Social anxiety symptoms and suicidal ideation in a clinical sample of early adolescents: Examining loneliness and social support as longitudinal mediators
Open accessAbstract
Recent research has shown that social anxiety may be related to increased risk for suicidal ideation in teens, although this research largely has been cross-sectional and has not examined potential mediators of this relationship. A clinical sample of 144 early adolescents (72 % female; 12-15 years old) was assessed during psychiatric inpatient hospitalization and followed up at 9 and 18 months post-baseline. Symptoms of social anxiety, depression, suicidal ideation, loneliness, and perceived social support were assessed via structured interviews and self-report instruments. Structural equation modeling revealed a significant direct relationship between social anxiety symptoms at baseline and suicidal ideation at 18 months post-baseline, even after controlling for baseline depressive symptoms and ideation. A second multiple mediation model revealed that baseline social anxiety had a significant indirect effect on suicidal ideation at 18 months post-baseline through loneliness at 9 months post-baseline. Social anxiety did not have a significant indirect effect on suicidal ideation through perceived social support from either parents or close friends. Findings suggest that loneliness may be particularly implicated in the relationship between social anxiety and suicidality in teens. Clinicians should assess and address feelings of loneliness when treating socially anxious adolescents.
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Of the three studies with four results that recruited exclusively from psychiatric inpatient populations, only Gallagher et al. (2014, T2-T3) found that loneliness was a significant predictor of later SIB.
“Of the three studies (4 results) which recruited exclusively from psychiatric inpatient populations only Gallagher et al. (2014, T2-T3) found that loneliness was a significant predictor of later SIB.”
From Loneliness as a predictor of suicidal ideation and behaviour: a systematic review and meta-analysis of prospective studies (2020) · cites this paper as Gallagher et al. (2014, T2-T3)
In the Gallagher et al. (2014) study, loneliness did not predict suicidal ideation 18 months later in unadjusted analysis.
“Unadjusted: Loneliness did not predict suicidal ideation 18 months later.”
From Loneliness as a predictor of suicidal ideation and behaviour: a systematic review and meta-analysis of prospective studies (2020) · cites this paper as Gallagher et al. (2014; T2- T3)
In the Gallagher et al. (2014) study, loneliness significantly predicted suicidal ideation 9 months later in unadjusted analysis (p<0.05).
“Unadjusted: Loneliness significantly predicted suicidal ideation 9 months later (p<0.05)”
From Loneliness as a predictor of suicidal ideation and behaviour: a systematic review and meta-analysis of prospective studies (2020) · cites this paper as Gallagher et al. (2014; T1- T3)
The association between loneliness and suicidality supports the theory that thwarted belongingness and perceived burdensomeness are major determinants of suicidality.
“The association between loneliness and suicidality supports the theory [32] that thwarted belongingness and perceived burdensomeness are major determinants of suicidality (see also [33]).”
From Loneliness in the general population: prevalence, determinants and relations to mental health (2017) · cites this paper as [33]
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“Loneliness is associated with feelings of hopelessness in adolescents (Page 1991), and a domain-specific form of social hopelessness has been linked to suicidal ideation in young adults (Heisel et al. 2011).”
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“The Present Study Prior research suggests that socially anxious adolescents are at increased risk for suicidal thoughts and behaviors (Nelson et al. 2000; Valentiner et al. 2002).”
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“Research has shown that feelings of loneliness are highest during adolescence (Perlman and Landolt 1999), and that socially anxious teens report even greater feelings of loneliness than non-anxious teens (e.g., Beidel et al. 2007).”
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ResultLoneliness in Late Adolescence: A Social Skills Training Study
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BackgroundConstruct validity of cognitive-behavioral treatments for intimate and social loneliness
McWhirter, B. T., & Horan, J. J. (1996) · Current Psychology · doi:10.1007/bf02686933 · Cited by 34 · cited 1× · see citing works
“Both social skills training and loneliness-focused cognitive behavioral therapy have been shown to reduce feelings of loneliness in teens (Adams et al. 1988; McWhirter and Horan 1996), and practitioners may find it helpful to employ these techniques with socially anxious adolescents.”
BackgroundParent-Child Relationships and Suicidal Ideation in French-Canadian Adolescents
Man, A. F. D., Labrèche-Gauthier, L., & Leduc, C. P. (1993) · The Journal of Genetic Psychology · doi:10.1080/00221325.1993.9914717 · Cited by 33 · cited 1× · see citing works
“…that adolescent ideation and attempts are negatively associated with perceptions of family-related support and connectedness (Czyz et al. 2012; Eskin et al. 2007; Kerr et al. 2006; Yuen et al. 1996), particularly with perceptions of parental support (Babiss and Gangwisch 2009; De Man et al. 1993).”
