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Exploring loneliness in individuals with diabetes – The role of childhood abuse and neglect, and personality functioning: Findings from a German population-based sample

Year: 2025

Type: article

Abstract: This study examines 1) loneliness frequency in individuals with diabetes, 2) associated factors, and 3) personality functioning and the epistemic stance as underlying mechanisms linking childhood abuse and neglect, and loneliness. Using representative population data ( N = 2428), loneliness (UCLA-LS) was assessed in individuals with self-reported diabetes ( n = 206) and compared to those without. Regression analyses tested age, sex, relationship status, childhood abuse and neglect (ICAST-R), depression and anxiety (PHQ-4), personality functioning (OPD-SQS), and the epistemic stance (ETMCQ-12) as predictors. Structural equation modeling (SEM) investigated personality functioning and the epistemic stance as mediators between childhood abuse and neglect, and loneliness. In the total sample, 12.4 % reported loneliness, and loneliness was more frequent in individuals with diabetes (24.8 %) than those without (11.3 %). Higher loneliness was linked to being single, greater depression and anxiety symptoms, and impaired personality functioning. While childhood abuse and neglect were initially associated with loneliness, this became nonsignificant when personality functioning was included as a mediator, increasing the explained variance from 3.4 % to 42.0 %. Nearly a quarter of individuals with diabetes experience loneliness, particularly linked to emotional abuse. Impaired personality functioning, associated with interpersonal difficulties, appears as a shared mechanism for diabetes and loneliness. Considering loneliness and impairments in personality functioning might be highly important in research and clinical practice. • In individuals with diabetes, 24.8 % experience loneliness. • Associations were found with e.g. symptoms of depression and anxiety as well as impaired personality functioning. • Impaired personality functioning mediates the association between childhood abuse and neglect, and loneliness. • Hence, it might be a shared aspect of both diabetes and loneliness. • Loneliness and personality functioning might open up new clinical treatment avenues.

Source: Journal of Psychosomatic Research

DOI: 10.1016/j.jpsychores.2025.112390