مدل¬یابی معادلات ساختاری نقش میانجی احساس تنهایی در رابطه بین حمایت اجتماعی ادراک شده و شفقت به خود با اختلال سوگ طولانی مدت در بازماندگان متوفی سرطان پستان
محورهای موضوعی : مدل سازی
زینب جعفری حنان
1
,
محمدرضا تمنایی فر
2
*
1 - دانشجوی کارشناس ارشد روانشناسی، گروه روانشناسی، موسسه علامه فیض کاشانی، کاشان، ایران
2 - (نویسنده مسئول)، دانشیار، گروه روانشناسی، دانشکده علوم انسانی، دانشگاه کاشان، کاشان، ایران tamannai@kashanu.ac.ir Tel: 09131616609
کلید واژه: احساس تنهایی, بازماندگان, حمایت اجتماعی ادراک شده, سرطان پستان, شفقت به خود با اختلال سوگ طولانی مدت, مدل¬یابی معادلات ساختاری,
چکیده مقاله :
چکیده مقدمه: هدف از پژوهش حاضر بررسی مدل¬یابی معادلات ساختاری نقش میانجی احساس تنهایی در رابطه بین حمایت اجتماعی ادراک شده و شفقت به خود با اختلال سوگ طولانی مدت در بازماندگان متوفی سرطان پستان بود. روش پژوهش: روش این مطالعه توصیفی- همبستگی بود. جامعه آماری پژوهش بازماندگان متوفی(فرزندان و همسران) سرطان پستان شهر قم در فروردین و اردیبهشت سال 1403 بودند. حجم نمونه بر اساس مدل کلاین با روش نمونهگیری هدفمند 300 نفر انتخاب شد. ابزار گردآوری داده¬¬های پژوهش شامل مقیاس اختلال سوگ طولانی مدت(PG-13-R) پریگرسون و همکاران، مقیاس چندبعدی حمایت اجتماعی ادراک شده(MSPSS) زیمت و همکاران، مقیاس شفقت خود(SCS) نِف و مقیاس احساس¬تنهایی-نسخه سوم(UCLALS3) راسل بود. داده‌ها با استفاده از همبستگی پیرسون و معادلات ساختاری تحلیل شد. یافته¬ها: یافته¬های پژوهش نشان داد که اثرات مستقیم حمایت اجتماعی ادراک شده(77/0- =β و 001/0=sig) و شفقت خود(47/0- =β و 001/0=sig) بر اختلال سوگ طولانی مدت معنادار بود. همچنین نتایج نشان داد که احساس تنهایی در رابطه بین حمایت اجتماعی ادراک شده(65/0- =β و 001/0=sig) و شفقت خود(62/0- =β و 001/0=sig) با اختلال سوگ طولانی مدت نقش میانجی و معنادار دارد. همچنین مدل نهایی پژوهش از برازش مطلوبی برخوردار بود (06/0=RMSEA و 05/0>p). نتیجه¬گیری: با توجه به یافته¬های این پژوهش و اهمیت نقش حمایت اجتماعی ادراک شده و شفقت به خود در اختلال سوگ طولانی مدت، به روانشناسان پیشنهاد می¬شود، از آموزش حمایت اجتماعی و مداخلات مبتنی بر شفقت خود برای کاهش اختلال سوگ طولانی مدت در بازماندگان متوفی سرطان پستان استفاده کنند
Abstract Introduction: The purpose of the present study was to investigate structural equation modeling of the mediating role of loneliness in the relationship between perceived social support and self-compassion with prolonged grief disorder in breast cancer survivors. Methods: This was descriptive-correlation research. The statistical population of the study was breast cancer survivors (children and spouse) of Qom city in spring of year 2024. The sample size was selected based on Klein's model and with subjectivw sampling of 300 people. Data collection tools include the prolonged grief ‐13‐revised (PG‐13‐R) scale of Prigerson and et al, multidimensional perceived social support scale (MSPSS) of Zimet and et al (1988), self- compassion scale (SCS) of Neff and University of California, Los Angeles- loneliness scale, version 3 (UCLA LS3) of Russell. Data were analyzed using Pearson correlation and structural equations modeling. Results: The results showed direct effect of perceived social support (β= -0.77 and sig=0.001) and self-compassion (β= -0.47 and sig=0.001) were significant on prolonged grief disorder. Also, the results showed that theory of mind had a mediating role in relationship between perceived social support (β= -0.65 and sig=0.001) and self-compassion (β= -0.62 and sig=0.001) with prolonged grief disorder. Also, the final research model had a good fit (RMSEA=0.06, p<0.05). Conclusion: According to the findings of this research and the importance of the role of perceived social support and self-compassion in prolonged grief disorder, psychologists are suggested to use social support training and interventions based on self-compassion to reduce the prolonged grief disorder in breast cancer survivors.