BackgroundLoneliness as a risk factor in adolescent hopelessness
Page, R. M. (1991) · Journal of Research in Personality · doi:10.1016/0092-6566(91)90014-h · Cited by 27 · cited 2× · see citing works
“Loneliness is associated with feelings of hopelessness in adolescents (Page 1991), and a domain-specific form of social hopelessness has been linked to suicidal ideation in young adults (Heisel et al. 2011).”
BackgroundFollow-up studies of child and adolescent suicide attempters
Boergers, J., & Spirito, A. (2003) · Cambridge University Press eBooks · doi:10.1017/cbo9780511550423.013 · Cited by 23 · cited 1× · see citing works
“%) took part in the final assessment, a retention rate that is consistent with previous longitudinal studies of adolescent suicide ideators and attempters (see Boergers and Spirito 2003, for a review).”
ResultSelf-citationClinical presentation of social anxiety disorder in adolescents and young adults.
Mesa, F., Nieves, M. M., & Beidel, D. C. (2011) · American Psychological Association eBooks · doi:10.1037/12315-001 · Cited by 20 · cited 1× · see citing works
“Characterized by a fear of social situations, social anxiety disorder involves physical symptoms such as blushing and trembling, cognitive symptoms such as worry and negative self-evaluation, and a pattern of behavioral avoidance (Mesa et al. 2011).”
Background
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Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research
Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., Musacchio, K. M., Jaroszewski, A. C., Chang, B. P., & Nock, M. K. (2017) · Psychological Bulletin · doi:10.1037/bul0000084 · Cited by 3,784 · see citing works
Loneliness in the general population: prevalence, determinants and relations to mental health
Beutel, M. E., Klein, E. M., Brähler, E., Reiner, I., Jünger, C., Michal, M., Wiltink, J., Wild, P. S., Münzel, T., Lackner, K. J., et al. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1262-x · Cited by 1,223 · see citing works
“The association between loneliness and suicidality supports the theory [32] that thwarted belongingness and perceived burdensomeness are major determinants of suicidality (see also [33]).”
BackgroundRueger, S. Y., Malecki, C. K., Pyun, Y., Aycock, C., & Coyle, S. (2016) · Psychological Bulletin · doi:10.1037/bul0000058 · Cited by 946 · see citing works
Annual Research Review: Suicide among youth – epidemiology, (potential) etiology, and treatment
Cha, C. B., Franz, P. J., M. Guzmán, E., Glenn, C. R., Kleiman, E. M., & Nock, M. K. (2018) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12831 · Cited by 602 · see citing works
“…select cases where loneliness plays a more central role, such as mediating the relationship between social anxiety and subsequent suicidal ideation during adolescence (Gallagher et al., 2014), or the prediction of suicide attempt later in life, specifically early adulthood (Johnson et al., 2002).”
BackgroundMcClelland, H., Evans, J. J., Nowland, R., Ferguson, E., & O'Connor, R. C. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.05.004 · Cited by 466 · see citing works
“participants (Fulginiti et al, 2018; Gallagher et al. 2014; Hom et al. 2019; Joiner and Rudd, 1996; Kleiman et al., 2017 Study 1; Kleiman et al., 2017, Study 2; Pietrzak et al., 2017; Schinka et al., 2013) while Salzinger (2007) recruited predominantly Hispanic participants (54%).”
BackgroundBentley, K. H., Franklin, J. C., Ribeiro, J. D., Kleiman, E. M., Fox, K. R., & Nock, M. K. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.11.008 · Cited by 422 · see citing works
Christina, S., Magson, N. R., Kakar, V., & Rapee, R. M. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.101979 · Cited by 251 · see citing works
Jiang, S., Ren, Q., Jiang, C., & Wang, L. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.08.085 · Cited by 219 · see citing works
Maes, M., Nelemans, S. A., Danneel, S., Fernández-Castilla, B., Van den Noortgate, W., Goossens, L., & Vanhalst, J. (2019) · Developmental Psychology · doi:10.1037/dev0000719 · Cited by 207 · see citing works
Supportive Peer Relationships and Mental Health in Adolescence: An Integrative Review
Roach, A. (2018) · Issues in Mental Health Nursing · doi:10.1080/01612840.2018.1496498 · Cited by 203 · see citing works
“Researchers in three studies assessed participants from inpatient hospital settings (Czyz et al., 2012; Gallagher et al., 2014; Miller et al., 2015).”
