Loneliness as a mediator of the relationship between shame and health problems in young people exposed to childhood violence

• Published in: Social science & medicine (1982) 2018-08, Vol.211, p.183-189
• Main Authors: Thoresen, Siri, Aakvaag, Helene Flood, Strøm, Ida Frugård, Wentzel-Larsen, Tore, Birkeland, Marianne Skogbrott
• Format: Article
• Language: English
• Subjects: Adolescents; Anxiety; Attachment; Causal mediation analysis; Childhood; Childrens health; Complaints; Connectedness; Health problems; Health status; Indirect effects; Loneliness; Mental depression; Mental health; Norway; Physical health; Polls & surveys; Shame; Social interaction; Social isolation; Somatic symptoms; Structural equation modeling; Symptoms; Victims; Violence; Young adults; Youth
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2018.06.002

Shame related to childhood violence can be detrimental to mental and physical health. Shame may erode social bonds. In this study we tested whether loneliness is an important pathway between violence-related shame and health problems. Individuals who reported exposure to childhood violence in a telephone interview survey in 2013 (wave one) were re-contacted 12–18 months later (wave two), as part of a more general survey of the Norwegian adult population. In total, 505 adolescent and young adult participants (mean age = 21 years) responded to questions about violence exposure, violence-related shame, loneliness, anxiety/depression symptoms, and somatic health complaints. We used counterfactually based causal mediation analysis within the structural equation modelling framework to test whether loneliness mediated a potential association between shame and health. Shame had a profound effect on anxiety/depression symptoms and we identified both direct and indirect effects. Loneliness mediated about one third of the relationship between shame and anxiety/depression symptoms. The relationship between shame and somatic health complaints was weaker in total, but this more modest effect largely occurred indirectly through loneliness. Our results add to the literature by highlighting the role of loneliness in the relationship between shame and health. Shame may have the potential to break down social connectedness, with a detrimental effect on health. Clinicians may find it helpful to pay close attention to the way shame regulates social interaction. Preventing social isolation and loneliness may promote good health in violence victims. •We investigated loneliness, shame and health in violence-exposed individuals.•All dimensions of shame related to increased loneliness over time.•The relationship between shame and health was partly mediated by loneliness.•Interpersonal processes are important for the relationship between shame and health.•Prevention should focus on promoting social connectedness.