Cited by 21Health disparities and outcomesAdolescent Health and BehaviorsChild and Adolescent Psychosocial and Emotional Development

Prevalence and factors associated with loneliness among Indonesian female adolescents: a cross-sectional study

Open access
Marthoenis, Dahlia, Nassimbwa, Jacqueline·2022·BMC Women's Health

Abstract

Background: Loneliness, or the perception of social disconnectedness, is a public health concern and is reported to be a frequent experience during adolescence (10–19 years). This study investigates the prevalence of loneliness and associated health-risk behaviors among Indonesian female adolescents. Methods: This was a cross-sectional study, data for which were extracted from the WHO’s Global School-based Student Health Survey (GSHS), which uses a globally standardized cross-sectional methodology to provide accurate data on behaviors and protective factors among students. Data from 4993 female students aged 13–17 years old from 74 schools were extracted from the 2015 survey in Indonesia and analyzed. Loneliness was used as a single measure, as happens in other studies using GSHS data. Descriptive analysis was done for age, socioemotional issues, health-risk behaviors, and contextual factors. This was followed by multiple logistic regression analysis to identify loneliness-associated factors. Results: Approximately 6.5% of Indonesian female adolescents experience loneliness most of the time or always. Adolescents experiencing loneliness had a higher rate of sleep disturbance (37.6%), suicide ideation (21%), suicide plan (20.8%), smoking behavior (15%), and alcohol use (15.7%) than the general population. Multiple regression analysis confirms that adolescents who have no close friends, have been bullied during the past month, experience sleep disturbance, have had suicide ideation and suicide plans, are always feeling hungry, are exposed to passive smoking, and are engaged in a sedentary lifestyle are at a higher likelihood of suffering from loneliness (p < 0.05). On the other hand, having kind and helpful classmates served as a useful protection against loneliness (p < 0.05). Conclusions: The rate of loneliness in Indonesian female adolescents is relatively lower than previously reported elsewhere. Several health-risk behaviors and contextual factors are associated with loneliness. It is important to gain insight into the exact interplay between factors and loneliness since that could inform future intervention development and lead to better well-being among female adolescents.

AI snapshot

Written from the paper’s full text.

TL;DR

This cross-sectional study of 4,993 Indonesian female adolescents aged 13–17 found that 6.5% reported loneliness most of the time or always. Loneliness was associated with sleep disturbance, having no close friends, bullying, suicidal ideation/plan, hunger, passive smoking, and sedentary lifestyle, while kind and helpful classmates were protective.

Key findings

  • The overall prevalence of loneliness among Indonesian female adolescents was 6.5% (323/4,993).
  • In adjusted logistic regression, higher odds of loneliness were found for sleep disturbance (AOR = 7.02, 95% CI = 4.78–10.30), no close friends (AOR = 3.80, 95% CI = 2.06–7.02), suicide plan (AOR = 2.35, 95% CI = 1.41–3.92), suicide ideation (AOR = 1.66, 95% CI = 1.01–2.74), being bullied (AOR = 1.63, 95% CI = 1.20–2.22), always feeling hungry (AOR = 2.03, 95% CI = 1.21–3.43), sedentary lifestyle (AOR = 1.53, 95% CI = 1.16–2.00), and passive smoking (AOR = 1.46, 95% CI = 1.05–2.04).
  • Having kind and helpful classmates was protective against loneliness (AOR = 0.65, 95% CI = 0.49–0.86).
  • Adolescents experiencing loneliness had higher rates of sleep disturbance (37.6%), suicide ideation (21%), suicide plan (20.8%), smoking behavior (15%), and alcohol use (15.7%) than the general population.

Methods

  • Cross-sectional analysis of data from the 2015 Indonesian Global School-based Student Health Survey (GSHS); 4,993 female students aged 13–17 years from 74 junior and senior high schools were included after excluding missing cases, with a response rate of 94% of the total GSHS population.
  • Loneliness was assessed using a single GSHS item asking how often the respondent felt lonely in the past 12 months; the paper states that “some of the time and/or always” was considered lonely, while the abstract and results describe loneliness as “most of the time or always.”
  • Descriptive analysis, Chi-square tests, and multiple logistic regression were performed using Stata.

Limitations

  • Stated: the GSHS is conducted only in schools, so findings do not represent all female adolescents in Indonesia; including out-of-school female adolescents may generate different results.
  • Stated: loneliness was used as a single-item measure and the absence of covariates has been previously reported as limiting; the cross-sectional design makes it difficult to measure causation.
  • Evident from the text: all measures come from self-reported survey items in a single wave, so recall or social-desirability bias may affect responses and temporal order cannot be established; the paper also notes that the direction of association for bullying and suicidal behavior is unclear.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s12905-022-01909-5

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

1 of 6 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured

  • Findingown data

    Adolescents who perceived that other students were kind and helpful had a lower rate of loneliness (5.1%).