BackgroundMethodInfluentialEsmaeelzadeh, S., Moraros, J., Thorpe, L. U., & Bird, Y. (2018) · Journal of Clinical Medicine · doi:10.3390/jcm7120543 · Cited by 187 · see citing works
“Adolescents and young adults with mental health disorders are at an increased risk of many negative health and social outcomes including self-harm and suicide [11], poor academic performance [12], and involvement in risky behaviors and poor sexual health [13].”
BackgroundDanneel, S., Nelemans, S., Spithoven, A., Bastin, M., Bijttebier, P., Colpin, H., Van Den Noortgate, W., Van Leeuwen, K., Verschueren, K., & Goossens, L. (2019) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-019-00539-0 · Cited by 145 · see citing works
Academic stress and academic burnout in adolescents: a moderated mediating model
Gao, X. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1133706 · Cited by 144 · see citing works
“Adolescents, especially junior high school students, as a group just entering adolescence, have significant and rapid development and transition in psychological functioning (Gallagher et al., 2014).”
BackgroundAssociation between insufficient sleep and suicidal ideation among adolescents
Baiden, P., Tadeo, S. K., Tonui, B. C., Seastrunk, J. D., & Boateng, G. O. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.112579 · Cited by 80 · see citing works
Baiden, P., Graaf, G., Zaami, M., Acolatse, C. K., & Adeku, Y. (2019) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2019.02.018 · Cited by 77 · see citing works
Cyberbullying victimization and suicide ideation: A crumbled belief in a just world
Bai, Q., Huang, S., Hsueh, F.-H., & Zhang, T. (2021) · Computers in Human Behavior · doi:10.1016/j.chb.2021.106679 · Cited by 70 · see citing works
Hill, R. M., del Busto, C. T., Buitron, V., & Pettit, J. W. (2018) · Archives of Suicide Research · doi:10.1080/13811118.2018.1427163 · Cited by 63 · see citing works
Family environment as a moderator of the association between anxiety and suicidal ideation
Machell, K. A., Rallis, B. A., & Esposito-Smythers, C. L. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.03.002 · Cited by 62 · see citing works
“In another study conducted with a clinical sample of psychiatrically hospitalized adolescents, loneliness was found to mediate the relationship between social anxiety and SI [10].”
BackgroundPearce, E., Myles-Hooton, P., Johnson, S., Hards, E., Olsen, S., Clisu, D., Pais, S. M. A., Chesters, H. A., Shah, S., Jerwood, G., et al. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01740-w · Cited by 53 · see citing works
“In a clinical sample of adolescents, loneliness measured at 9 months postbaseline was found to mediate an indirect relationship between baseline social anxiety and suicidal ideation measured at 18 months post-baseline [7].”
BackgroundCross-Cultural Differences in the Use of Online Mental Health Support Forums
Pendse, S. R., Niederhoffer, K. G., & Sharma, A. (2019) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3359169 · Cited by 60 · see citing works
“Feeling isolated and alone is a common symptom of mental illness [18, 28, 39], and design choices that cause minority groups to feel otherized could only serve to exacerbate symptoms.”
BackgroundSuicidality in subjects with anxiety or obsessive-compulsive and related disorders: recent advances
De La Vega, D., Giner, L., & Courtet, P. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0885-z · Cited by 60 · see citing works
Houghton, S., Hattie, J., Carroll, A., Wood, L., & Baffour, B. (2016) · Journal of Psychologists and Counsellors in Schools · doi:10.1017/jgc.2016.1 · Cited by 53 · see citing works
“Although loneliness is to be expected during adolescence, in up to 30% of individuals it can become chronic and in some cases pathological (Heinrich & Gullone, 2006), and for some young people it can lead to suicidal behaviour (Gallagher et al., 2014).”