1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021; 71(3): 209-49. https://doi.org/10.3322/caac.21660
2. Abachizadeh K, Moradi-Kouchi A, Ghanbari-Motlagh A, Kousha A, Shekarriz-Foumani R, Erfani A. Breast cancer in Iran: Levels, variations and correlates. Community Health (Salamat ijtimai). 2018; 5(1): 11-21. https://journals.sbmu.ac.ir/ch/index.php/ch/article/view/15856/14461
3. Whelan TJ, Smith S, Parpia S, Fyles AW, Bane A, Liu FF, Levine MN. Omitting radiotherapy after breast-conserving surgery in luminal a breast cancer. New England Journal of Medicine, 2023; 389 (7): 612-619. https://doi.org/10.1056/NEJMoa2302344
4. Yue L, Luo Y, Jiang L, Sekido Y, Toyokuni S. PCBP2 knockdown promotes ferroptosis in malignant mesothelioma. Pathology International, 2022; 72 (4): 242-251. https://doi.org/10.1111/pin.13209
5. Jefford M, Howell D, Li Q, Lisy K, Maher J, Alfano CM, Emery J. Improved models of care for cancer survivors. The Lancet, 2022; 399(10334): 1551-1560. https://doi.org/10.1016/s0140-6736(22)00306-3
6. Kaiser J, Treml J, Hoffmann R, Linde K, Nagl M, Kersting A. Factors associated with treatment response in an internet-based intervention for prolonged grief disorder after cancer bereavement. Behavior Therapy, 2023; 54(1): 119-131. https://doi.org/10.1016/j.beth.2022.07.008
7. Goveas JS, O'Connor MF. Prolonged grief disorder: unveiling neurobiological mechanisms for a shared path forward. The American Journal of Geriatric Psychiatry, 2024; 32(5): 535-538. https://doi.org/10.1016/j.jagp.2023.12.016
8. Cerel J, Brown MM, Maple M, Singleton M, Van de Venne J, Moore M, Flaherty C. How many people are exposed to suicide? Not six. Suicide and Life‐Threatening Behavior, 2019; 49(2): 529-534. https://doi.org/10.1111/sltb.12450
9. Verdery AM, Smith-Greenaway E, Margolis R, Daw J. Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States. Proceedings of the National Academy of Sciences, 2020; 117(30): 17695-17701. https://doi.org/10.1073/pnas.2007476117
10. Yuan MD, Liu JF, Zhong BL. Prevalence of prolonged grief disorder and its symptoms among bereaved individuals in China: a systematic review and meta-analysis. General Psychiatry, 2024; 37(2): 1-10. https://doi.org/10.1136%2Fgpsych-2023-101216
11. Aeschlimann A, Gordillo N, Ueno T, Maercker A, Killikelly C. Feasibility and Acceptability of a mobile app for prolonged grief disorder symptoms. Clinical Psychology in Europe, 2024; 6(1): 1-23. http://dx.doi.org/10.32872/cpe.10881
12. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifth edition, text revision. Washington: American Psychiatric Association. 2022. https://www.psychiatry.org/psychiatrists/practice/dsm
13. Wen FH, Prigerson HG, Chou WC, Huang CC, Hu TH, Chiang MC, Tang ST. How symptoms of prolonged grief disorder, posttraumatic stress disorder, and depression relate to each other for grieving ICU families during the first two years of bereavement. Critical Care, 2022; 26(1): 336-347. https://doi.org/10.1186/s13054-022-04216-5
14. Lechner-Meichsner F, Comtesse H, Olk M. Prevalence, comorbidities, and factors associated with prolonged grief disorder, posttraumatic stress disorder and complex posttraumatic stress disorder in refugees: a systematic review. Conflict and Health, 2024; 18(1): 32-52. https://doi.org/10.1186/s13031-024-00586-5
15. Eisma MC. Prolonged grief disorder in ICD-11 and DSM-5-TR: Challenges and controversies. Australian & New Zealand Journal of Psychiatry, 2023; 57(7): 944-951. https://doi.org/10.1177/00048674231154206
16. Kustanti CY, Chu H, Kang XL, Huang TW, Jen HJ, Liu D, Chou KR. Prevalence of grief disorders in bereaved families of cancer patients: A meta-analysis. Palliative Medicine, 2022; 36(2): 305-318. https://doi.org/10.1177/02692163211066747
