Wang Jingyi, Zhang Wei, Song Peige, Wang Tingting, Yao Ye, Chen Yun, Lin Haijiang, Yang Xiaoqi, Chen Xiaoxiao, Fu Chaowei
School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People's Republic of China.
School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
Psychol Res Behav Manag. 2024 Nov 21;17:3993-4008. doi: 10.2147/PRBM.S484113. eCollection 2024.
COVID-19 threatened global health, however little is known about the long-term courses of loneliness and their effect on mental health in adolescents. This study aimed to explore the trajectories of loneliness among adolescents in Taizhou, Zhejiang Province, China, during the last phase of the pandemic. We also aimed to identify risk factors in each loneliness course and the impact of loneliness on emotional problems, peer problems, hyperactivity and conduct problems.
The study employed multistage cluster sampling to collect four waves of data from 2347 Chinese adolescents (average baseline age of 14.7 years) covering a period of 20 months (October 2021 - May 2023). The UCLA 3-Item Loneliness Scale and the Strengths and Difficulties Questionnaire were utilized to assess loneliness and mental health problems, respectively. Growth mixture modelling was employed to identify latent classes of loneliness trajectories. Associated risk factors were investigated using multinomial logistic regression model. Mixed-effects logistic regression models were constructed to examine the long-term impact of loneliness classes on mental health outcomes.
The overall percentage of loneliness increased from 22.9% at baseline to 32.2% at the fourth wave in our sample. Three classes of loneliness were identified: Decreasing Low Loneliness (58.71%), Increasing Medium Loneliness (36.52%), and Increasing High Loneliness (4.77%). Risk factors for poorer loneliness trajectories included lack of physical exercise habits, poorer mental health literacy, medium or low perceived social support, having study difficulties, being female, higher grades, and lower economic status. Loneliness classes were associated with the severity and variability of emotional problems, peer problems, hyperactivity and conduct problems (ORs for the highest loneliness class: 10.24, 4.21, 3.87, 2.68, respectively). Individuals in the higher loneliness classes experienced a significant increase in these mental health problems over time (p < 0.05 for interactions between loneliness classes and time).
During the last phase of the pandemic, a large proportion of adolescents in our study endured medium to high levels of loneliness with no signs of improvement. Both unfavorable loneliness trajectories adversely affected internalizing and externalizing problems and displayed an upward trend in these difficulties. Results highlight the importance of tackling loneliness and improving mental health in adolescents.
新冠疫情威胁全球健康，但对于青少年孤独感的长期发展轨迹及其对心理健康的影响却知之甚少。本研究旨在探索中国浙江省台州市青少年在疫情最后阶段的孤独感轨迹。我们还旨在确定每种孤独感轨迹中的风险因素，以及孤独感对情绪问题、同伴问题、多动和行为问题的影响。
本研究采用多阶段整群抽样，从2347名中国青少年（平均基线年龄14.7岁）中收集了四波数据，时间跨度为20个月（2021年10月至2023年5月）。分别使用加州大学洛杉矶分校3项孤独感量表和长处与困难问卷来评估孤独感和心理健康问题。采用生长混合模型来识别孤独感轨迹的潜在类别。使用多项逻辑回归模型研究相关风险因素。构建混合效应逻辑回归模型以检验孤独感类别对心理健康结果的长期影响。
在我们的样本中，孤独感的总体百分比从基线时的22.9%上升至第四波时的32.2%。识别出三类孤独感轨迹：低孤独感下降型（58.71%）、中等孤独感上升型（36.52%）和高孤独感上升型（4.77%）。孤独感轨迹较差的风险因素包括缺乏体育锻炼习惯、心理健康素养较差、感知到的社会支持中等或较低、存在学习困难、女性、年级较高以及经济状况较低。孤独感类别与情绪问题、同伴问题、多动和行为问题的严重程度及变异性相关（最高孤独感类别的比值比分别为：10.24、4.21、3.87、2.68）。随着时间的推移，孤独感较高类别的个体在这些心理健康问题上有显著增加（孤独感类别与时间之间的交互作用p < 0.05）。
在疫情的最后阶段，我们研究中的很大一部分青少年忍受着中等至高水平的孤独感，且没有改善的迹象。两种不利的孤独感轨迹均对内化和外化问题产生不利影响，且这些问题呈上升趋势。结果凸显了解决青少年孤独感和改善其心理健康的重要性。
