Prevalence and Associated Factors of Loneliness Among National Samples of In-School Adolescents in Four Caribbean Countries

Abstract

Background

The goal of the study was to estimate the prevalence and correlates of loneliness among adolescent school children in four Caribbean countries.

Methods

Nationally representative cross-sectional data were analysed from 9,143 adolescents (15 years=median age) that took part in the “2016 Dominican Republic, 2016 Suriname, 2017 Jamaica and 2017 Trinidad and Tobago “Global School-Based Student Health Survey (GSHS).”

Results

The prevalence of loneliness was 15.3% in four Caribbean countries, ranging from 12.1% in Dominican Republic to 18.6% in Jamaica. In adjusted logistic regression analysis, female sex, having no close friends, older age, anxiety induced sleep disturbance, frequent bullying victimization (≥3 days/month), having been physically attacked, parental emotional neglect, having sustained multiple serious injuries (past year) and not eating fruit and vegetables were associated with loneliness. In addition, in sex stratified adjusted logistic regression analysis, among boys, daily exposure to passive smoking, and being from Suriname, and among girls, frequent experience of hunger, low peer support, trouble from drinking alcohol and high leisure-time sedentary behaviour (≥8 hrs/day) were associated with loneliness. Moreover, in addition to above results, in unadjusted analysis, involvement in physical fight, parents never check on homework, parental disrespect of privacy, frequent school truancy (≥3 days/month), current tobacco use, having no physical education and drinking frequently soft drinks (≥3/day) were associated with loneliness.

Conclusion

Almost one in six students reported loneliness and several associated factors were identified which can aid intervention strategies.

Keywords

Loneliness risk behaviour protective factors adolescents Dominican Republic Jamaica Suriname Trinidad and Tobago

Introduction

Loneliness is defined as a “distressing feeling that accompanies the perception that one’s social needs are not being met by the quantity or especially the quality of one’s social relationships” (Hawkley & Cacioppo, 2010, p. 218). Developmental changes during adolescence imply an increased vulnerability and frequent experience of loneliness (Van Rode et al., 2015). Longitudinal research showed that loneliness increases the risk for morbidity and mortality (Hawkley & Cacioppo, 2010). According to Rönkä et al. (2014, p. 184), “loneliness is a subjective, multidimensional phenomenon, with emotional, social and contextual dimensions and it is associated with adolescents’ health and well-being.”

In a school survey among adolescents in the Caribbean and Latin America (in 25 countries), 18.1% reported loneliness (single item: mostly or always lonely) (Sauter et al., 2020). This included 19.5% loneliness in Jamaica in 2010, 15.0% in Suriname in 2009 and 9.8% in Trinidad and Tobago in 2011 (Sauter et al., 2020). The prevalence of loneliness among adolescents was 7.8% (mostly or always lonely with a single item) in seven ASEAN countries (Peltzer & Pengpid, 2017), in Ghana 18.1% (single item: mostly or always lonely) (Glozah et al., 2018), in USA 14.7% of girls and 6.7% of boys, and in Russia 14.4% of the girls and 8.9% of the boys had loneliness (assessed with one item: “certainly true, as opposed to not true, or somewhat true”) (Stickley et al., 2014). There is a lack of recent national data on the prevalence and correlates of loneliness among adolescents in the Caribbean. It would be important to identify the prevalence and risk factors of loneliness in the adolescent population so as to better design measures to prevent and control loneliness.

Following a multi-dimensional explanatory model, social-emotional, contextual, and health and well-being factors are associated loneliness among adolescents (Rönkä et al., 2014). Social-emotional factors associated with loneliness among adolescents include having no close friends (Peltzer & Pengpid, 2017; Rönkä et al., 2014; Vanhalst et al., 2014), being bullied (Peltzer & Pengpid, 2017; Rönkä et al., 2014; Vanhalst et al., 2014), peer victimization (León-Moreno et al., 2019; Stickley et al., 2016), unhappy, sad or depressed (Mahon et al., 2006; Qualter et al., 2010; Rönkä et al., 2014), social anxiety (Mahon et al., 2006), shyness (Mahon et al., 2006; Stickley et al., 2016) avoiding company (Rönkä et al., 2014), not being liked (Rönkä et al., 2014). Contextual factors associated with loneliness among adolescents may include poverty (Murphy & Shevlin, 2012), experience of hunger (Peltzer & Pengpid, 2017), lack of social support (Mahon et al., 2006), poor quality friendships (Vanhalst et al., 2014), lack of parental support (J. Liu et al., 2015; Mahon et al., 2006; Peltzer & Pengpid, 2017), and inconsistent parenting (Stickley et al., 2016). Health and well-being factors associated with loneliness among adolescents may include poor self-rated health status (Rönkä et al., 2014), dissatisfaction with life (Neto & Barros, 2000; Rönkä et al., 2014), poor diet, such as frequent soft drink intake (Pengpid & Peltzer, 2019) and inadequate fruit and vegetable intake (Głąbska et al., 2020), physical inactivity (Pinto et al., 2019), leisure-time sedentary behaviour (Vancampfort et al., 2019) and less active in physical education classes (Dos Santos et al., 2020).

