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LONLINESS AND SUICIDE 1

Correlations Between Loneliness and Suicide: Demographics, Age, and Comorbid Disorders

Mikayla Nelson

Concordia College
LONLINESS AND SUICIDE 2

Abstract

Suicide is a rising problem on a global scale and learning more about correlations of

suicide can help prevent it in the future. In this review, the idea of suicide correlating with

loneliness is looked at. Comorbid disorders, demographics, and social support are all factors that

relate and correlate with both loneliness as well as suicide. No conclusions of causation can be

drawn from this review, due to the lack of research, lack of numerical data, different definitions

of loneliness, low variety of testing tools, self-reporting, and correlations does not mean

causation. However, it can be concluded that loneliness is correlated to suicidal ideation and or

attempt. However, there are many factors that relate to this correlation that are explored here.
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Introduction

Every 40 seconds, 1 person dies by suicide, 100,000 of these suicides are of people under

the age of 20 (Hatcher et al, 2013). Suicide is the second leading cause of death in people ages

10 to 24, and one of the top three leading causes of death in people ages 15 to 44; and over the

past 45 years, suicide rates have increased by 60% (Hatcher et al, 2013). Suicide is a rising

mental health problem in the United States and globally throughout all age groups. One factor

that has been studied and shown to relate to suicide is loneliness. In this review I will look at

studies linking suicide, loneliness, and other contribution factors such as comorbid disorders,

feelings of belongingness and social support. I will look at loneliness and suicide and how they

relate amongst different demographics and age groups. I will also discuss future research that

could contribute to the reduction of suicide and or loneliness as well as discuss how these studies

prove helpful in alleviating these concerns.

Loneliness, Suicide, and Comorbid Disorders

In a study done by Stickley and Koyanagi (2016) they looked at loneliness, common

mental disorders, and suicidal behavior. They aimed to look at if loneliness is associated with

suicidal behavior in adults, if the association varies based on degrees of loneliness, and to look at

common mental disorders in this association as well (Stickley et al, 2016). They used the 2007

Adult Psychiatric Morbidity Survey data where they randomly selected one person from each of

the 7,403 eligible households and had them complete the survey for this study (Stickley et al,

2016). They were asked questions about loneliness, suicidal behavior, alcohol dependence,

social support, physical health conditions, stressful life events and sociodemographic indicators

(Stickley et al, 2016). There results found that that there was a significant difference with all

sample characteristics except ethnicity (Stickley et al, 2016). Some specific characteristics
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include: female sex, no educational qualifications, not being married/cohabitating, unemployed,

alcohol dependency, comorbid mental disorders, low social support and wealth, more health

conditions, and more stressful life events (Stickley et al, 2016). These characteristics were

associated with higher levels of loneliness (Stickley et al, 2016). Odds ratios increased a lot for

all forms of suicidal behavior among those who were lonely and had at least one comorbid

mental disorder (Stickley et al, 2016). The Odds ratio ranged from 7.67 for lifetime suicidal

ideation to 30.44 in the last 12 months; and 4.37 for lifetime suicide attempts to 16.24 in the past

12 months (Stickley et al, 2016). That is a major shift and could help explain what leads to

suicide attempts as opposed to suicidal thoughts, and the importance of reducing loneliness in the

general population. Overall, feeling lonely increase the odds of for both lifetime and 12-month

suicidal ideation and attempt (Stickley et al, 2016). Also, feeling lonely and having a comorbid

mental disorder creates higher odds of suicidal ideation (Stickley et al, 2016). However, it is

uncertain the effect of loneliness on suicidal behavior (Stickley et al, 2016).

Some factors that Stickely, et all (2016) hypothesized might play a role in how loneliness

effects suicidal behavior is that lonely people may experience more chronic stressors and

perceive daily life as more stressful. This is important to consider because stress has been linked

to suicidal behavior. Another factor could be that lonely people tend to have a lower self-esteem,

and a low external locus of control (Stickley, et al, 2016). Some limitations of this study include

the use of single-item measure, underreporting due to stigma and that causation cannot be

concluded in a cross-sectional study (Stickley, et al, 2016).

Interesting findings exist within this study. It looked at many different factors when

looking at loneliness that are important to look at. Even though loneliness was expected to

increase the odds of suicidal ideation and attempt, it was not expected to be by this much. Future
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research should look at a quantitative way to measure loneliness in relation to suicide that could

prove causality. However, there can be so many factors contributing to suicidal ideation and

attempt, that it would be impossible to conclude causation of loneliness alone. Through the

clinical lens, these findings could prove beneficial in reducing suicide rates worldwide.

However, more research will need to be done to look at other factors, which influence suicide as

well as how to reduce loneliness throughout populations.