17. Skalski S, Konaszewski K, Dobrakowski P, Surzykiewicz J, Lee SA. Pandemic grief in Poland: Adaptation of a measure and its relationship with social support and resilience. Current Psychology: A Journal for Diverse Perspectives on Diverse Psychological Issues, 2022; 41(10): 7393–7401. https://doi.org/10.1007/s12144-021-01731-6
18. Lipp N, O’Brien KM. Bereaved college students: Social support, coping style, continuing bonds, and social media use as predictors of complicated grief and posttraumatic growth. OMEGA-journal of Death and Dying, 2022; 85(1): 178-203. https://doi.org/10.1177/0030222820941952
19. Kokou-Kpolou CK, Adansikou K, Park S, Hajizadeh S, Iorfa SK, Cénat JM. Prolonged grief and posttraumatic growth among middle-aged and older widowed persons: A latent class analysis and testing for the role of social support. Death Studies, 2022; 46(6): 1401-1413. https://doi.org/10.1080/07481187.2021.1978115
20. Xiao H, Zhang Y, Kong D, Li S, Yang N. The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Medical science monitor: international medical journal of experimental and clinical research, 2020; 26(1): 1-10. https://doi.org/10.12659/msm.923549
21. Yildirim M, Turan ME, Albeladi NS, Crescenzo P, Rizzo A, Nucera G, Chirico F. Resilience and perceived social support as predictors of emotional well-being. J. Health Soc. Sci, 2023; 8(1): 59-75. http://dx.doi.org/10.19204/2023/rsln5
22. Pike C. K, Burdick KE, Millett C, Lipschitz JM. Perceived loneliness and social support in bipolar disorder: relation to suicidal ideation and attempts. International journal of bipolar disorders, 2024; 12(1): 8-20. https://doi.org/10.1186/s40345-024-00329-8
23. Cacciatore J, Thieleman K, Fretts R, Jackson L. B. What is good grief support? Exploring the actors and actions in social support after traumatic grief. PloS one, 2021; 16(5): 1-10. https://doi.org/10.1371/journal.pone.0252324
24. Szőcs H, Sandheden L, Horváth Z, Vizin G. The mediating role of state shame, guilt, and pride in the relationship between self-compassion and prolonged grief. European Psychiatry, 2022; 65(1): 179-180. https://doi.org/10.1192%2Fj.eurpsy.2022.475
25. Vara H, Thimm, JC. Associations between self-compassion and complicated grief symptoms in bereaved individuals: An exploratory study. Nordic Psychology, 2020; 72(3): 235-247. https://doi.org/10.1080/19012276.2019.1684347
26. Neff KD, Bluth K, Tóth-Király I, Davidson O, Knox MC, Williamson Z, Costigan A. Development and validation of the Self-Compassion Scale for Youth. Journal of personality assessment. 2021; 03(1) :92-105. https://doi.org/10.1080/00223891.2020.1729774
27. Neff KD, Tóth-Király I, Knox MC, Kuchar A, Davidson O. The development and validation of the State Self-Compassion Scale (long- and short form). Mindfulness, 2021; 12(1): 121–140. https://doi.org/10.1007/s12671-020-01505-4
28. Neff KD. Setting the record straight about the Self-Compassion Scale. Mindfulness. 2019; 10(1):200-202. https://doi.org/10.1007/s12671-018-1061-6
29. Neff KD. Self-compassion: Theory, method, research, and intervention. Annual Review of Psychology, 2023; 74(2): 193-218. https://doi.org/10.1146/annurev-psych-032420-031047
30. Zhang N, Sandler I, Tein J, Wolchik S, Donohue E. Caregivers’ self-compassion and bereaved children’s adjustment: Testing caregivers’ mental health and parenting as mediators. Mindfulness, 2022; 13(1): 462–473. https://doi.org/10.1007/s12671-021-01807-1
31. Adamczy, K. An investigation of loneliness and perceived social support among single and partnered young adults. Current psychology, 2016; 35(1): 674-689. https://doi.org/10.1007/s12144-015-9337-7
