Journal of psychosomatic research · 2025
Exploring loneliness in individuals with diabetes - The role of childhood abuse and neglect, and personality functioning: Findings from a German population-based sample.
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Zara Sandra, Kruse Johannes, Brähler Elmar, Ernst Mareike, Fegert Jörg M, Lampe Astrid, Nolte Tobias, Rassenhofer Miriam, Riedl David, Kampling Hanna
Аннотация
BACKGROUND: This study examines 1) loneliness frequency in individuals with diabetes, 2) associated factors, and 3) personality functioning and the epistemic stance as underlying mechanisms linking childhood abuse and neglect, and loneliness.
METHODS: Using representative population data (N = 2428), loneliness (UCLA-LS) was assessed in individuals with self-reported diabetes (n = 206) and compared to those without. Regression analyses tested age, sex, relationship status, childhood abuse and neglect (ICAST-R), depression and anxiety (PHQ-4), personality functioning (OPD-SQS), and the epistemic stance (ETMCQ-12) as predictors. Structural equation modeling (SEM) investigated personality functioning and the epistemic stance as mediators between childhood abuse and neglect, and loneliness.
RESULTS: In the total sample, 12.4 % reported loneliness, and loneliness was more frequent in individuals with diabetes (24.8 %) than those without (11.3 %). Higher loneliness was linked to being single, greater depression and anxiety symptoms, and impaired personality functioning. While childhood abuse and neglect were initially associated with loneliness, this became nonsignificant when personality functioning was included as a mediator, increasing the explained variance from 3.4 % to 42.0 %.
CONCLUSIONS: Nearly a quarter of individuals with diabetes experience loneliness, particularly linked to emotional abuse. Impaired personality functioning, associated with interpersonal difficulties, appears as a shared mechanism for diabetes and loneliness. Considering loneliness and impairments in personality functioning might be highly important in research and clinical practice.
METHODS: Using representative population data (N = 2428), loneliness (UCLA-LS) was assessed in individuals with self-reported diabetes (n = 206) and compared to those without. Regression analyses tested age, sex, relationship status, childhood abuse and neglect (ICAST-R), depression and anxiety (PHQ-4), personality functioning (OPD-SQS), and the epistemic stance (ETMCQ-12) as predictors. Structural equation modeling (SEM) investigated personality functioning and the epistemic stance as mediators between childhood abuse and neglect, and loneliness.
RESULTS: In the total sample, 12.4 % reported loneliness, and loneliness was more frequent in individuals with diabetes (24.8 %) than those without (11.3 %). Higher loneliness was linked to being single, greater depression and anxiety symptoms, and impaired personality functioning. While childhood abuse and neglect were initially associated with loneliness, this became nonsignificant when personality functioning was included as a mediator, increasing the explained variance from 3.4 % to 42.0 %.
CONCLUSIONS: Nearly a quarter of individuals with diabetes experience loneliness, particularly linked to emotional abuse. Impaired personality functioning, associated with interpersonal difficulties, appears as a shared mechanism for diabetes and loneliness. Considering loneliness and impairments in personality functioning might be highly important in research and clinical practice.