    “On the other hand, a significantly lower rate was found among adolescents with parents who understood their problem (5.4%) and those who perceived that other students were kind and helpful (5.1%).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Excluding missing cases did not introduce bias into the prevalence and association estimates.
  • Findingown data

    Adolescents with parents who understood their problem had a lower rate of loneliness (5.4%).

    “On the other hand, a significantly lower rate was found among adolescents with parents who understood their problem (5.4%) and those who perceived that other students were kind and helpful (5.1%).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Excluding missing cases did not introduce bias into the prevalence and association estimates.
  • Findingown data

    Adolescents experiencing loneliness had a higher rate of sleep disturbance (37.6%) than the general population.

    “Adolescents experiencing loneliness had a higher rate of sleep disturbance (37.6%), suicide ideation (21%), suicide plan (20.8%), smoking behavior (15%), and alcohol use (15.7%) than the general population.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Excluding missing cases did not introduce bias into the prevalence and association estimates.
  • Findingown data

    Female adolescents with suicidal ideation had higher adjusted odds of loneliness (AOR = 1.66, 95% CI = 1.01-2.74) than those without suicidal ideation.

    “those with suicidal ideation were 1.6 times more likely to be lonely (AOR = 1.66, 95% CI = 1.01–2.74).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Excluding missing cases did not introduce bias into the prevalence and association estimates.
  • Findingown data

    Adolescents experiencing loneliness had a higher rate of suicide plan (20.8%) than the general population.

    “Adolescents experiencing loneliness had a higher rate of sleep disturbance (37.6%), suicide ideation (21%), suicide plan (20.8%), smoking behavior (15%), and alcohol use (15.7%) than the general population.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Excluding missing cases did not introduce bias into the prevalence and association estimates.
  • May combine two claims. 4
  • The quote only partly states this claim. 2
  • Classified as probably not a substantial claim. 8
  • May combine two claims.

    Interpretationcitation

    The prevalence of loneliness among Indonesian female adolescents is lower than that reported in ASEAN countries (7.8%), some African countries (Morocco 25.1%, Tanzania 17.4%), Latin American and Caribbean countries (14.6%), the USA (14.4%), and Russia (14.7%).

    “This finding is lower than that reported among female adolescents in ASEAN countries at 7.8% [8] and is even significantly lower than in some African countries, such as Morocco (25.1%) [6] and Tanzania (17.4%) [7]. It is also significantly lower than in the Latin American and the Caribbean countries (14.6%) [5], as well as the USA (14.4%) and Russia (14.7%) [27].”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites [8] Peltzer K, Pengpid S. Loneliness and health risk behaviors among ASEAN adolescents. Iran J Psychiatry Behav Sci. 2017;11(3):1–7. source

      Section 4.1 (page unavailable) reports that 7.8% of adolescents across seven ASEAN countries were mostly or always lonely. That figure is for the full sample, not female adolescents specifically. The other countries’ figures are attached to different citations in the citing sentence and are not judged against this source. (LLM, conf=0.90)

      Experimental — accuracy not yet measured
    • cites [6] Pengpid S, Peltzer K. Prevalence and associated factors of loneliness among a national sample of in-school adolescents in Morocco. J Psychol Afr. 2021;31(3):303–9. https://doi.org/10.1080/14330237.2021.1928918. source
    • cites [5] Sauter SR, Kim LP, Jacobsen KH. Loneliness and friendlessness among adolescents in 25 countries in Latin America and the Caribbean. Child Adolesc Ment Health. 2020;25(1):21–7. source
    • Rests on an assumption: Excluding missing cases did not introduce bias into the prevalence and association estimates.
  • The quote only partly states this claim.

    Findingown data

    Adolescents experiencing loneliness had a higher rate of suicide ideation (21%) than the general population.

    “Adolescents experiencing loneliness had a higher rate of sleep disturbance (37.6%), suicide ideation (21%), suicide plan (20.8%), smoking behavior (15%), and alcohol use (15.7%) than the general population.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Excluding missing cases did not introduce bias into the prevalence and association estimates.
  • The quote only partly states this claim.

    Findingown data

    Having kind and helpful classmates was protective against loneliness (AOR = 0.65, 95% CI = 0.49-0.86).

    “On the other hand, having kind and helpful friends was protective against loneliness (AOR = 0.65, 95% CI = 0.49–0.86).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Excluding missing cases did not introduce bias into the prevalence and association estimates.
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The GSHS applied a two-stage cluster sampling to ensure an even representation of all students in junior and senior high schools aged 13-17 years in Indonesia.

    “The GSHS applied a two-stage cluster sampling to ensure an even representation of all students in junior and senior high schools aged 13–17 years in Indonesia.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] World Health Organization (WHO). Global School-based Student Health Survey [Internet]. NCD Microdata Repository. 2016. https://extranet.who.int/ncdsmicrodata/index.php/catalog/GSHS.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The cross-sectional design makes it difficult to measure causation.