32. Ikhtabi S, Pitman A, Maconick L, Pearce E, Dale O, Rowe S, Johnson S. The prevalence and severity of loneliness and deficits in perceived social support among who have received a ‘personality disorder’diagnosis or have relevant traits: a systematic review. BMC psychiatry, 2024; 24(1): 21-31. https://doi.org/10.1186%2Fs12888-023-05471-8
33. Caba Machado V, Mcilroy D, Padilla Adamuz F. M, Murphy R, Palmer-Conn S. The associations of use of social network sites with perceived social support and loneliness. Current Psychology, 2023; 42(17): 14414-14427. https://doi.org/10.1007/s12144-021-02673-9
34. Fan Y, Shen BJ, Ho R. Loneliness, perceived social support, and their changes predict medical adherence over 12 months among patients with coronary heart disease. British Journal of Health Psychology, 2024; 1(1): 1-10. https://doi.org/10.1111/bjhp.12732
35. Wollast R, Preece DA, Schmitz M, Bigot A, Gross JJ, Luminet O. The role of self-compassion in loneliness during the COVID-19 pandemic: a group-based trajectory modelling approach. Cognition and Emotion, 2024; 38(1): 103-119. https://doi.org/10.1080/02699931.2023.2270201
36. Gao P, Mosazadeh, H, Nazari, N. The buffering role of self-compassion in the Association between loneliness with depressive symptoms: A cross-sectional Survey Study among older adults living in Residential Care Homes during COVID-19. International Journal of Mental Health and Addiction, 2023; 1(1): 1-21. https://doi.org/10.1007/s11469-023-01014-0
37. Wang S, Tang Q, Lv Y, Tao Y, Liu X, Zhang L, Liu G. The temporal relationship between depressive symptoms and loneliness: the moderating role of self-compassion. Behavioral Sciences, 2023; 13(6): 472-485. https://doi.org/10.3390/bs13060472
38. Reiland H, Banerjee A, Claesges SA, Giuca A. M, Hillard C. J, Reynolds CF, Goveas JS. The influence of depression on the relationship between loneliness and grief trajectories in bereaved older adults. Psychiatry research communications, 2021; 1(1): 1-10. https://doi.org/10.1016/j.psycom.2021.100006
39. Eisma MC, Buyukcan-Tetik, A. Prolonged Grief Symptoms Predict Social and Emotional Loneliness and Depression Symptoms. Behavior Therapy, 2024; 1(1): 1-10. https://doi.org/10.1016/j.beth.2024.04.014
40. Achterbergh L, Pitman A, Birken M, Pearce E, Sno H, Johnson S. The experience of loneliness among young people with depression: a qualitative meta-synthesis of the literature. BMC psychiatry, 2020; 20(1): 1-23. https://doi.org/10.1186/s12888-020-02818-3
41. Hang S, Jost GM, Guyer AE, Robins RW, Hastings PD, Hostinar CE. Understanding the development of chronic loneliness in youth. Child Development Perspectives, 2024; 18(1): 44-53. https://doi.org/10.1111/cdep.12496
42. Wang J, Mann F, Lloyd-Evans B, Ma R, Johnson S. Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC psychiatry, 2018; 18(1): 1-16. https://doi.org/10.1186/s12888-018-1736-5
43. Haokip HR, Chauhan H, Rawat I, Mehra J, Jyoti J, Sharma K, Xavier. Relationship between spirituality and depression among patients with malignant cancer at a selected tertiary care Institute-A study from North India. Journal of Psychosocial Oncology, 2022; 40 (3): 331-346. https://doi.org/10.1080/07347332.2021.1990184
44. Kline RB. Principles and practice of structural equation modeling. Guilford publications. 2023. https://www.guilford.com/books/Principles-and-Practice-of-Structural-Equation-Modeling/Rex-Kline/9781462551910
45. Prigerson HG, Boelen PA, Xu J, Smith KV, Maciejewski PK. Validation of the new DSM‐5‐TR criteria for prolonged grief disorder and the PG‐13‐Revised (PG‐13‐R) scale. World Psychiatry, 2021; 20(1): 96-106. https://doi.org/10.1002/wps.20823
46. Barrett TW, Scott TB. Development of the grief experience questionnaire. Suicide and Life‐Threatening Behavior, 1989; 19(2): 201-215. https://doi.org/10.1111/j.1943-278X.1989.tb01033.x
