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      Loneliness and self-harm in adolescents during the first national COVID-19 lockdown: results from a survey of 10,000 secondary school pupils in England

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          Abstract

          Adolescents’ loneliness and self-harm have received considerable attention during the COVID-19 pandemic with concerns that the socioecological changes taking place would contribute to an escalation of both loneliness and self-harm. However, empirical evidence is scant. We estimated the prevalence of loneliness and self-harm in adolescent school pupils and investigated the association of loneliness and change in loneliness during the UK’s first lockdown with self-harm during lockdown in a cross-sectional school survey (OxWell) involving 10,460 12–18-year-olds from south England. Loneliness was measured with four items. Self-harm was ascertained through a detailed questionnaire. The prevalence of loneliness and self-harm were estimated applying post-stratification weights to account for differences between the study sample and the target population. The associations between indicators of loneliness and self-harm were examined using mixed effect models. 1,896 of 10,460 adolescents (18.1%) reported feeling lonely ‘often’ (weighted proportion 16.8%). 3,802/10,460 (36.4%; weighted proportion 35%) felt more lonely since lockdown. Self-harm during lockdown was reported by 787/10,460 adolescents (7.5%; weighted proportion 6.7%). Controlling for confounders, adolescents who reported feeling lonely ‘often’ [adjusted odds ratio (aOR) 2.8, 95% CI 2.1–3.9, p < 0.0001] or ‘sometimes’ (aOR 2.2, 95% CI 1.5–3.2, p < 0.0001) were more likely to self-harm during lockdown relative to adolescents who reported ‘never’ or ‘hardly ever’ feeling lonely. Exacerbation in loneliness during lockdown was associated with an increase in the odds of self-harm during lockdown. Loneliness, heightened loneliness and self-harm were common during lockdown and closely linked. It is important to support schools in address loneliness and self-harm as part of efforts to improve well-being as the long tail of the pandemic continues to impact on child and adolescent mental health. Understanding how loneliness and self-harm may co-vary could be important for future self-harm reduction strategies in young persons.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s12144-022-03651-5.

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          Most cited references36

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          Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19

          Objective Disease containment of COVID-19 has necessitated widespread social isolation. We aimed to establish what is known about how loneliness and disease containment measures impact on the mental health in children and adolescents. Method For this rapid review, we searched MEDLINE, PSYCHINFO, and Web of Science for articles published between 01/01/1946 and 03/29/2020. 20% of articles were double screened using pre-defined criteria and 20% of data was double extracted for quality assurance. Results 83 articles (80 studies) met inclusion criteria. Of these, 63 studies reported on the impact of social isolation and loneliness on the mental health of previously healthy children and adolescents (n=51,576; mean age 15.3) 61 studies were observational; 18 were longitudinal and 43 cross sectional studies assessing self-reported loneliness in healthy children and adolescents. One of these studies was a retrospective investigation after a pandemic. Two studies evaluated interventions. Studies had a high risk of bias although longitudinal studies were of better methodological quality. Social isolation and loneliness increased the risk of depression, and possibly anxiety at the time loneliness was measured and between 0.25 to 9 years later. Duration of loneliness was more strongly correlated with mental health symptoms than intensity of loneliness. Conclusion Children and adolescents are probably more likely to experience high rates of depression and probably anxiety during and after enforced isolation ends. This may increase as enforced isolation continues. Clinical services should offer preventative support and early intervention where possible and be prepared for an increase in mental health problems.
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            UCLA Loneliness Scale (Version 3): reliability, validity, and factor structure.

            D. Russell (1996)
            In this article I evaluated the psychometric properties of the UCLA Loneliness Scale (Version 3). Using data from prior studies of college students, nurses, teachers, and the elderly, analyses of the reliability, validity, and factor structure of this new version of the UCLA Loneliness Scale were conducted. Results indicated that the measure was highly reliable, both in terms of internal consistency (coefficient alpha ranging from .89 to .94) and test-retest reliability over a 1-year period (r = .73). Convergent validity for the scale was indicated by significant correlations with other measures of loneliness. Construct validity was supported by significant relations with measures of the adequacy of the individual's interpersonal relationships, and by correlations between loneliness and measures of health and well-being. Confirmatory factor analyses indicated that a model incorporating a global bipolar loneliness factor along with two method factor reflecting direction of item wording provided a very good fit to the data across samples. Implications of these results for future measurement research on loneliness are discussed.
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              The interpersonal theory of suicide.

              Suicidal behavior is a major problem worldwide and, at the same time, has received relatively little empirical attention. This relative lack of empirical attention may be due in part to a relative absence of theory development regarding suicidal behavior. The current article presents the interpersonal theory of suicidal behavior. We propose that the most dangerous form of suicidal desire is caused by the simultaneous presence of two interpersonal constructs-thwarted belongingness and perceived burdensomeness (and hopelessness about these states)-and further that the capability to engage in suicidal behavior is separate from the desire to engage in suicidal behavior. According to the theory, the capability for suicidal behavior emerges, via habituation and opponent processes, in response to repeated exposure to physically painful and/or fear-inducing experiences. In the current article, the theory's hypotheses are more precisely delineated than in previous presentations (Joiner, 2005), with the aim of inviting scientific inquiry and potential falsification of the theory's hypotheses. PsycINFO Database Record (c) 2010 APA, all rights reserved.
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                Author and article information

                Contributors
                galit.geulayov@psych.ox.ac.uk
                Journal
                Curr Psychol
                Curr Psychol
                Current Psychology (New Brunswick, N.j.)
                Springer US (New York )
                1046-1310
                1936-4733
                15 September 2022
                15 September 2022
                : 1-12
                Affiliations
                [1 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, Centre for Suicide Research, Department of Psychiatry, , University of Oxford, Warneford Hospital, ; Oxford, UK
                [2 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, Section of Child and Adolescent Psychiatry, Department of Psychiatry, , University of Oxford, Warneford Hospital, ; Oxford, UK
                [3 ]GRID grid.7468.d, ISNI 0000 0001 2248 7639, Institute for Educational Quality Improvement, , Humboldt University, ; Berlin, Germany
                [4 ]GRID grid.451190.8, ISNI 0000 0004 0573 576X, Oxford Health NHS Foundation Trust, ; Oxford, UK
                [5 ]GRID grid.410556.3, ISNI 0000 0001 0440 1440, Oxford University Hospitals NHS Foundation Trust, ; Oxford, UK
                Article
                3651
                10.1007/s12144-022-03651-5
                9476392
                36124048
                08c9bdc2-aa2d-40f1-874e-959cc1ec277a
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 12 August 2022
                Categories
                Article

                Clinical Psychology & Psychiatry
                loneliness,self-harm,adolescents,covid-19,pandemic
                Clinical Psychology & Psychiatry
                loneliness, self-harm, adolescents, covid-19, pandemic

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