Based on above literature, we hypothesize that social-emotional, contextual, and health risk behaviour factors are associated with the subjective experience of loneliness among adolescents. The aims of the study are: 1) to estimate the prevalence of the loneliness experience and 2) to assess how social-emotional, contextual, and health risk behaviour factors are associated loneliness among adolescents in four Caribbean countries.

Methods

Sources of data

Cross-sectional nationally representative survey data from the 2016 Dominican Republic, 2016 Suriname, 2017 Jamaica and 2017 Trinidad and Tobago GSHS were analyzed (World Health Organization [WHO], 2019). A two-stage cluster sample design was used to produce data representative of all students in grades 8th, Freshman, Sophmore, Junior, Senior in Dominican Republic, grades 7th - 12th in Jamaica, Grades 1–3, other in Suriname and Forms 1–6 in Trinidad and Tobago. At the first stage, schools were selected with probability proportional to enrollment size. At the second stage, classes were randomly selected and all students in selected classes were eligible to participate (WHO, 2019). More detailed information can be publically accessed (WHO, 2019); the overall response rate was 63% in the Dominican Republic, 60% in Jamaica, 83% in Suriname and 89% in Trinidad and Tobago (WHO, 2019). National ethics committees approved the study and “written informed consent was obtained from the participating schools, parents and students.” (WHO, 2019).

Measures

The GSHS questionnaire utilized can be found in supplementary file 1 (WHO, 2019). The GSHS measure draws on content from the CDC Youth Risk Behavior Survey for which test- and retest reliability has been established (Brener et al., 1995). In a study examining the test-retest reliability of the GSHS measure among Fijian girls found an “average agreement between test and retest was 77%, and average Cohen's kappa was 0.47.” (Becker et al., 2010, p. 181). Loneliness was assessed with one item and defined as mostly or always feeling lonely in the past 12 month (see supplementary file 1). Emotional neglect was classified as “never parental or guardian understanding of your problems and worries? AND never parents or guardians really know what you were doing with your free time when you were not at school or work?” (WHO, 2016).

Data analysis

Statistical analyses were computed with “STATA software version 15.0 (Stata Corporation, College Station, Texas, USA).” Unadjusted and adjusted (including variables significant in univariate analysis) logistic regression analyses were used to assess predictors of loneliness. Only complete values were included in the analysis. P < 0.05 was accepted as significant.

We also checked the models’ goodness of fit based on Nagelkerke’s R² and Hosmer- Lemeshow test.

Results

Sample and loneliness characteristics

The sample comprised of 9,143 school adolescents (15 years=median age, 3 years=interquartile range), 50.7% were female and 4.6% were mostly or always hungry. Almost one in ten of the participants (9.1%) had frequently (≥3 days/month) been bullied, 14.1% had frequently (≥2 times/year) been attacked and 12.9% had frequently (≥2 times/year) been in a physical fight. More than one in ten students (13.8%) used currently tobacco, 6.4% used cannabis currently, 11.9% had trouble from alcohol use, and 16.7% were daily exposed to secondary smoke. Half of the participants (49.6%) engaged in leisure-time sedentary behaviour (≥3 hours/day), 15.5% had multiple injuries (past year), 25.5% had ≥3 soft drinks a day, 19.8% did not eat fruit and vegetables, and 30.7% do not attend physical. One in ten of the students (9.5%) were frequently (≥3 days/months) school truant, 31.2% had low peer support, 23.8% had parents who never checked on their home work, 11.1% experienced parental emotional neglect, and 15.0% had parents who mostly or always disrespected their privacy. Almost one in six students (15.3%) reported loneliness, 20.3% among females and 10.5% among males, and the highest student in Jamaica (18.6%) and lowest in the Dominican Republic (14.1%) (see Table 1).

Table 1.

Sample and loneliness characteristics among adolescents in four Caribbean countries, 2016–2017.