Another study done by Lasgaard et al (2011) focused on similar associations particularly

within adolescence. The aim of their study was to see how peer-related and family-related

loneliness is associated with depression, anxiety, social phobia, suicide ideation, self-harm and

eating disorders (Lasgaard et al, 2011). They used a sample of 1,009 high school students taken

from the High School Loneliness Study, a Danish national study (Lasgaard et al, 2011). They

utilized the Social and Emotional Loneliness Scale for Adults to assess peer-related loneliness,

family-related loneliness, and romantic loneliness (Lasgaard et al, 2011). Depression and

anxiety were measured by the Danish equivalent of the Beck Depression/Anxiety Inventory for

Youth (Lasgaard et al, 2011). Social phobia was measured using the Social Interaction Anxiety

Scale (Lasgaard et al, 2011). Suicidal ideation was assessed using the Suicide Ideation subscale

from the Suicide Probability Scale (Lasgaard et al, 2011). Self-harm was measured using three

items that looked at general self-harm behaviors, skin cutting, and thoughts of self-harm, and

finally, risk behaviors of eating disorders was assessed by the Risk Behavior relate to Eating

Disorders scale (Lasgaard et al, 2011). They found that peer and family-related loneliness were

associated with depression, anxiety and suicide ideation, and family-related loneliness was

associated with self-harm and eating disorders (Lasgaard et al, 2011). They didn’t have much to

say about romantic loneliness, as this study was done among adolescents who haven’t
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experienced many or any romantic experiences at this life stage (Lasgaard et al, 2011). This goes

hand in hand with Chang et al (2017) study about family support being a mediator of suicidal

ideation and attempt.

These results show the importance of family ties and family support which will be

discussed more thoroughly later, especially among adolescents (Lasgaard et al, 2011). This

study does well at breaking down the different types of loneliness as opposed to loneliness as a

broader term (Lasgaard et al, 2011). However, it only looks at loneliness and comorbid disorders

and symptoms in terms of adolescence. It would be helpful to look at these things throughout the

lifespan to see the changes that can occur as people change in their stages of life.

Adolescent loneliness is a popular topic in research. Lasgaard, et al (2011) did a cross-

sectional study related to loneliness, depressive symptomology, and suicide ideation in

adolescents. This study was similar to the last one, also by Lasgaard, but they did the survey in

two waves with a one-year gap in between, and only measured loneliness using the Danish

equivalent of the UCLA Loneliness Scale, depressive symptoms using the Danish equivalent of

the Beck Depression Inventory for Youth, and suicidal ideation was assessed using the Suicide

Ideation subscale from the Suicide Probability Scale (Lasaagard, 2011). They did measure for

other factors as well to determine if the depression and suicidal ideation were associated

independently (Lasaagard, 2011). They found that loneliness is still a correlate of depressive

symptoms and depression is a stronger predictor of suicidal ideation than is loneliness

(Lasaagard, 2011). Some large limitations to this study include attrition that effects their internal

and external validity and the use of the UCLA Loneliness Scale focusing mostly on peer-related

loneliness (Lasaagard, 2011).


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It is interesting that two studies conducted by the same researcher within a few years span

could have such different results. One concluded that loneliness and suicidal ideation are

correlated and one reported that depression is more correlated than loneliness. When doing

research about loneliness, it is important to take these things into account. There are multiple

variables that go into suicidal ideation.

Adolescents were a major focus of study within these studies, along with findings that

associate depression and loneliness. There are studies that are discussed later on about age and

loneliness and the ages that are prone to being the most lonely are the younger (18-29) and the

oldest (65-81) (Nicolaisen et al, 2014). Adolescents or earlier looks like an important time to

establish coping skills, relationship skills, and mental illness prevention strategies to better

prevent feelings of loneliness, social exclusion, depression, and possibly suicidal ideation and

attempt in the future.

Loneliness, Suicide, and Situational Factors:

Along with comorbid disorders, situational factors and ways people live and function can

affect loneliness and suicide. A study done by Muyan et al (2015) looks at the trait of

perfectionism and its effect for suicide risk in Turkish college students (Muyan et al, 2015). In

young adults, perfectionism has been linked to suicidal risk (Muyan et al, 2015). The purposes

of this study were to examine perfectionism and its different predictive measures of suicidal risk,

and to see if loneliness adds to the suicidal risk associated with perfectionism (Muyan et al,

2015). They assessed perfectionism in 288 Turkish college students using the FMPS, a 35-tier

multidimensional measure of perfectionism, as well as the revised UCLA Loneliness Scale, Beck

Depression Inventory, and the Frequency of Suicide Ideation Inventory (Muyan et al, 2015).