BackgroundThe role of family and computer-mediated communication in adolescent loneliness
Favotto, L., Michaelson, V., Pickett, W., & Davison, C. (2019) · PLOS ONE · doi:10.1371/journal.pone.0214617 · Cited by 54 · see citing works
Oppenheimer, C. W., Silk, J. S., Lee, K. H., Dahl, R. E., Forbes, E., Ryan, N., & Ladouceur, C. D. (2020) · Child Psychiatry & Human Development · doi:10.1007/s10578-019-00920-6 · Cited by 55 · see citing works
The relationship between chronic diseases and mental health: A cross-sectional study
Huang, Y., Loux, T. M., Huang, X., & Feng, X. (2023) · Mental Health & Prevention · doi:10.1016/j.mhp.2023.200307 · Cited by 54 · see citing works
Social Anxiety and Suicidality in Youth: A Systematic Review and Meta-analysis
Leigh, E., Chiu, K., & Ballard, E. D. (2023) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-022-00996-0 · Cited by 51 · see citing works
Pitman, A., Marston, L., Lewis, G., Semlyen, J. K., McManus, S., & King, M. (2021) · Psychological Medicine · doi:10.1017/s0033291721000052 · Cited by 51 · see citing works
“…sexual groups are not well understood, but candidate contributors include substance misuse (Blosnich et al. 2014), parental disapproval (Bouris et al. 2010; Russell and Fish, 2016), loneliness (Gallagher et al. 2014; Westefeld et al. 2001), and discrimination (Government Equalities Office, 2018).”
BackgroundSuicidal ideation among Lebanese adults: scale validation and correlates
Zakhour, M., Haddad, C., Sacre, H., Fares, K., Akel, M., Obeïd, S., Salameh, P., & Hallit, S. R. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03111-7 · Cited by 50 · see citing works
“Also, social anxiety was seen as an indicator of suicidal ideation, as addressing the feeling of loneliness and low perception of social support may increase suicidal ideation and attempts [19].”
BackgroundDuan, W.-J., & Ho, S. M. (2018) · Journal of Happiness Studies · doi:10.1007/s10902-017-9864-z · Cited by 41 · see citing works
Rapp, A. M., Lau, A. S., & Chavira, D. A. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.09.009 · Cited by 44 · see citing works
Reta, Y., Ayalew, M., Yeneabat, T., & Bedaso, A. (2020) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s235416 · Cited by 42 · see citing works
“Social phobia is associated with significant impairment in educational achievement, occupational performance, social interaction, relationships, and quality of life that leads to decrease achievement, lower-income and reduce individuals’ quality of life.(9,24) Medical and health science students are often confronted w…”
BackgroundMyhr, A., Anthun, K. S., Lillefjell, M., & Sund, E. R. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01472 · Cited by 43 · see citing works
“Children and adolescents who experience loneliness are often also at risk for anxiety and suicidality (Gallagher et al., 2014; Junker et al., 2017).”
BackgroundFadiji, A. W., Yendork, J. S., & Somhlaba, N. Z. (2016) · Child Indicators Research · doi:10.1007/s12187-016-9367-1 · Cited by 40 · see citing works
“Within adolescent research, social support has been found to reduce both the effects of bullying on psychological health (Owusu et al. 2011; Rigby 2000) and the propensity for engaging in suicidal behaviours (Gallagher et al. 2014; Rigby and Slee 1999).”
BackgroundThe experience of the self in Canadian youth living with anxiety: A qualitative study
Woodgate, R. L., Tailor, K., Tennent, P., Wener, P. F., & Altman, G. (2020) · PLoS ONE · doi:10.1371/journal.pone.0228193 · Cited by 40 · see citing works
“Anxiety-affected youth also tend to be at greater risk for suicidal ideation and behaviour than their peers without an anxiety diagnosis [7].”
BackgroundCai, H. X., Chow, I. H. I., Lei, S., Lok, K.-I., Su, Z., Cheung, T. C. C., Peshkovskaya, A. G., Tang, Y., Jackson, T., Ungvari, G. S., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.093 · Cited by 41 · see citing works
Cannabis use and suicidal ideations in high-school students
Chabrol, H., Melioli, T., & Goutaudier, N. (2014) · Addictive Behaviors · doi:10.1016/j.addbeh.2014.06.008 · Cited by 39 · see citing works
Suicide risk around the world: a meta-analysis of longitudinal studies
Guzmán, E. M., Cha, C. B., Ribeiro, J. D., & Franklin, J. C. (2019) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-019-01759-x · Cited by 39 · see citing works
Orkibi, H., Azoulay, B., Snir, S., & Regev, D. (2017) · Clinical Psychology and Psychotherapy · doi:10.1002/cpp.2103 · Cited by 37 · see citing works
Theory of mind and suicide ideation and attempt in adolescent inpatients
Hatkevich, C. E., Venta, A. C., & Sharp, C. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.05.051 · Cited by 37 · see citing works
“Taken together, suicide ideation and attempt represent major public health problems in adolescence, associated with a number of severe psychosocial and affective outcomes (e.g., shame, loneliness, acquired capability for suicide; Gallagher et al., 2014; Kene and Hovey, 2014; Wiklander et al., 2003).”