Variable	Sample	Loneliness
	N (%)	% (95 % CI)
Socio-demographics
All	9143	15.3 (13.9, 16.9)
Age in years
13 or less	2406 (26.4)	10.6 (8.7, 12.9)
14–15	4017 (44.1)	15.3 (13.4, 17.4)
16 or more	2677 (29.4)	16.4 (13.8, 19.4)
Gender
Female	4816 (50.7)	20.3 (17.7, 23.3)
Male	4221 (49.3)	10.5 (9.0, 12.2)
Country
Dominican Republic	1481 (16.2)	14.1 (12.1, 16.3)
Jamaica	1667 (18.2)	18.6 (16.5, 21.0)
Suriname	2126 (23.3)	16.8 (14.7, 19.0)
Trinidad and Tobago	3869 (42.3)	14.6 (12.8, 16.7)
Social-emotional factors distress
No close friends	937 (11.3)	29.5 (22.8, 37.3)
Anxiety induced sleep disturbance	1159 (8.8)	48.9 (42.2, 55.6)
Bullied in past month
0 days	6848 (76.6)	10.3 (9.4, 11.38)
1 or 2 days	1039 (14.4)	24.4 (20.0, 29.3)
3–30 days	822 (9.1)	36.4 (31.2, 42.0)
Physically attacked in past year
0 times	6650 (75.6)	11.7 (10.1, 13.5)
1 time	880 (10.3)	24.9 (19.7, 31.0)
2 or more times	1518 (14.1)	27.3 (24.1, 30.8)
In physical fight in past year
0 times	6481 (74.5)	13.4 (11.9, 15.1)
1 time	1167 (12.5)	20.5 (16.4, 25.2)
2 or more times	1399 (12.9)	21.3 (16.7, 26.7)
Contextual factors
Mostly/always feeling hungry	701 (4.6)	31.2 (25.8, 37.1)
Low peer support	3004 (31.2)	21.8 (19.3, 24.5)
Parental emotional neglect	1057 (11.1)	27.0 (21.0, 34.1)
Parents never check home work	2589 (23.8)	21.8 (18.3, 25.8)
Parents disrespect privacy	1512 (15.0)	19.7 (16.0, 24.0)
Passive smoking in past week
0 days	4253 (44.4)	12.2 (10.9, 13.7)
1–6 days	3057 (38.9)	15.9 (13.4, 18.8)
All 7 days	1733 (16.7)	22.2 (19.1, 25.7)
School truancy (past month)
0 days	6850 (74.1)	14.3 (13.0, 15.7)
1–2 days	1232 (16.4)	16.2 (12.7, 20.4)
3 or more days	774 (9.5)	23.6 (19.4, 28.4)
Health risk behaviours
Current tobacco use	1222 (13.8)	25.5 (21.9, 29.3)
Current cannabis use	563 (6.4)	19.8 (14.6, 26.4)
Trouble from alcohol use	834 (11.9)	28.6 (23.0, 35.0)
Multiple sexual partners	1468 (23.5)	18.9 (15.1, 23.4)
No physical education	2674 (30.7)	18.0 (15.6, 20.6)
Leisure time sedentary behaviour/day
	4579 (50.4)	13.2 (11.5, 15.2)
3–4 hours	1882 (22.4)	14.0 (11.7, 16.7)
5–7 hours	1248 (14.7)	19.6 (15.7, 24.2)
≥ 8 hours	1122 (12.5)	22.4 (18.0, 27.6)
Injury in past 12 months
0 times	4905 (66.1)	10.8 (9.4, 12.4)
1 time	1589 (18.4)	18.8 (16.5, 21.3)
2 or more times	1492 (15.5)	24.8 (20.9, 29.2)
Soft drink consumption (drinks/day)
0	3268 (30.1)	15.1 (12.7, 17.8)
1	1897 (23.1)	13.4 (11.0, 16.1)
2	1626 (21.3)	12.5 (10.3, 15.1)
3 or more	2273 (25.5)	19.6 (16.7, 22.9)
Fruit and vegetable intake (servings)
0 a day	1630 (19.8)	21.8 (17.5, 26.8)
1 or 2 a day	3262 (41.0)	13.9 (12.1, 15.9)
3 or 4 a day	2190 (21.5)	13.3 (10.6, 16.6)
5 or more a day	1857 (17.7)	14.4 (11.5, 17.9)