They found that perfectionism, especially parental criticisms, and doubts about actions, was
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positively correlated with depressive symptoms and suicidal ideation. In addition, loneliness was

an important predictor of variance in suicidal ideation even when controlling for perfectionism

and depressive symptoms (Muyan et al, 2015).

Another problem that college students face is sexual assault. Change et al (2014) found

that there may be a correlation between sexual assault, loneliness, and suicide. They examined

loneliness and sexual assault as predictors for suicide risk and want to see if their interaction

accounts for additional variance in suicide risk (Chang et al, 2014). They had a sample of 343

college students (Chang et al, 2014). They used the UCLA Loneliness Scale to assess their

loneliness, self-reporting questions from the National College Health Assessment scale to assess

for sexual assault, and used a combination of the Beck Hopelessness Scale and Suicidal

Behaviors Questionnaire to assess suicide risk (Chang et al, 2014). They found that loneliness,

like it has been shown before, is a predictor of suicide risk (Chang et al, 2014). However, it

showed a larger link with hopelessness, which is often a key predictor in suicide risk (Chang et

al, 2014). Sexual assault is also linked to more degrees of hopelessness and a higher suicidal

probability (Chang et al, 2014). The highest risk for suicidal ideation was among those students

who were lonely and had experienced sexual assault (Chang et al, 2014).

This study brings up many interesting thoughts about what could be done to decrease

suicides in this population, especially college-aged people. Finding ways to combat loneliness in

schools and colleges across the globe could decrease suicidal thoughts and attempts as well as

implementing programs, and decreasing stigma and shame among those who are sexually

assaulted.

Insomnia is a common impairment among many people and has been shown to be linked

to loneliness as well, according to Hom et al (2017). A few factors may contribute to loneliness
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of people who experience insomnia (Hom et al, 2017). First, being awake for hours by yourself

can be a lonely experience (Hom et al, 2017). Second, daytime functioning is impaired which

limits the motivation to engage with others during the day (Hom et al, 2017). Finally, sleep is

critical for processing emotional information; this can contribute to maladaptive thoughts

regarding belongingness (Hom et al, 2017). Hom et al (2017) conducted six studies that looked

closely at the relationship between insomnia and loneliness both cross-sectionally and

prospectively. They found that insomnia and loneliness are associated across all six of the study

samples (Hom et al, 2017). However, when accounting for depressive symptoms, loneliness was

not significantly associated with insomnia (Hom et al, 2017). This result is similar to other

studies that controlled for depressive symptoms (Hom et al, 2017). This suggests that depressive

symptoms may be more of a predictor of suicidal ideation than loneliness is (Hom et al, 2017).

However, they are often associated with similar symptoms (Hom et al, 2017). This is something

to consider for future research. Overall, more severe insomnia symptoms are associated with

loneliness (Hom et al, 2017).

An article done by Goossens et al (2015) discussed the possible link between loneliness,

genetics, and environment. It used information and findings from multiple studies of epigenetics

and genome-wide genetics, and social science studies (Goossens et al, 2015). The article

discussed the serotonin transporter gene and how having the short allele is thought to be linked to

less dampening of negative emotions, especially regarding social threat (Goossens et al, 2015). It

discusses that people with short alleles could be more likely to succumb to loneliness due to

these alleles and depending on their level of social support (Goossens et al, 2015). There weren’t

any major conclusions made from this article and a lot more research must be done for any

practical use of these findings (Goossens et al, 2015). However, more research on this topic
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could benefit many people and be used for many good things. This is an interesting take on the

topic of loneliness, especially looking at what articles that have been looked at throughout this

paper. There is a lot about genetics that is unknown, but beneficial in predicting many different

illnesses and traits. Finding evidence towards a gene that could predict or make someone more

vulnerable to loneliness could be beneficial for many.

These articles don’t have a whole lot of overlap besides loneliness. However, sexual

assault, perfectionism, and insomnia, are all things that are associated with the college aged

population. Because of this, some questions and future research ideas come to mind. Does age,

specifically college age, effect the impact of these situations on loneliness and suicide? Is there a

difference or increase in loneliness and suicidal ideation between having multiple of these

situations, as compared to only one? Does the environment where these situations occur make a

difference in their effect? Future research could look at these questions.

Loneliness, Suicide, and Demographics

Many researchers looked at loneliness in terms of age, gender, nationality, etc. Looking

at different demographics of people and their susceptibility to loneliness and possibly suicidal

ideations is important. Page et al (2006) looked at Taiwanese, Philippine and Thai adolescent

suicide attempters for feelings of hopelessness and loneliness. They took between 2,000 to 3,000

students per school and had them complete a survey that assessed their suicide attempts,

hopelessness using the Beck Hopelessness Scale, and loneliness using the revised UCLA

Loneliness Scale (Page et al, 2006). They found that hopelessness was the strongest variable

linking suicidal ideations in all of the cultures (Page et al, 2006). The hopelessness scores

ranked highest among the Taiwanese students, lowest among the Philippine students and the

Thai were somewhere in between (Page et al, 2006). Also, loneliness had an impact on suicidal
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ideation as well (Page et al, 2006). Often times hopelessness and loneliness coexist, and this

could be the reasoning behind the higher link between hopelessness then loneliness. In future

research, looking at emotions that coexist together could help solidify causation and or

correlation.