BackgroundZaboski, B. A., Gilbert, A., Hamblin, R. J., Andrews, J., Ramos, A., Nadeau, J. M., & Storch, E. A. (2019) · Bulletin of the Menninger Clinic · doi:10.1521/bumc_2019_83_03 · Cited by 36 · see citing works
Coyle, S., & Malecki, C. K. (2018) · School Psychology Review · doi:10.17105/spr-2017-0067.v47-3 · Cited by 37 · see citing works
Reciprocal Relationships between Trajectories of Loneliness and Screen Media Use during Adolescence
Lawrence, D. M., Hunter, S. C., Cunneen, R., Houghton, S. J., Zadow, C., Rosenberg, M., Wood, L. J., & Shilton, T. (2021) · Journal of Child and Family Studies · doi:10.1007/s10826-021-02066-3 · Cited by 36 · see citing works
Beshārat, M. A., Atari, M., & Mirjalili, R. S. (2019) · Practice in Clinical Psychology · doi:10.32598/jpcp.7.4.281 · Cited by 34 · see citing works
Zentner, K., Lee, H., Dueck, B. S., & Masuda, T. (2022) · Current Psychology · doi:10.1007/s12144-022-03116-9 · Cited by 37 · see citing works
“People with severe social anxiety are at an increased risk for other mental health problems, such as depression, substance abuse, eating disorders and suicidal ideation (Gallagher et al., 2014).”
BackgroundSuicidal Plans and Attempts Among Adolescents in Mongolia
Davaasambuu, S., Batbaatar, S., Witte, S. S., Hamid, P., Oquendo, M. A., Kleinman, M., Olivares, M., & Gould, M. S. (2017) · Crisis · doi:10.1027/0227-5910/a000447 · Cited by 34 · see citing works
Association Between Loneliness and Suicidal Behaviour: A Scoping Review
Saeed, F., Gürcan, A., Shoib, S., Amanda, T. W., Ransing, R. S., Bhandarı, S. S., Armiya’u, A. Y., & Chandradasa, M. (2023) · Turkish Journal of Psychiatry · doi:10.5080/u27080 · Cited by 40 · see citing works
Wu, D., Liu, M., Li, D., & Yin, H. (2024) · Journal of Adolescence · doi:10.1002/jad.12309 · Cited by 35 · see citing works
Devenish, B. D., Berk, L., & Lewis, A. J. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415627374 · Cited by 32 · see citing works
“Social support is a known protective factor for suicidality in adolescents, and increasing social support for adolescents has been shown to decrease suicidality (Babiss and Gangwisch, 2009; Brausch and Decker, 2013; Gallagher et al., 2014; Ystgaard et al., 2009).”
Wang, Q., Hu, W., Ouyang, X., Chen, H., Qi, Y., & Jiang, Y. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.105272 · Cited by 31 · see citing works
Xu, L., & Li, L. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1430539 · Cited by 31 · see citing works
Stress, Anxiety, and School Burnout Post COVID ‐19: A Study of French Adolescents
Simoës‐Perlant, A., Barreau, M., & Vezilier, C. (2022) · Mind Brain and Education · doi:10.1111/mbe.12346 · Cited by 31 · see citing works
Panayiotou, G., Panteli, M., & Theodorou, M. (2016) · Psychology Community & Health · doi:10.5964/pch.v5i1.142 · Cited by 29 · see citing works
A study on the association of psychiatric diagnoses and childhood adversities with suicide risk
Salokangas, R. K. R., Luutonen, S. H., Heinimaa, M., From, T., & Hietala, J. A. (2019) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2018.1493748 · Cited by 31 · see citing works
Perceived burdensomeness uniquely accounts for suicidal ideation severity in social anxiety disorder
Duffy, M. E., Mueller, N. E., Cougle, J. R., & Joiner, T. E. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.116 · Cited by 28 · see citing works
Baiden, P., den Dunnen, W., & Fallon, B. (2016) · Social Indicators Research · doi:10.1007/s11205-015-1224-y · Cited by 28 · see citing works
“Similar results have also been 143 found by Gallagher et al. (2014) in a clinical sample of adolescents with suicidal ideation.”
