Ma Kris Pui Kwan, Keiser Brennan, Garcia Melissa, Hsu Chialing, Cortez Karina, Johnson Ashley, Pleho Ajla, Curran Mary C, Schloredt Kelly, Chan Kwun C G, Stephens Kari A, Tong Sebastian T
Department of Family Medicine, University of Washington, Seattle, WA, United States.
Department of Psychology, University of Washington, Seattle, WA, United States.
Front Psychiatry. 2025 May 15;16:1470725. doi: 10.3389/fpsyt.2025.1470725. eCollection 2025.
Loneliness among emerging adults is common and is associated with poor physical and mental health. Most loneliness interventions have not been adapted nor tested in primary care that can broadly reach this population. This study aims to pilot test the feasibility, acceptability, and preliminary impact of two adapted interventions -cognitive behavioral therapy (CBT) and social prescribing (SP) - on reducing loneliness in emerging adults in primary care.
Participants aged 18-25, who were seen in primary care and met the cut-off score on the UCLA-3 loneliness, were assigned to either CBT (N=6) or SP (N=9). Both group interventions were delivered virtually for five weeks. Outcomes included the 20-item UCLA loneliness scale, PHQ-9 depression, and GAD-7 anxiety. Ten qualitative interviews were conducted to understand participants' experience of the interventions and effects on their loneliness.
Of 15 participants (11 women, mean age = 22), 14 of them completed either intervention. Results from paired T-tests showed pre-post reductions in loneliness, depression, and anxiety for both CBT and SP interventions, though they were statistically non-significant. Four themes described participants' i) experience of loneliness, ii) changes in self and behavior, iii) barriers and facilitators to participation, and iv) suggestions for intervention adaptations.
The results suggest that it may be feasible to treat loneliness in emerging adults in primary care with adapted interventions like CBT and SP. Further research with larger sample sizes and pragmatic, randomized controlled trial designs are needed to test the effectiveness of these interventions in primary care settings.
新兴成年人中的孤独现象很常见，且与身心健康不佳有关。大多数孤独干预措施尚未在能够广泛覆盖这一人群的初级保健中进行调整或测试。本研究旨在对两种调整后的干预措施——认知行为疗法（CBT）和社会处方（SP）——在初级保健中减少新兴成年人孤独感方面的可行性、可接受性和初步影响进行试点测试。
年龄在18至25岁之间、在初级保健机构就诊且在加州大学洛杉矶分校孤独感量表（UCLA - 3）上达到临界分数的参与者，被分配到CBT组（N = 6）或SP组（N = 9）。两组干预均通过虚拟方式进行，为期五周。结果指标包括20项加州大学洛杉矶分校孤独感量表、患者健康问卷 - 9（PHQ - 9）抑郁量表和广泛性焦虑障碍量表（GAD - 7）。进行了十次定性访谈，以了解参与者对干预措施的体验及其对孤独感的影响。
在15名参与者（11名女性，平均年龄 = 22岁）中，有14人完成了其中一项干预。配对t检验结果显示，CBT和SP干预在孤独感、抑郁和焦虑方面均有前后降低，尽管在统计学上不显著。四个主题描述了参与者的：i）孤独体验，ii）自我和行为的变化，iii）参与的障碍和促进因素，以及iv）对干预调整的建议。
结果表明，在初级保健中使用CBT和SP等调整后的干预措施治疗新兴成年人的孤独感可能是可行的。需要进一步开展更大样本量和实用的随机对照试验设计的研究，以测试这些干预措施在初级保健环境中的有效性。