Loneliness and suicidality in adolescence has been looked at quite frequently and has had

many studies done about it. In a particular study done by Schinka et al (2012) they looked at

loneliness and suicidality during middle childhood and adolescence in a longitudinal study while

also looking at demographics. Loneliness in adolescents is much more intense than that of

middle childhood. In fact, some have said that loneliness peaks during adolescence (Schinka et

al, 2012). In regard to ethnicity, American Indians and Alaskan Natives have the highest suicide

rates followed by Caucasian males (Schinka et al, 2012). There hasn’t been any concluding

evidence on differences in gender or socioeconomic status (Schinka et al, 2012). In Schinka’s

(2012) study, they looked to find an association between suicide and loneliness as well as

looking at associations between ethnicity, gender, and socioeconomic status within this

association. They also want to determine if the effect of loneliness on suicidality is time-limited

or longitudinal, and if loneliness effects suicidality differently across different demographics

(Schinka et al, 2012). The study followed 937 children from birth to age 15 where they gathered

information during four phases (Schinka et al, 2012). They found that there was a longitudinal

link between loneliness in middle childhood suicidal behavior at 15, but it did not hold up over

time (Schinka et al, 2012). There was also no association between loneliness and suicidality

across demographics (Schinka et al, 2012).

These conclusions can be implemented to help reduce suicidal risk by showing the

importance of interpersonal relationships (Schinka et al, 2012). Long-term deficits in


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interpersonal relationships can have a large impact on psychological functioning and focusing

this knowledge in schools and at ages across the lifespan to provide help during these deficits

could prove beneficial in decreasing loneliness and possibly suicide in all kinds of demographics.

Another study focused exclusively on sex differences and loneliness. Loneliness is a

common problem among college undergraduates, but looking at sex differences in terms of this

loneliness has limited research (Schultz et al, 1986). In this study, Schultz et al (1986) focused

on examining sex differences among college students. They focused primarily on gender

differences in emotional reactivity to loneliness and the gender differences in risk-taking skills as

it relates to loneliness (Schultz et al, 1986). They assessed 53 female and 59 male undergraduate

students (Schultz et al, 1986). They assessed their loneliness using the revised UCLA Loneliness

Scale, self-esteem using a self-esteem scale, anxiety using the Spielberger Stat-Trait Anxiety

Inventory, depression using the Zung Depression Scale. social risk-taking using an eight-item

social risk-taking scale, perceived likability, happiness, and life satisfaction using a seven-point

self-rating scale of likability, happiness, and life satisfaction, and loneliness frequency (Schultz

et al, 1986). They found that men are significantly lonelier than females on the UCLA

Loneliness Scale, but females were more likely to admit to being lonely, therefore, disclosing

more loneliness frequency (Schultz et al, 1986). Qualitatively, there were higher correlations

between emotional reactivity and loneliness for both genders (Schultz et al, 1986). These results

are interesting compared to the study that looked at gender differences and found no difference

in loneliness. However, comparing the studies years (1986 and 2012), gender norm changes and

culture change could attribute to this difference.

More research on the differences in gender would be a good idea for future research.

There is very little literature about gender and how it correlates to suicide risk and loneliness.
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Some interesting factors to look at in terms of gender is touched on in Schultz’s et al (1986)

study; gender norms, perception of loneliness, etc. This could be interesting research that could

be conducted within psychology, sociology, and women and gender studies or a combination of

the three.

Another demographic that has a large amount of focus in terms of loneliness and suicide

is college students. In a study by Chesin (2012) they discuss suicidal behavior among Latina

college students. They assessed data from 554 Latina college undergraduate students (Chesin et

al, 2012). They tested for ethnic identity using The Multigroup Ethnic Identity Measure,

loneliness using the UCLA Loneliness Scale, depressive symptoms using the Beck Depression

Inventory, social problem-solving skills using the Social Problem-Solving Inventory,

hopelessness using the Beck Hopelessness Scale, delinquency using Self-Report Delinquency

Scale, and suicidal behavior using the Suicide Behaviors Questionnaire (Chesin et al, 2012). It

was found that suicidal behavior or expectations of such among Latinas was predicted by

loneliness, hopelessness, depression, and a less positive problem-solving orientation, but not for

ethnic identity (Chesin et al, 2012). Across many of these studies, it seems that ethnicity is not a

factor at predicating loneliness or probability of suicide. This is an interesting and refreshing

factor.