47. Yousefi R, Haghnazari Esfahlam A. Cross-validation of the Persian version of the revised scale of Prolonged Grief Disorder. Clinical Psychology and Personality, 2024; 1(1): 1-10. (In Persian) https://doi.org/10.22070/cpap.2024.17243.1315
48. Ashouri A, Yousefi S, Prigerson HG. Psychometric properties of the PG-13-R scale to assess prolonged grief disorder among bereaved Iranian adults. Palliative & Supportive Care, 2024; 22(1): 174-181. https://doi.org/10.1017/s1478951523000202
49. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 1988; 52(1): 30-41. http://dx.doi.org/10.1207/s15327752jpa5201_2
50. Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L. The Hopkins Symptom Checklist (HSCL): A self‐report symptom inventory. Behavioral science, 1974; 19(1): 1-15. https://doi.org/10.1002/bs.3830190102
51. Basharat M. Validity and validity of the 28-question form of the mental health scale. Scientific Journal of Forensic Medicine, 2009; 54(1): 91-87. (In Persian) https://www.sid.ir/paper/356316/fa
52. Basharat M. Multidimensional scale of perceived social support: Questionnaire, instruction and scoring. Journal of Developmental Psychology (Iranian Psychologists): 2018; 15(60): 336-338. (In Persian) https://sid.ir/paper/516322/fa
53. Neff KD. The development and validation of a scale to measure self-compassion. Self and identity, 2003; 2(3): 223-250. https://doi.org/10.1080/15298860309027
54. Rosenberg M. Determinants of self-esteem-a citation classic commentary on society and the adolescent self-image by Rosenberg, M. Current Contents/Social & Behavioral Sciences, 1989; 1(11): 16-16. https://www.scirp.org/reference/ReferencesPapers?ReferenceID=1184974
55. Khosravi S, Sadeghi M, Yabandeh M. Psychometric Properties of Self-Compassion Scale(SCS). Psychological Models and Methods, 2013; 4(13): 47-59. https://dorl.net/dor/20.1001.1.22285516.1392.4.13.3.2
56. Russell DW. UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure. Journal of personality assessment, 1996; 66(1): 20-40. https://doi.org/10.1207/s15327752jpa6601_2
57. Schmidt N, Sermat V. Measuring loneliness in different relationships. Journal of Personality and Social Psychology, 1983; 44(5): 1038–1047. https://doi.org/10.1037/0022-3514.44.5.1038
58. Bahirayi H, Delavar A, Ahadi H. Standardization of UCLA Loneliness Scale (version 3) on Students Attending Universities in Tehran. Thought & Behavior in Clinical Psychology, 2006; 1(1): 18-6. (In Persian) https://ensani.ir/file/download/article/20101111133919
59. Abdollahi PS, Kamkar A, Khosravi S. Effectiveness of Dialectical Behavioral Therapy on Loneliness and Internet Addiction in students. Rooyesh, 2023; 12(10): 191-200. (In Persian) http://frooyesh.ir/article-1-4596-fa.html
60. Lovibond SH, Lovibond, PF. Manual for the depression anxiety stress scales. Psychology Foundation of Australia. 1996. https://cir.nii.ac.jp/crid/1370294643851494273
61. Bottaro R, Valenti G. D, Farac, P. Assessment of an Epidemic Urgency: Psychometric Evidence for the UCLA Loneliness Scale. Psychology Research and Behavior Management, 2023; 1(1): 2843-2855. https://doi.org/10.2147%2FPRBM.S406523
62. Azimi K, Shehni Yailagh M, Khoshnamvand M. Designing and Testing the Causal Model of the Relationship between Moral Identity and Bullying with the Mediation of Moral Disengagement among Iranian Adolescents. Social Psychology Research, 2024; 13(52): 13-30. (In Persian) https://doi.org/10.22034/spr.2024.410580.1852
63. Zou R, Xu X, Hong X, Yuan J. Higher socioeconomic status predicts less risk of depression in adolescence: Serial mediating roles of social support and optimism. Frontiers in psychology, 2020; 11(1): 1-12. https://doi.org/10.3389%2Ffpsyg.2020.01955
