 Jun;33(5):608-624. doi: 10.1080/10503307.2022.2143300. Epub 2022 Nov 20.
The last 10 years have seen a surge of interest in loneliness and interventions to reduce it. However, there is little evidence regarding differential treatment effectiveness and predictors of treatment outcome. This paper aimed to investigate possible predictors of treatment response.
We analysed data from two clinical trials of an evidence-based loneliness intervention: Groups 4 Health (G4H). Study 1 had 163 observations across two timepoints, = 94; Study 2 had 297 observations across four timepoints; = 84. Theorised predictors-symptom severity at baseline, program engagement, and demographic characteristics-were assessed for their effect on the primary outcome: loneliness.
Across both trials, participants with more severe baseline loneliness or social anxiety, or who attended more sessions, experienced greater improvement in loneliness. In Study 2, those with diagnosed mental illness or more severe baseline depression also tended to have better outcomes. There was no evidence that age, gender, or ethnicity predicted program efficacy.
Overall, those with greater need-reflected in either severity of loneliness or psychological distress-tended to show greater improvement over time. This was due, in part, to greater engagement with the program among those who were lonelier. We discuss how loneliness interventions can be deployed most effectively to combat this profound public health challenge.
过去 10 年，人们对孤独感及其干预措施产生了浓厚的兴趣。然而，关于治疗效果的差异性和治疗结果的预测因素的证据很少。本文旨在探讨可能的治疗反应预测因素。
我们分析了基于证据的孤独感干预措施 Groups 4 Health（G4H）的两项临床试验的数据。研究 1 在两个时间点有 163 个观测值，=94；研究 2 在四个时间点有 297 个观测值，=84。对假设的预测因素（基线时的症状严重程度、项目参与度和人口统计学特征）进行了评估，以了解它们对主要结局（孤独感）的影响。
在两项试验中，基线孤独感或社交焦虑程度较高、参加更多疗程的参与者，孤独感改善程度更大。在研究 2 中，患有精神疾病或基线时抑郁程度更严重的参与者也往往有更好的结果。没有证据表明年龄、性别或种族可以预测方案的疗效。
总体而言，需求更大的人（表现为孤独感或心理困扰程度更严重）随着时间的推移往往会有更大的改善。这部分是由于孤独感较强的人更积极地参与了该项目。我们讨论了如何最有效地部署孤独感干预措施来应对这一深刻的公共卫生挑战。