A study done by Chang et al (2010) looked at loneliness and negative life events in

Hispanics. They took a sample of 160 Hispanic adults and measured for loneliness using the

revised UCLA Loneliness Scale, negative life events using the Life Events Checklist for College

Students, hopelessness using the Beck Hopelessness Scale, and suicidal behaviors using the

Suicidal Behaviors Questionnaire revised (Chang et al, 2010). They found that loneliness and

negative events were associated with greater hopelessness and suicidal behavior in Hispanics
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(Chang et al, 2010). From that, association involving loneliness and suicide risk had a larger

effect size then negative life events and suicide risk (Chang et al, 2010). This shows that

loneliness has a large effect on suicide risk among Hispanics in this study (Chang et al, 2010).

Looking at these two studies focusing on ethnicity in relation to suicide and loneliness

risk, there is no correlation between these factors and their ethnicity. Would these effects and

results prove similar to that of an Asian, Caucasian, African American, or any other rates of

suicide and or loneliness. Though, different cultures of people have differences in suicide rates,

these studies lead to believe that those differences are not because of ethnicity, but because of

another contributing factors, such as comorbid disorders.

A large theme throughout these studies is that there is little to no difference between

ethnicity, loneliness, and suicidality. This is a factor that no longer needs to be focused on in

future research. Hopelessness was also a common emotion that was looked at in correlation with

loneliness and suicide, and most of the studies found it to be the largest effect size. Hopelessness

and depression are often experienced with one another, in fact, hopelessness is a symptom of

depression. Hopelessness could be associated with depression in the same way that loneliness is.

Or hopelessness could be the relating factor between loneliness and depression, or vice versa. It

would be interesting to look at these three factors separately and together and possibly pinpoint

their relation.

Loneliness, Suicide, and Age

Another interesting demographic to look at in terms of loneliness is age. Nicolaisen et

al (2014) looked at loneliness in different age groups ranging from 18 to 81 years old. Their

sample size consisted of 14,743 Norwegian’s ranging from the age of 18 to 81 (Nicolaisen et al,

2014). They looked at prevalence rates of loneliness among those age groups while also looking
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at gender, health, and partner status (Nicolaisen et al, 2014). There results found that the

youngest age group (18 – 29) and the oldest age group (65 – 81) had reported more frequent

loneliness (Nicolaisen et al, 2014). There was a correlation between loneliness and age; the

older, the lonelier (Nicolaisen et al, 2014). Why are older people lonelier? Nicolaisen et al

(2014) suggests that due to retirement, death of spouse and friends, deterioration of health, and

other life stages that occur during old age can result in a lonelier population. This finding, with

research, could correlate with the elderly having the highest suicide rate.

Some future research on loneliness in old age could be beneficial for reducing the suicide

rate among the elderly. An interesting topic to consider in this research could be marriage. If a

person was married or not married could affect their amount of loneliness in old age, especially

if they have lost a spouse or partner. Looking at this effect might be able to pinpoint specific

people at a higher risk of suicide, or pinpoint more concrete reasons. A way to possibly help

reduce these loneliness and suicide rates among the elderly is with the use of support groups.

There are many support groups out there that could be utilized for all of these deficits of old age

that could benefit them as a population and others of different age groups as well.

Loneliness, Suicide and Social Support and Connection

A big theme that has emerged from many of these articles and have been used as some

explanations for loneliness and suicide is social connection. As we know, loneliness is the lack

of social connection and can often bring on feelings of loneliness. You et al (2011) looks at the

idea of social connections and suicidal thoughts and behaviors. This study used 814 participants

from four nearby substance-use treatment programs (You et al, 2011). They filled out a self-

report questionnaire and sat through a one-on-one, 30-minute screening session (You et al,

2011). They measured for suicidal ideation and attempts, social connectedness using the
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Interpersonal Needs Questionnaire, and covariates (You et al, 2011). They found that all aspects

of social connectedness were associated with a higher probability of a history for suicidal

ideation and attempt (You et al, 2011). Social connectedness, covariates, interpersonal conflict,

and belongingness showed an association with a history of suicidal ideation; whereas,

belongingness, perceived social support, and living alone were associated with past suicide

attempts (You et al, 2011). Belongingness was a predictor for both suicidal ideation and attempt.

This could be an important factor in continuing research. However, this study was only done on

substance-use patients. It might be beneficial to look at the broader population to get a better

idea of what is going on.

In regard to adolescents, peer relationships and suicidal ideation and attempt, Cui et al

(2011) took 8,778 11- to 17-year-old Chinese students. Each student filled out a survey that

assessed their suicidal ideation, peer relationships, and feelings of loneliness (Cui et al, 2011).