Associations with loneliness

In adjusted logistic regression analysis, female sex, having no close friends, older age, anxiety induced sleep disturbance, frequent bullying victimization (≥3 days/month), having been physically attacked, parental emotional neglect, having sustained multiple serious injuries (past year) and not eating fruit and vegetables were associated with loneliness. In addition, in sex stratified adjusted logistic regression analysis, among boys, daily exposure to passive smoking (AOR: 2.73, 95% CI: 1.06–7.01), and being from Suriname (AOR: 2.02, 95% CI: 1.15–3.55), and among girls, frequent experience of hunger (AOR: 2.75, 95% CI: 1.23–6.17), low peer support (AOR:1.34, 95% CI: 1.02–1.76), trouble from drinking alcohol (AOR: 2.29, 95% CI: 1.11–4.75) and high leisure-time sedentary behaviour (≥8 hrs/day) (AOR 1.61, CI: 1.05, 2.48) were associated with loneliness. Moreover, in addition to above results, in unadjusted analysis, involvement in physical fight, parents never check on homework, parental disrespect of privacy, frequent school truancy (≥3 days/month), current tobacco use, having no physical education and drinking frequently soft drinks (≥3/day) were associated with loneliness (see Table 2).

Table 2.

Associations with loneliness among adolescents in four Caribbean countries.

Variable	Unadjusted odds ratio (95% CI)	Adjusted odds ratio (95% CI)¹
Socio-demographics
Age in years
13 or less	1 (Reference)	1 (Reference)
14–15	1.52 (1.17, 1.98)**	1.39 (1.00, 1.93)*
16 or more	1.66 (1.25, 2.20)***	1.35 (0.89, 2.05)
Gender
Female	1 (Reference)	1 (Reference)
Male	0.46 (0.36, 0.59)***	0.34 (0.25, 0.47)***
Country
Dominican Republic	1 (Reference)	1 (Reference)
Jamaica	1.40 (1.11, 1.76)**	1.19 (0.97, 1.63)
Suriname	1.23 (0.99, 1.53)	1.23 (0.95, 1.60)
Trinidad and Tobago	1.05 (0.83, 1.33)	0.91 (0.66, 1.25)
Social-emotional factors
No close friends	2.63 (1.80, 3.84)***	1.72 (1.10, 2.69)*
Anxiety induced sleep disturbance	7.89 (5.78, 10.78)***	6.01 (3.91, 9.22)***
Bullied in past month
0 days	1 (Reference)	1 (Reference)
1 or 2 days	2.80 (2.16, 3.62)***	1.25 (0.77, 2.01)
3–30 days	4.98 (3.84, 6.46)***	2.84 (1.66, 4.86)***
Physically attacked in past year
0 times	1 (Reference)	1 (Reference)
1 time	2.51 (1.74, 3.62)***	1.54 (1.06, 2.22)*
2 or more times	2.84 (2.25, 3.58)***	1.81 (1.09, 3.01)*
In physical fight in past year
0 times	1 (Reference)	1 (Reference)
1 time	1.66 (1.22, 2.26)***	1.20 (0.81, 1.79)
2 or more times	1.75 (1.25, 2.44)***	1.18 (0.76, 1.84)
Contextual factors
Mostly/always feeling hungry	2.66 (1.99, 3.56)***	1.73 (0.95, 3.16)
Low peer support	1.91 (1.59, 2.28)***	1.24 (0.56, 1.47)
Parental emotional neglect	2.29 (1.56, 3.35)***	2.03 (1.22, 3.39)**
Parents never check home work	1.79 (1.36, 2.36)***	1.00 (0.71, 1.40)
Parents disrespect privacy	1.42 (1.09, 1.84)**	0.94 (0.64, 1.36)
Passive smoking in past week
0 days	1 (Reference)	1 (Reference)
1–6 days	1.36 (1.09, 1.70)**	0.96 (0.65, 1.41)
All 7 days	2.05 (1.61, 2.61)***	1.32 (0.83, 2.07)
School truancy (past month)
0 days	1 (Reference)	1 (Reference)
1–2 days	1.16 (0.88, 1.53)	0.91 (0.62, 1.33)
3 or more days	1.86 (1.44, 2.39)***	1.05 (0.64, 1.36)
Health risk behaviours
Current tobacco use	2.14 (1.72, 2.66)***	0.91 (0.56, 1.47)
Current cannabis use	1.44 (0.99, 2.09)	—
Trouble from alcohol use	2.63 (1.83, 3.79)***	1.85 (0.97, 3.53)
Multiple sexual partners	1.39 (0.97, 2.01)	—
No physical education	1.28 (1.06, 1.54)**	1.11 (0.85, 1.45)
Leisure time sedentary behaviour/day
	1 (Reference)	1 (Reference)
3–4 hours	1.07 (0.81, 1.41)	1.28 (0.96, 1.71)
5–7 hours	1.60 (1.19, 2.15)**	1.34 (0.91, 1.98)
≥ 8 hours	1.90 (1.44, 2.49)***	1.25 (0.86, 1.82)
Injury in past 12 months
0 times	1 (Reference)	1 (Reference)
1 time	1.91 (1.53, 2.38)***	1.48 (1.00, 2.20)
2 or more times	2.72 (2.07, 3.57)***	1.72 (1.16, 2.55)**
Soft drink consumption (drinks/day)
0	1 (Reference)	1 (Reference)
1	0.87 (0.66, 1.15)	0.88 (0.62, 1.23)
2	0.81 (0.60, 1.07)	0.92 (0.64, 1.32)
3 or more	1.37 (1.05, 1.80)*	0.97 (0.67, 1.40)
Fruit and vegetable intake (servings)
0 a day	1 (Reference)	1 (Reference)
1 or 2 a day	0.58 (0.43, 0.78)***	0.62 (0.41, 0.93)*
3 or 4 a day	0.55 (0.35, 0.87)**	0.48 (0.26, 0.91)*
5 or more a day	0.60 (0.41, 0.89)*	0.55 (0.30, 1.04)