ResultCrawford, E. A., Burke, T. A., Siegel, D., Jager‐Hyman, S., Alloy, L. B., & Kendall, P. C. (2018) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12479 · Cited by 28 · see citing works
Dat, N. T., Mitsui, N., Asakura, S., Watanabe, S., Takanobu, K., Fujii, Y., Toyoshima, K., Kako, Y., & Kusumi, I. (2021) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2021.100192 · Cited by 28 · see citing works
Baldini, V., Gnazzo, M., Varallo, G., Vincenzo, M. D., Scorza, M., Franceschini, C., Ronchi, D. D., Fiorillo, A., & Plazzi, G. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1612067 · Cited by 26 · see citing works
Seo, E. H., Yang, H.-J., Kim, S.-G., & Yoon, H. (2022) · Annals of General Psychiatry · doi:10.1186/s12991-022-00399-x · Cited by 26 · see citing works
“Previous epidemiological studies showed that social anxiety disorder (SAD) symptoms were associated with increased risk of suicidality [48, 49].”
BackgroundDifferences in suicide risk severity among suicidal youth with anxiety disorders
Herres, J., Shearer, A., Kodish, T., Kim, B., Wang, S. B., & Diamond, G. S. (2019) · Crisis · doi:10.1027/0227-5910/a000571 · Cited by 25 · see citing works
“Youth with SAD are likely to experience particular problems forming and maintaining interpersonal relationships, which may lead to feelings of loneliness and a poor sense of belonging (Gallagher et al., 2014).”
BackgroundWeymouth, B. B., & Buehler, C. (2018) · Journal of family psychology · doi:10.1037/fam0000396 · Cited by 24 · see citing works
Buissonnière-Ariza, V. L., Schneider, S. C., Cepeda, S. L., Wood, J. J., Kendall, P. C., Small, B. J., Wood, K. S., Kerns, C. M., Saxena, K., & Storch, E. A. (2021) · Child Psychiatry & Human Development · doi:10.1007/s10578-020-01114-1 · Cited by 25 · see citing works
Núñez, D. E., Monjes, P., Campos, S., & Wigman, J. T. W. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.552343 · Cited by 24 · see citing works
“Overall, our findings highlight the need of further research examining the prominent role of loneliness and its relationships with social anxiety and PE, which are regarded as potential predictors of suicidal behavior (75) in school-based sample of adolescents (76), early adolescent patients (77), and young adults wit…”
BackgroundNúñez, D. E., Fresno, A., van Borkulo, C. D., Courtet, P., Arias, V. B., Garrido, V. V., & Wigman, J. T. W. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.05.020 · Cited by 23 · see citing works
Ciavolino, E., Ferrante, L., Sternativo, G. A., Cheah, J., Rollo, S., Marinaci, T., & Venuleo, C. (2021) · Behaviormetrika · doi:10.1007/s41237-021-00151-x · Cited by 23 · see citing works
“2001), suicide (Davidson et al. 2011; Gallagher et al. 2014), substance abuse (Buckner et al.”
BackgroundYang, Y., & Xiao-zhou, L. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.836461 · Cited by 22 · see citing works
Liang, Y., Huebner, E. S., & Tian, L. (2022) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-022-01993-w · Cited by 22 · see citing works
“Notably, although the differences were only statistically significant at Time 5, the frequencies of suicidal ideation were higher at each time point among youth in the moderate with predominant loneliness and depressive symptoms group than those in the congruent-high group, which may reflect that loneliness and depres…”
BackgroundResultYang, T., He, Y., Wu, L., Ren, L., Lin, J., Wang, C., Wu, S., & Liu, X. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e20938 · Cited by 21 · see citing works
Loneliness as Moderator Between Trauma and Posttraumatic Growth
Zeligman, M. R., Bialo, J. A., Brack, J. L., & Kearney, M. A. (2017) · Journal of Counseling & Development · doi:10.1002/jcad.12158 · Cited by 22 · see citing works
Chiu, K., Stringaris, A. K., & Leigh, E. (2024) · JCPP Advances · doi:10.1002/jcv2.12249 · Cited by 22 · see citing works
“…(Kessler et al., 2005) and is associated with multiple adverse outcomes during adolescence, such as poorer social functioning (Chiu et al., 2021), poorer academic performance (Leigh et al., 2021a), suicidal ideation (Gallagher et al., 2014), and depressive symptoms (Hamilton et al., 2016).”
InfluentialPilkionienė, I., Širvinskienė, G., Žemaitienė, N., & Jonynienė, J. (2021) · Children · doi:10.3390/children8090737 · Cited by 21 · see citing works
“SA was also associated with adolescent suicide risk [12,13].”