They found that peer relationship problems increase the likelihood of suicidal ideation and

attempts, and loneliness increased this likelihood (Cui et al, 2011). If a child is having

relationships problems and feels lonely, their probability of suicidal ideation and or attempt goes

up (Cui et al, 2011). Without this feeling of loneliness, it may buffer those tendencies (Cui et al,

2011). In a school setting, having few close friends, viewing peers as unkind, bullying, and

physical fighting could have effect of suicide rates among this population (Cui et al, 2011).

Focusing on anti-bullying campaigns, focusing on helping students make meaningful

relationships with peers and teachers could benefit this feeling of loneliness within the school

setting. Learning these skills from a young age could also aid in these feeling in the future if

necessary.
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Family support goes hand in hand with social support, especially among the younger

generation. Chang et al (2017) looks at family support as a moderator between loneliness and

suicide risk in college students. Suicide is the second leading cause of death among college-age

students, behinds unintentional injury (Chang et al, 2017). They wanted to see how family

support effects loneliness and suicide risk, and to determine if there is significant effect between

loneliness and family support in predicting suicide risk (Chang et al, 2017). They used data from

456 Hungarian college students from the ages of 18 to 35 (Chang et al, 2017). They measured

for loneliness using the R-UCLA, family support using the Family Support Scale, and suicide

risk using the Beck Depression Inventory and the Frequency of Suicidal Ideation Inventory

(Chang et al, 2017). They found that loneliness is positively associated with both depressive

symptoms and suicidal ideation (Chang et al, 2017). Also, family support was shown to be a

protective factor (had a negative correlation) with suicide risk (Chang et al, 2017). This study

also underlies the importance of reducing loneliness in college students, but also by showing

importance of family to maintain support for their child in college.

In a study done by Hatcher et al (2013), they look at suicide and how it correlates with

feelings of belongingness. They selected eligible studies based on experiences of suicidal

ideation, suicide attempt, completed suicide, or self-harm, as well as having a component of

belongingness Hatcher et al, 2013). Sixteen studies fit all the criteria and were analyzed

independently (Hatcher et al, 2013). They found that people who have a low sense of

belongingness have a higher risk of suicide (Hatcher et al, 2013). However, the association is

weak and may be impacted by other variables (Hatcher et al, 2013).

Gunn et al (2012) also looked at belongingness and suicide. However, they studied

people who have successfully attempted suicide and who have left suicide notes (Gunn et al,
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2012). The interpersonal theory of suicide (ITS), claims that two elements must be present in

order for suicidal behavior to occur: the desire for suicide and the capability for suicide (Gunn et

al, 2012). The desire for suicide has two components: thwarted belongingness and perceived

burdensomeness (Gunn et al, 2012). Thwarted belongingness is the perception of social

alienation and/or difficulty forming close social bonds (Gunn et al, 2012). Perceived

burdensomeness is the perception that one is a burden to others (Gunn et al, 2012). Together

these two elements create motivation for suicidal behavior (Gunn et al, 2012). They contained

261 suicide notes and assessed them for signs of thwarted belongingness and perceived

burdensomeness (Gunn et al, 2012). They found that out of the 261 suicide notes, 234 (89.7%)

had no signs of perceived burdensomeness, 17 (6.5%) may have had some signs of perceived

burdensomeness, and 10 (3.8%) did have signs of perceived burdensomeness (Gunn et al, 2012).

Perceived burdensomeness was not expressed often in this sample. However, out of the 261

suicide notes, 181 (69.3) had no signs of thwarted belongingness, 23 (8.8%) may have had some

signs of thwarted belongingness, and 57 (21.8%) did have signs of thwarted belongingness

(Gunn et al, 2012). Though this number is still low, it is more prevalent in this sample than

perceived burdensomeness (Gunn et al, 2012). These results don’t show much evidence to

support interpersonal theory of suicide, however, these aspects of suicide may have been present

in the individual, but not portrayed in their suicide note (Gunn et al, 2012).

Looking in relation to suicide attempters, Spino et al (2016) looks at social support

related to symptoms of loneliness and depression in people who have survived a suicide of a

person close to them. There were 44 participants over 18 years of age who participated (Spino et

al, 2016). The participants first took an assessment that looked at their depressive symptoms

using the Beck Depression Inventory, their loneliness using the UCLA Loneliness Scale, their
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social support using the Norbeck Social Support Questionnaire, and their health using the Sf

12v2 Health Survey (Spino et al, 2016). It was found that social support among these individuals

as well as good health were associated with lower levels of depression (Spino et al, 2016).