¹Cox & Snell R² = 0.168; Nagelkerke R² Square = 0.303; Hosmer & Lemeshow Chi-square = 1544.120, p = <0.01. CI=Confidence Interval.

***P<.001; **P<.01; *P<.05.

Discussion

The investigation aimed to estimate the prevalence and correlates of loneliness among school adolescents in four Caribbean countries. Our results show for the first time that a number of social-emotional, contextual and health risk behaviour factors are associated with the experience of loneliness in the Caribbean. The prevalence of past 12-month loneliness (15.3%) in this study, was lower than in adolescents in 25 countries in the Americas (18.1%) (Sauter et al., 2020) and in Ghana (18.1%) (Glozah et al., 2018), and higher than in Southeast Asian countries (7.8%) (Peltzer & Pengpid, 2017), USA (14.7% and 6.7% in girls and boys, respectively) and Russia (14.4% and 8.9% in girls and boys, respectively) (Stickley et al., 2014). The prevalence of loneliness in Jamaica (18.6%) in 2017 was lower than in the 2010 Jamaica GSHS (19.5%), the prevalence of loneliness in Suriname (16.8%) in 2016 was higher than in the 2009 Suriname GSHS (9.8%), and the prevalence of loneliness in Trinidad and Tobago (14.7%) in 2017 was higher than in the 2011 Trinidad and Tobago GSHS (9.8%) (Sauter et al., 2020). Since loneliness among adolescents increases their risk for morbidity and mortality (Hawkley & Cacioppo, 2010), the found high prevalence of loneliness calls for mental health programmes in this adolescent population in four Caribbean countries.

The study showed that being female increased the likelihood of loneliness, which was also found in some previous investigations (e.g., Peltzer & Pengpid, 2017). Generally, girls may be more vulnerable to loneliness than boys because of different coping styles in responding to stressors, such that girls display more emotion-focused and less problem-focused copying styles than boys (Siziya & Mazaba, 2015; Zhang et al., 2018). The study showed that older age increased the likelihood of loneliness. Similar results were found in a study among adolescents globally and in Southeast Asian countries (Mahon et al., 2006; Peltzer & Pengpid, 2017). Possible reasons for higher loneliness among older than younger adolescents include increasing reliance on peers, physical and psychosocial changes (Byrne et al., 2007, Marsh et al., 2018; Spear, 2000).

As hypothesised, lonely adolescents differed from not lonely adolescents regarding several social-emotional, contextual and health risk behabiour factors. Consistent with former research (Mahon et al., 2006; Peltzer & Pengpid, 2017; Shevlin et al., 2014; Stickley et al., 2016; Storch & Masia-Warner, 2004; Vanhalst et al., 2014), this survey showed that several social-emotional factors, including anxiety induced sleep disturbance, having no close friends, physically attacked and in unadjusted analysis involvement in physical fighting were associated with loneliness. In a review, Chorney et al. (2008, p. 339) found that there is “a significant symptom overlap between anxiety, depression, and sleep” among children and adolescents. Students exposed to interpersonal violence victimization (being bullied and being physically attacked) in this study may worry about further or future victimization increasing their loneliness. León-Moreno et al. (2019) showed that “most victimized students showed greater motivation for revenge and avoidance, as well as a greater perception of emotional loneliness.”

