Traumatization, Loneliness, and Suicidal Ideation among Former Prisoners of War: A Longitudinally Assessed Sequential Mediation Model

Stein, Jacob Y.; Itzhaky, Liat; Levi‐Belz, Yossi; Solomon, Zahava

doi:10.3389/fpsyt.2017.00281

Cited by 14 publications

(21 citation statements)

References 91 publications

(113 reference statements)

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“…The current study was the first to simultaneously assess the relationship between loneliness and both childhood and adulthood trauma, and our results indicated that traumatic exposure in these different developmental periods were positively associated with feelings of deficiencies in both social network size and intimate connections. Current results add to a growing literature attesting to the importance of trauma history in understanding the characteristic nature of the experience of loneliness [14][15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 69%

Quality not quantity: loneliness subtypes, psychological trauma, and mental health in the US adult population

Hyland

Shevlin

Cloitre

et al. 2018

Soc Psychiatry Psychiatr Epidemiol

104

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Purpose: Loneliness is a recognised public-health concern that is traditionally regarded as a unidimensional construct. Theories of loneliness predict the existence of subtypes of loneliness. In this study, latent class analysis (LCA) was used to test for the presence of loneliness subtypes and to examine their association with multiple mental health variables. Methods: A nationally representative sample of US adults (N = 1,839) completed the De Jong Gierveld Loneliness Scale, along with self-report measures of childhood and adulthood trauma, psychological wellbeing, major depression, and generalized anxiety. Results: When treated as a unidimensional construct, 17.1% of US adults aged 18-70 were classified as lonely. However, the LCA results identified four loneliness classes which varied quantitatively and qualitatively: 'low' (52.8%), 'social' (8.2%), 'emotional' (26.6%), and 'social and emotional' (12.4%) loneliness. The 'social and emotional' class were characterised by the highest levels of psychological distress, followed by the 'emotional' class. The 'social' loneliness class had similar mental health scores as the 'low' loneliness class. Childhood and adulthood trauma were independently related to the most distressed loneliness classes. Conclusions: Current findings provide support for the presence of subtypes of loneliness and show that they have unique associations with mental health status. Recognition of these subtypes of loneliness revealed that the number of US adults aged 18-70 experiencing loneliness was twice as high as what was estimated when loneliness was conceptualized as a unidimensional construct. The perceived quality, not the quantity, of interpersonal connections was associated with poor mental health.

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Section: Discussionmentioning

confidence: 69%

Quality not quantity: loneliness subtypes, psychological trauma, and mental health in the US adult population

Hyland

Shevlin

Cloitre

et al. 2018

Soc Psychiatry Psychiatr Epidemiol

104

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“…Of the 20 analyses that explored suicidal ideation 12 results indicated that loneliness was a significant predictor variable. Additionally, Stein et al (2017) reported an indirect pathway from post-traumatic stress syndrome (PTSS) to loneliness at the same timepoint predicting later suicidal ideation. Gallagher et al (2014;T2-T3) reported a significant association while Gallagher et al (2014;T1-T3) did not.…”

Section: Narrative Summary Of Study Findingsmentioning

confidence: 99%

Loneliness as a predictor of suicidal ideation and behaviour: a systematic review and meta-analysis of prospective studies

McClelland

Evans

Nowland

et al. 2020

Journal of Affective Disorders

268

149

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Background: Suicide and suicidal behaviour are global health concerns with complex aetiologies.Given the recent research and policy focus on loneliness, this systematic review aimed to determine the extent to which loneliness predicts suicidal ideation and/or behaviour (SIB) over time.Methods: A keyword search of five major databases (CINHAL, Medline, PsychArticles, PsychInfo and Web of Knowledge) was conducted. Papers for inclusion were limited to those using a prospective longitudinal design, written in English and which measured loneliness at baseline and SIB at a later time-point.Results: After duplicates were removed, 947 original potential papers were identified, with 22 studies meeting the review criteria. Meta-analysis revealed loneliness was a significant predictor of both suicidal ideation and behaviour and there was evidence that depression acted as a mediator.Furthermore, studies which consisted of predominantly female participants were more likely to report a significant relationship, as were studies where participants were aged 16-20 or >55 years at baseline.Limitations: There was considerable variability in measures, samples and methodologies used across the studies. Middle-aged adults were under-represented, as were individuals from minority ethnic backgrounds. All studies were conducted in countries where self-reliance and independence (i.e. individualism) are the cultural norm.Conclusions: Loneliness predicts later SIB in select populations. However, due to the heterogeneity of the studies further research is needed to draw more robust conclusions. Suicide death also needs to be included as an outcome measure. A focus on more collectivist countries is also required.