This concept of the loneliness effects of suicide on the people who were affected by

somebody else’s suicide is interesting to look at. Though these people may not have a mental

illness or a reason for suicide, witnessing or being affected by one can cause these feelings to

emerge. This corresponds with the earlier idea of stressful life events which has been linked to

higher amounts of loneliness according to Stickley et al (2016).

Overall, social support is an important aspect of life as we are social creatures, but

especially those who are lonely because loneliness is seen as a lack of social support and

meaning relationships. However, having social support may not affect a person who is already

lonely due to their maladaptive thinking and perception about feeling lonely. They may know

that they have social support, but still feel lonely.

The concept of chronic loneliness is important to discuss. Many are lonely or become

lonely at some part of their life. However, are there other risk factors or reasoning behind

prolonged loneliness? Vanhalst et al (2015) looks at chronic loneliness in adolescents in regard

to social inclusion and exclusion. During adolescence, many social changes occur which can

lead to an increased probability of experiencing loneliness (Vanhalst et al, 2015). They took 730

9-12 undergraduate students from schools in Belgium in a four-wave study (Vanhalst et al,

2015). The students completed an assessment that assessed their loneliness using the Loneliness

and Aloneness Scale for Children and Adolescents four different times (Vanhalst et al, 2015).

They identified that chronically lonely students responded more strongly to situations of social

exclusion and less positive responses to situations of social inclusion (Vanhalst et al, 2015).
LONLINESS AND SUICIDE 20

They also indicated that chronically lonely individuals are more likely to be cautious and adapt a

prevention-focused technique in social situations (Vanhalst et al, 2015). They are more focused

on avoiding negative outcomes than they are enjoying the positive outcomes; this can lead to the

prolonging of their loneliness (Vanhalst et al, 2015). They also discovered that chronically

lonely individuals lack a self-serving attribution style (Vanhalst et al, 2015). They will often

contribute good outcomes to a situation and bad outcomes to themselves.

Knowing this research and these finding can lead to finding better methods to helping

those with chronic loneliness or acute loneliness so that it does not become chronic. By instilling

or re-instilling the concept of self-serving attribution within these individuals may help them to

take more promotion-focused actions towards getting out of loneliness.

Knowing the importance of social connection, belongingness, and inclusion as a

protective factor against suicide and loneliness has huge implications. Implementing skills,

knowledge, and programs in schools, the workplace, and everywhere across the globe that

increases social support and inclusion, and increases a cohesive sense of belongingness could

benefit society in a great way. Researching effective ways to increase beloningness, and

implementing them across platforms and places could decrease depressive symptoms and suicide

rates, as well as increase social belonging and support.

Also, more research about the way the chronically lonely adapt to their loneliness, and

finding better ways and skills to adapt to this loneliness would be a great way to combat

loneliness. Implementing these skills in therapy, and in schools for younger aged children would

be great preventative measures for the future.


LONLINESS AND SUICIDE 21

Limitations and Themes

Overall, some common problems emerged in studies about loneliness. Fist is that there

are different definitions of loneliness. Second, loneliness is difficult to qualitatively measure.

Third, self-reporting bias. Fourth, low diversity of inventory used to measure (loneliness,

suicide, etc.) Fifth, other variables. Sixth, varying results across the board, and finally,

correlation does not mean causation.

Many of the studies identified different, but often similar, definitions of loneliness. Many

of them mention feelings of social isolation, and perceived social network as not meeting

expectations. However, a few of them fail to mention the idea of this being a distressing feeling.

It can be assumed that such a feeling causes emotional distress in many, but in some definitions,

it is not mentioned. One interesting definition was given in the Nicolaisen et al (2014) article.

Not only do they discuss that loneliness is a “deficiency in a person’s social network (Nicolaisen

et al, 2014),” but they also mention that it is a subjective experience. People who feel lonely do

not necessarily have no social contact or are socially isolated. They may feel lonely in a room

full of people, but it is the inner feeling of a lack of social connection and meaningful

relationships that makes up the lonely feeling. Due to the discrepancy in the definitions and the

differences in complexity of these definitions, are all of these studies studying the same thing, or

are they going at it from different angles?

Another limitation in these articles is that loneliness is something that is hard to measure

quantitatively. With any psychological disorder or feeling, it is hard to convert into numbers and

numerical data to analyze. Because of this, psychologists often use self-reported or quantitative

data. This isn’t a bad thing. In fact, it can be useful, but it is also subjective, hard to control, and
LONLINESS AND SUICIDE 22

has a different experience and level for everybody. If there was to be more research on

loneliness, it would be helpful to develop a means of collecting consistent quantitative data.

Self-reported measures are another issue within this data. Often times, self-reporting can

be unreliable and inconsistent. The answer is subjective to what the client thinks is average or

not. This leaves with inconsistent data that may not have an effective means of analysis. Also,

self-reporting can cause people to lie due to shame or embarrassment. If someone is

embarrassed about what they are reporting about, whether anonymous or not, they may lie for

their benefit and this can sway data.

