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Loneliness Among People With Spinal Cord Injury: Exploring the Psychometric Properties of the 3-Item Loneliness Scale

  • Susan Robinson-Whelen
    Correspondence
    Corresponding author Susan Robinson-Whelen, PhD, Spinal Cord Injury and Disability Research Center, TIRR Memorial Hermann, 1333 Moursund, A-207, Houston, TX 77030.
    Affiliations
    Spinal Cord Injury and Disability Research Center, The Institute of Rehabilitation and Research–Memorial Herman, Houston, TX

    Center for Research on Women with Disabilities, Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
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  • Heather B. Taylor
    Affiliations
    Spinal Cord Injury and Disability Research Center, The Institute of Rehabilitation and Research–Memorial Herman, Houston, TX

    Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX
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  • Michelle Feltz
    Affiliations
    Spinal Cord Injury and Disability Research Center, The Institute of Rehabilitation and Research–Memorial Herman, Houston, TX
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  • Megan Whelen
    Affiliations
    Department of Psychology, University of Houston, Houston, TX
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      Abstract

      Objectives

      To (1) examine a measure of loneliness and its correlates in people with spinal cord injury (SCI) to enhance our understanding of loneliness, which has received limited scientific study in the context of SCI; and (2) conduct preliminary analyses of the reliability and validity of the measure, including an evaluation of the unique impact of loneliness on psychological health.

      Design

      Cross-sectional.

      Setting

      Spinal Cord Injury Model Systems.

      Participants

      People with SCI (N=175) participating in Spinal Cord Injury Model Systems follow-up interviews at 1 study site between April 2014 and June 2015.

      Interventions

      Not applicable.

      Main Outcome Measure

      The 3-item Loneliness Scale.

      Results

      Examination of individual items showed that approximately 40% of the sample reported that they felt they lacked companionship, felt left out, and felt isolated from others either some of the time or often. Mean scores in our sample were elevated compared with published data on middle-aged and older adults. Results provided evidence of internal consistency, comparable to that reported in the literature, and preliminary evidence of convergent and divergent validity. Loneliness was related to psychological health even after controlling for measures of demographics, disability, and social integration, suggesting that loneliness captures more than just social isolation or social integration in people with SCI.

      Conclusions

      Loneliness, which may be more common among people with SCI, is related to poorer psychological health. Given the serious physical and psychological health consequences of loneliness documented in the general literature, it is imperative that the experience of loneliness among people with SCI be given serious and systematic attention in the literature as well as in clinical practice.

      Keywords

      List of abbreviations:

      CHART-SF (Craig Handicap Assessment and Reporting Technique–Short Form), ES (effect size), HRS (Health and Retirement Study), PHQ-2 (Patient Health Questionnaire-2), SCI (spinal cord injury)
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