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“…Several conditions have already been recognized as major risk factors for suicide ideation and suicide attempts among veterans in the postrecruitment period, including diagnoses of depressive disorders, posttraumatic stress disorder (PTSD), substance use disorders, personal traits (e.g., impulsivity), and environmental variables, such as imitation (O'Connor & Nock, ). Specifically, a considerable body of research suggests that previous trauma in general and war‐related trauma in particular are associated with increased risk of suicidal behaviors among veterans (e.g., Stein, Itzhaky, Levi‐Belz, & Solomon, ). However, although these elements may help detect some veterans engaged in self‐injurious thoughts and behaviors (SITB), a much more thorough examination of the combat‐related stressors and their association with SITB is needed.…”

mentioning

confidence: 99%

“…In the generally stressful atmosphere of combat service (Stein et al., ), with the possibly complex and often ambiguous nature of PMIES scenarios, it can be assumed that veterans with high levels of IU may experience more continued distress and a tendency toward depressive attributes and symptoms that are recognized facilitators of SITB. Some studies have found IU to moderate the link between stressful events and worry (e.g., Zlomke & Jeter, ) but not the link between anxiety sensitivity and panic disorder (Carleton et al., ).…”

mentioning

confidence: 99%

Intolerance of Uncertainty Moderates the Association Between Potentially Morally Injurious Events and Suicide Ideation and Behavior Among Combat Veterans

Zerach

Levi‐Belz

2019

Journal of Traumatic Stress

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Exposure to potentially morally injurious events (PMIEs) among combat veterans has been acknowledged as significant stressful combat events that may lead to mental health problems, including self‐injurious thoughts and behavior (SITB). However, few studies have examined the risk and protective factors that can explain the conditions in which PMIEs may contribute to the development and maintenance of SITB. In the current study, we aimed to examine the association between PMIEs and SITB among combat veterans and explore the moderating roles of intolerance of uncertainty (IU) in this association. A volunteer sample of 191 Israeli combat veterans was recruited during 2017. Participants completed validated self‐report questionnaires in a cross‐sectional study. Results indicated that two separate measures of PMIEs, the Perceived Perpetration by Oneself and Others subscale of the Moral Injury Events Scale (MIES) and the Causes subscale of the Moral Injury Questionnaire (MIQ–Causes), were positively associated with higher levels of SITB. Moreover, beyond the contributions of reserve duty, posttraumatic stress symptoms, and depressive symptoms, MIQ–Causes scores significantly predicted current SITB. Importantly, under low and average levels of inhibitory IU, significant positive effects were revealed for the MIQ–Causes on current SITB, R² = .34. Although veterans exposed to PMIEs are more prone to SITB, even years after their release from military service, their IU may temper the link between experiences of PMIEs and SITB.

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Traumatization, Loneliness, and Suicidal Ideation among Former Prisoners of War: A Longitudinally Assessed Sequential Mediation Model

Cited by 14 publications

References 91 publications

Quality not quantity: loneliness subtypes, psychological trauma, and mental health in the US adult population

Quality not quantity: loneliness subtypes, psychological trauma, and mental health in the US adult population

Loneliness as a predictor of suicidal ideation and behaviour: a systematic review and meta-analysis of prospective studies

Intolerance of Uncertainty Moderates the Association Between Potentially Morally Injurious Events and Suicide Ideation and Behavior Among Combat Veterans

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