    “The cross-sectional design also makes it difficult to measure causation.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The GSHS uses a globally standardized cross-sectional methodology to provide accurate data on behaviors and protective factors among students.

    “The GSHS uses a globally standardized cross-sectional methodology to provide accurate data on behaviors and protective factors among students [21].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] World Health Organization (WHO). Global School-based Student Health Survey [Internet]. NCD Microdata Repository. 2016. https://extranet.who.int/ncdsmicrodata/index.php/catalog/GSHS.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The GSHS study in Indonesia adhered to the GSHS study protocols and was approved by the government of Indonesia.

    “The GSHS study in Indonesia adhered to the GSHS study protocols and was approved by the government of Indonesia.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The response rate was 94% of the total GSHS population.

    “The response rate was 94% of the total GSHS population.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The Indonesian National Institute of Health Research and Development ethical review board approved the GSHS, and a study permit was obtained from the Indonesian Ministry of Internal Affairs.

    “The Indonesian National Institute of Health Research and Development ethical review board approved the GSHS, and a study permit was obtained from the Indonesian Ministry of Internal Affairs.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationnone given

    The factors associated with loneliness are numerous, interrelated, and bidirectional as causes and effects of loneliness.

    “The associated factors are numerous, interrelated, and bidirectional as causes and effects of loneliness.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Excluding missing cases did not introduce bias into the prevalence and association estimates.
  • Classified as probably not a substantial claim.

    Premisecitation

    Loneliness can be used as a single-item measure if survey space and time are major constraints.

    “According to guidance from Snape and Martin [22], loneliness can be used as a single-item measure if survey space and time are major constraints.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Snape and Martin [22] Snape D, Martin G. Measuring loneliness: guidance for use of the national indicators on surveys. Off Natl Stat. 2018;1–10. https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/methodologies/measuringlonelinessguidanceforuseofthenationalindicatorsonsurveys.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

11 of 11
  • The paper relies on this without support.

    This is the first study among Indonesian female adolescents to investigate the prevalence of loneliness and associated health-risk behaviors.

    “This is the first study among Indonesian female adolescents to investigate the prevalence of loneliness and associated health-risk behaviors.”
  • The paper relies on this without support.

    The 2015 Indonesian GSHS is the most recent survey available.

    “The data were extracted from the most recent Indonesian Global School-based Student Health Survey (GSHS) of 2015.”
  • The paper relies on this without support.

    Excluding missing cases did not introduce bias into the prevalence and association estimates.

    “After excluding missing cases, 4.993 female respondents were included for statistical analysis in our study.”
3 of 3

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Handwashing subgroup loneliness percentage does not match its counts

    Minor

    Twelve of 84 students is approximately 14.3%, not the reported 15.3%.

    Reported 15.3 · recomputed 14.285714

  • Fruit-consumption odds ratio has an inconsistent significance marker

    Minor

    The unadjusted odds ratio is marked ***, which the note defines as p < 0.001, but Table 1 reports p = 0.009 for the same association.

  • Physically attacked percentage is tenfold too low

    Minor

    The table reports 1,110 students as 2.2% of the 4,993-student sample, but 1,110 is approximately 22.2% of that total.

    Reported 2.2 · recomputed 22.231124

  • Current alcohol use has an inconsistent significance marker

    Minor

    The unadjusted odds ratio is marked ***, meaning p < 0.001 under the table note, whereas Table 1 gives p = 0.002.

4 of 4

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. StataCorp. Stata statistical software: release 13. Collage Station: StataCorp LP; 2013.

Cited by

Sorted by citations

Authors
Marthoenis, Dahlia, & Nassimbwa, J.
Corresponding author
Nassimbwa, Jacqueline
Venue
BMC Women's Health
Published
2022-08-02
Volume
22
Issue
1
Pages
328-328
ISSN
1472-6874 (ISSN-L)
OpenAlex
W4289523331
Cited by
21
References
32
Citations by year
2026: 4 · 2025: 9 · 2024: 4 · 2023: 4
FWCI
3.09
Type
journal article
Language
en
Open access
Locations
  • BMC Women s Health (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • World Health Organization
  • Centers for Disease Control and Prevention
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Health Professions › General Health Professions › Adolescent Health and Behaviors
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
loneliness, adolescent girls, health risk behaviors, sleep disorders, suicidal ideation, suicide planning, smoking, alcohol consumption, bullying, passive smoking, sedentary lifestyle, social connectedness, protective factors, Indonesian adolescents
MeSH terms
Adolescent, Adolescent Behavior, Cross-Sectional Studies, Female, Health Surveys, Humans, Indonesia, Loneliness, Risk Factors, Prevalence, Suicidal Ideation

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