Several contextual factors (parental emotional neglect, among boys daily exposure to passive smoking, and among girls, frequently experiencing hunger or food insecurity and low peer support and in unadjusted analysis poor parental support, and school truancy) were found associated with loneliness. These results are consistent with various previous investigations (Murphy & Shevlin, 2012; Peltzer & Pengpid, 2017; Schwartz-Mette et al., 2020; Stickley et al., 2016). These results may be explained by the situational theory of loneliness (Weiss, 1973), which posits that “loneliness is a response to a deficit or absence of relational provisions with attachment figures or peers.” (Mahon et al., 2006, p. 313). This may explain why greater parental emotional neglect, poorer parental and lower peer support found among adolescents in this study increased the odds for loneliness. Findings call for programmes improving peer and parental support and addressing food insecurity.

In terms of health risk behaviours, having experienced multiple serious injuries, no fruit and vegetable intake, and among girls trouble from drinking alcohol and high leisure-time sedentary behaviour (≥5 hrs/day) increased the odds for loneliness. In addition, in unadjusted analysis, current tobacco use, not attending physical education classes and frequent soft drink consumption (≥3 drinks/day) increased the likelihood of having loneliness. These findings concur with previous studies among adolescents (Głąbska et al., 2020; Pinto et al., 2019; Vancampfort et al., 2019). Loneliness is a component of depression, and there is evidence that sedentary behaviour may lead to negative mood or depression (Farren et al., 2018; Vancampfort et al., 2019). In addition, sedentary behaviour in this adolescent population is likely to include social media use, which can lead to social isolation (Firth et al., 2019). Past 12 month, frequent serious injury was associated with a higher likelihood of loneliness. It is possible that by virtue of experiencing physical injuries, socialization activities may decrease and social isolation may increase. Possible reasons for the protective effect of fruit and vegetable consumption against loneliness may lie in the antioxidant and anti-inflammatory components of fruit and vegetables enhancing well-being (Hong & Peltzer, 2017; M. W. Liu et al., 2020). The possible association between not attending physical education and loneliness has also been found in a study among adolescents in Brazil (Santos et al., 2020), and may be attributed to lower socializing experiences when not attending physical education classes.

Study limitations

This investigation was limited because of its cross-sectional design, the self-report of the data, and the inclusion of only school adolescents. An additional limitation was that the GSHS in Trinidad and Tobago, Jamaica, Dominican Republic and Suriname only assessed loneliness with one item and did not assess help seeking behaviours for loneliness. However, in a previous study (Eccles et al., 2020, p. 1), “Pearson’s correlation analysis demonstrated a significant and positive relationship between scores on the single- and multi-item measure of loneliness (r = 0.622, p < 0.001)”.

Conclusion

The study showed among in-school nationally representative adolescents in four Caribbean countries that almost one in six students reported loneliness. Several risk factors, including female sex, having no close friends, older age, anxiety induced sleep disturbance, frequent bullying victimization (≥3 days/month), having been physically attacked, parental emotional neglect, having sustained multiple serious injuries (past year) and not eating fruit and vegetables, and among boys, daily exposure to passive smoking, and being from Suriname, and among girls, frequent experience of hunger, low peer support, trouble from drinking alcohol and high leisure-time sedentary behaviour (≥8 hrs/day) were identified for loneliness, which can help in guiding intervention programmes to prevent and control loneliness in this adolescent school population. It is important that parents and teachers identify loneliness early to prevent negative social, health and academic consequences. Therefore, health education about loneliness should be instituted for parents and teachers, and school programmes may want to involve programmes, such as social skills and social support building, to reduce loneliness among adolescents.

Supplemental Material

sj-pdf-1-prx-10.1177_0033294120968502 - Supplemental material for Prevalence and Associated Factors of Loneliness Among National Samples of In-School Adolescents in Four Caribbean Countries

Supplemental material, sj-pdf-1-prx-10.1177_0033294120968502 for Prevalence and Associated Factors of Loneliness Among National Samples of In-School Adolescents in Four Caribbean Countries by Supa Pengpid and Karl Peltzer in Psychological Reports

Footnotes

Acknowledgment

The data source, the “World Health Organization NCD Microdata Repository (URL: )”, is hereby acknowledged.

Article Notes

ORCID iD

Karl Peltzer

Supplemental Material

Supplemental material for this article is available online.

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