64. Yichen M, Chuntian L. Is lifestyle a bridge between perceived social support and depression in Chinese university students?. Children and Youth Services Review, 2024; 156(1): 1-10. http://dx.doi.org/10.1016/j.childyouth.2023.107283
65. Baran DM, Körük,S. The predictive role of dyadic adjustment and perceived social support in explaining psychological help-seeking attitudes of married individuals. British Journal of Guidance & Counselling, 2024; 1(2): 1-9. https://doi.org/10.1080/03069885.2023.2292093
66. Huang Y, Liu J, Huang G, Zhu D, Zhou Y, Hu J. Understanding suicidal ideation disparity between sexual minority and heterosexual Chinese young men: A multiple mediation model of social support sources, self-esteem, and depressive symptoms. Frontiers in psychiatry, 2024; 15(1): 1-10. https://doi.org/10.3389/fpsyt.2024.1265722
67. Hawkley L. C, Cacioppo JT. Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of behavioral medicine, 2010; 40(2): 218-227. https://doi.org/10.1007/s12160-010-9210-8
68. Vedder A, Stroebe M.S, Schut, HA, Boerner K, Stokes JE, Boelen PA. Loneliness in bereavement: Measurement matters. Frontiers in Psychology, 2021; 12(1): 1-10. https://doi.org/10.3389/fpsyg.2021.741762
69. Cacioppo JT, Cacioppo S, Boomsma D. Evolutionary mechanisms for loneliness. Cognition & emotion, 2014; 28(1): 3-21. https://doi.org/10.1080/02699931.2013.837379
70. Vedder A, Boerner K, Stokes JE, Schut HA, Boelen PA, Stroebe MS. A systematic review of loneliness in bereavement: Current research and future directions. Current Opinion in Psychology, 2022; 43(1): 48-64. https://doi.org/10.1016/j.copsyc.2021.06.003
71. Fried EI, Bockting C, Arjadi R, Borsboom D, Amshoff M, Cramer AO. J, Epskamp S, Tuerlinckx F, Carr D, Stroebe M. From loss to loneliness: The relationship between bereavement and depressive symptoms. Journal of Abnormal Psychology, 2015; 124(2): 256–265. https://doi.org/10.1037/abn0000028
72. Asch RH, Esterlis I, Southwick SM, Pietrzak RH. Risk and resilience factors associated with traumatic loss-related PTSD in US military veterans: Results from the National Health and Resilience in Veterans Study. Psychiatry Research, 2021; 298(1): 1-10. https://doi.org/10.1016/j.psychres.2021.113775
73. Hutten E, Jongen EM, Vos AE, van den Hout AJ, van Lankveld JJ. Loneliness and mental health: the mediating effect of perceived social support. International journal of environmental research and public health, 2021; 18(22): 1-10. https://www.mdpi.com/1660-4601/18/22/11963#
74. Haber MG, Cohen JL, Lucas T, Baltes BB. The relationship between self-reported received and perceived social support: A meta-analytic review. American journal of community psychology, 2007; 39(1): 133-144. https://doi.org/10.1007/s10464-007-9100-9
75. Cacioppo JT, Cacioppo S. The growing problem of loneliness. The Lancet, 2018; 391(10119): 426-426. https://doi.org/10.1016/S0140-6736(18)30142-9
76. Meng J, Wang X, Wei D, Qiu J. State loneliness is associated with emotional hypervigilance in daily life: A network analysis. Personality and Individual Differences, 2020; 165(1): 1-10. https://doi.org/10.1016/j.paid.2020.110154
77. Spithoven A. W, Cacioppo S, Goossens L, Cacioppo JT. Genetic contributions to loneliness and their relevance to the evolutionary theory of loneliness. Perspectives on Psychological Science, 2019; 14(3): 376-396. https://doi.org/10.1177/1745691618812684
78. Liu X, Yang Y, Wu H, Kong X, Cui L. The roles of fear of negative evaluation and social anxiety in the relationship between self-compassion and loneliness: A serial mediation model. Current Psychology, 2020; 1(2): 1-9. https://doi.org/10.1007/s12144-020-01001-x