In these studies, many of the same assessment inventory was used. This has both its pros

and its cons. In terms of consistency, using the same assessment inventory can be extremely

helpful. However, some of these assessments may not be measuring what exactly they were

hoping to measure, or they may be leaving out a component within that subject that is important.

What might alleviate these is using components from a few different inventories measuring the

same concept and look for consistencies that way. What is interesting about different studies

using the same assessment inventory, is that they sometimes found different results. This could

be due to the difference in population, sample size, or a specific variable that was measured.

Overall, in science, researchers try to aim for consistency and fair measurement, and this is

something that can always be improved.

The other two limitations often occur because of each other. The varying results in these

studies were mixed. Somewhere loneliness is a large contributing factor to suicidal risk, and

others not as much. The biggest reason for this discrepancy is outside variables. Loneliness and

suicide are both complex issues and looking at them only effecting or being affected by each

other is a limited view of such a complex problem. In every study in this review, there were
LONLINESS AND SUICIDE 23

other variables that were looked at and accounted for such as depressive symptoms,

hopelessness, belongingness, social support, etc. Also, samples size and specific populations

differ in their amounts of loneliness, suicide risk, etc. Loneliness has an association with suicide

risk, but it is not the only factor or even the most important factor. Certain variables may be

similar to loneliness or contribute to loneliness and suicide risk (such as depressive symptoms)

which could explain the association. Many different aspects of psychological health, physical

health, personality, and cognition play a role.

The biggest limitation to this research is the fact that correlation does not necessarily

mean causation. Even though loneliness and suicide do have a correlation in many studies, it

does not mean that loneliness causes suicide. Unfortunately, there are so many other factors that

play a role in that happening, as explained above, causation cannot be assumed. It would be

fantastic if it were simple enough to say, “This causes this” so society, practitioners, scientists,

doctors, etc. could focus on finding a solution. That is what makes mental health so unique is

that there is normally no one cause for a feeling or disorder, and that makes it difficult. Even

though researchers cannot say that loneliness causes suicide, they can say that loneliness can

contribute to someone thinking suicidal thoughts or attempting suicide, along with a plethora of

other factors.

Implications:

It is hard to conclude any solid implications due to the inconclusive research about

loneliness. However, it is important to look at loneliness and how often it is related to depressive

symptoms and suicide. This correlation could prove helpful in determining future suicidal

ideation and or depression in individuals. Schools, work places, mental health practitioners, and
LONLINESS AND SUICIDE 24

everyone could be more cautious of these signs and how they may impact that individual, and be

able to get them the help they need.

Another important factor is social support and inclusion. Loneliness is often correlated

with the lack of these things. Knowing this, practitioners can be aware of this for their clients,

and possibly teach skills and work with families and friends to better give them this social

support they need. Educators and employers could also look at their students and employees for

social exclusion to look for these warning signs and give them help as well.

Future Direction:

Future directions in this subject that would be helpful to research would be to focus less

on ethnicity differences because the studies that have focused on this has found minimal to no

correlation or difference between nationalities.

It would also be helpful to try and find a quantitative way to measure loneliness, and use

methods other than self-reporting. It would also be helpful to control for all other factors that are

related to it, such as depressive symptoms, hopelessness, etc. Along with this, using a variety of

measurement tools and inventory tests would allow for comparison, validity, and

generalizability.

Determining a static definition of loneliness would be beneficial to the reliability of the

research. However, determining different types of loneliness and looking at all the aspects of

each of them would be beneficial to the validity of the research.

Finally, looking at ways to improve loneliness would be helpful. Whether that be looking

at the brain and finding significant areas that are active in phases of loneliness and finding ways

to target those areas with medication; whether it be a mindfulness technique, and or a therapy
LONLINESS AND SUICIDE 25

group or skills group. Overall, finding solutions and looking at the results of those solutions

would be beneficial for many.

Conclusion

Is loneliness associated with suicide? Yes, loneliness can be a contributing factor to

suicide, and it often occurs with depressive symptoms, feelings of hopelessness, belongingness,

perceived lack of support among others across all ethnicities, ages, and genders, which can also

lead to suicidal thoughts and actions. Either way, loneliness is a crippling feeling and is

something that should be addressed in society today. It happens for all ages and is something

that we should be working to combat, along with suicide. Suicide is complex and is a mental

health epidemic that needs to be studied and prevented all over the globe as well. Hopefully, by

researching associations such as loneliness, depressive symptoms, life events, social support, and

others, a way can be found to combat against suicide and help those who feel lost and defeated

and becoming a more caring, loving, and exceptional society.


LONLINESS AND SUICIDE 26

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