BackgroundLewis, K. C., Roche, M. J., Brown, F., & Tillman, J. G. (2022) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12922 · Cited by 19 · see citing works
Wang, J.-A., Wang, H., Cao, B., Lei, X., & Long, C. (2024) · Journal of Youth and Adolescence · doi:10.1007/s10964-024-01977-w · Cited by 21 · see citing works
Suveg, C. M., Kingery, J. N., Davis, M., Jones, A., Whitehead, M., & Jacob, M. L. (2017) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2017.10.005 · Cited by 19 · see citing works
The Feasibility and Acceptability of LISTEN for Loneliness
Theeke, L. A., Mallow, J. A., Barnes, E. R., & Theeke, E. (2015) · Open Journal of Nursing · doi:10.4236/ojn.2015.55045 · Cited by 20 · see citing works
Hunter, S. C., Seth, R., Houghton, S. J., Lawrence, D. M., Zadow, C., Rosenberg, M., Wood, L. J., Qualter, P., & Shilton, T. (2023) · Journal of Youth and Adolescence · doi:10.1007/s10964-023-01925-0 · Cited by 15 · see citing works
“Loneliness in adolescence is a known risk factor for anxiety (Maes et al., 2019), depression (Fontaine et al., 2009; Lasgaard et al., 2011), suicidal ideation (Gallagher et al., 2014) and diminished positive mental health (Lyyra et al., 2021).”
BackgroundBaiden, P., Jahan, N., Mets, V. E., & Adeku, Y. (2021) · Current Psychology · doi:10.1007/s12144-021-02328-9 · Cited by 16 · see citing works
Jin, Y., Kieslich, K., Hall, A., & Pitman, A. (2025) · Archives of Suicide Research · doi:10.1080/13811118.2025.2489159 · Cited by 14 · see citing works
“Two studies using non-representative samples reported an association between loneliness and suicidal ideation in the US (Gallagher et al., 2014; Schinka et al., 2013) contrasting with non-representative studies reporting no association with suicidal ideation or suicide attempt in the US (Fulginiti…”
Tan, Y., Deng, J., Zhang, D., Peng, C., & Peng, A. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1337577 · Cited by 14 · see citing works
Deng, J., Liu, J., Luo, J., Pi, Y., Pan, J., Fu, Z., & Tang, X. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.107052 · Cited by 14 · see citing works
Wang, Z., Li, C., Xie, Z., & Hong, O. (2024) · Child Care Health and Development · doi:10.1111/cch.70005 · Cited by 14 · see citing works
'I Don't have the Best Life': A Qualitative Exploration of Adolescent Loneliness
Martin, K. (2014) · Journal of Child and Adolescent Behaviour · doi:10.4172/2375-4494.1000169 · Cited by 14 · see citing works
“Loneliness is considered a significant contributor to adolescent suicidality [4,5], and mental illnesses such as depression [4,6] and self-harm [7].”
BackgroundRisk profile of young people admitted to hospital for suicidal behaviour in Melbourne, Australia
Borschmann, R., Stark, P., Prakash, C., & Sawyer, S. M. (2018) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.13938 · Cited by 14 · see citing works
Chung, M., Forstner, A. J., Mücke, M., Geiser, F., Schumacher, J., & Conrad, R. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.11.017 · Cited by 14 · see citing works
Goodfellow, C., Willis, M., Inchley, J., Kharicha, K., Leyland, A. H., Qualter, P., Simpson, S. A., & Long, E. (2023) · British Journal of Educational Psychology · doi:10.1111/bjep.12581 · Cited by 13 · see citing works
“…et al., 2015; Public Health England, 2015), we do know that loneliness in adolescence is a risk factor for anxiety (Maes et al., 2019), depression (Fontaine et al., 2009; Lasgaard et al., 2011), suicidal ideation (Gallagher et al., 2014) and diminished positive mental health (Lyyra et al., 2021).”
BackgroundDizon, J. I. W. T., & Mendoza, N. B. (2022) · Archives of Suicide Research · doi:10.1080/13811118.2021.2022050 · Cited by 13 · see citing works
“, 2011), anxiety (Gallagher et al., 2014; Sareen et al., 2005), stress (Buitron et al.”
BackgroundSekowski, M. M., Gambin, M., & Sharp, C. (2021) · Journal of Personality Disorders · doi:10.1521/pedi_2021_35_501 · Cited by 15 · see citing works
Huang, Y., & Loux, T. M. (2023) · Mental Health & Prevention · doi:10.1016/j.mhp.2023.200302 · Cited by 14 · see citing works
Social anxiety and interpersonal risk for suicidal ideation: A longitudinal daily diary analysis
Brown, B. A., Rottenberg, J. A., & Goodman, F. R. (2023) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12996 · Cited by 11 · see citing works
Kushibiki, N., Aiba, M., Midorikawa, H., Komura, K., Sugawara, D., Shiratori, Y., Kawakami, N., Ogawa, T., Yaguchi, C., & Tachikawa, H. (2024) · PLoS ONE · doi:10.1371/journal.pone.0300401 · Cited by 13 · see citing works
The existence of manual mode increases human blame for AI mistakes
Arnestad, M. N., Meyers, S., Gray, K. J., & Bigman, Y. (2024) · Cognition · doi:10.1016/j.cognition.2024.105931 · Cited by 11 · see citing works
Fu, Y., & Zhou, X. (2022) · Child & Family Social Work · doi:10.1111/cfs.12899 · Cited by 11 · see citing works
Association Between Social Phobia and Parenting Styles Among Secondary School Students
Abdallah, E. S. (2016) · American Journal of Nursing Science · doi:10.11648/j.ajns.20160503.14 · Cited by 11 · see citing works
“[7].”
Yani, D. I., Chua, J. Y. X., Wong, J. C. M., Pikkarainen, M. A., & Shorey, S. (2024) · International Journal of Mental Health Nursing · doi:10.1111/inm.13494 · Cited by 10 · see citing works
Moller, C. I., Badcock, P. B., Hetrick, S. E., Rice, S., Berk, M., Witt, K., Chanen, A. M., Dean, O. M., Gao, C. X., Cotton, S., et al. (2023) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674221144262 · Cited by 10 · see citing works
“Factors such as negative social interactions (Lebowitz et al., 2019), somatisation (Lee et al., 2022) and loneliness (Gallagher et al., 2014) might play important roles and could directly inform intervention targets aimed at reducing SI.”
BackgroundYudes, C., Chamizo‐Nieto, M. T., Peláez-Fernández, M. Á., & Extremera, N. (2024) · Scandinavian Journal of Psychology · doi:10.1111/sjop.13072 · Cited by 9 · see citing works
“Future research testing these moderation models in control and clinical adolescent samples would be needed to examine the extent of this source of support (Gallagher, Prinstein, Simon & Spirito, 2017).”
Chandrasekhar, J. L., Bowen, A. E., Heberlein, E., Pyle, E., Studts, C. R., Simon, S. L., Shomaker, L. B., & Kaar, J. L. (2023) · Community Mental Health Journal · doi:10.1007/s10597-023-01090-5 · Cited by 9 · see citing works
“, 2019), loneliness (Gallagher et al., 2014; Zygo et al., 2019), relational conflicts (Randell et al.”
BackgroundSuicidal Ideation in Adolescents—A Transcultural Analysis
Rozanov, V. A., & Станиславовна, Р. А. (2017) · Springer eBooks · doi:10.1007/978-981-10-4816-6_15 · Cited by 9 · see citing works
Parallel computation of a domain decomposition method
Chin, R. C. Y., Hedstrom, G. W., Scroggs, J. S., & Sorensen, D. C. (1987) · OSTI OAI (U.S. Department of Energy Office of Scientific and Technical Information) · Cited by 9 · see citing works
Chen, F., Li, I. Y., Ling, C., & Zou, H. (2024) · BMC Psychology · doi:10.1186/s40359-024-02253-z · Cited by 9 · see citing works
- Authors
- Gallagher, M., Prinstein, M. J., Simon, V., & Spirito, A.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Wayne State University (US)
- Brown University (US)
- Corresponding author
- Gallagher, Michelle
- Venue
- Journal of Abnormal Child Psychology
- Published
- 2014-01-05
- Volume
- 42
- Issue
- 6
- Pages
- 871-883
- ISSN
- 0091-0627 (ISSN-L)
- 1573-2835
- PMC
- PMC5496444
- OpenAlex
- W2015309860
- Cited by
- 162
- References
- 72
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 23 · 2023: 14 · 2022: 18 · 2021: 19 · 2020: 11 · 2019: 17 · 2018: 10 · 2017: 10 · 2016: 11 · 2015: 2 · 2014: 2
- FWCI
- 9.86
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Research on Child and Adolescent Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- Centers for Disease Control and Prevention
- National Institute of Mental Health (R01MH085505, R01-MH85505, R01MH059766, R01 MH 59766)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K01HD061230)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- social anxiety, suicidal ideation, loneliness, perceived social support, early adolescents, depression, psychiatric inpatients, mediation
- MeSH terms
- Adolescent, Child, Female, Humans, Interpersonal Relations, Loneliness, Longitudinal Studies, Male, Phobic Disorders, Surveys and Questionnaires, Risk Factors, Social Support, Friends, Suicidal Ideation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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