Introduction
Loneliness, solitude, and positive solitude
Loneliness is the distressing feeling of a perceived gap between desired and obtained social relationships. It has detrimental effects on various aspects of health, including mental health, sleep quality, cognitive impairment, early mortality, and depression (Park et al., Reference Park2020). This paper focuses on depression, as loneliness is commonly experienced among older adults and is a significant precursor to depression.
While loneliness and solitude are sometimes used interchangeably, they have distinct meanings. Loneliness is a negative experience associated with adverse effects on health and well-being, while solitude can be either positive or negative. Negative solitude encompasses situations such as social isolation, social withdrawal, or ostracism. In contrast, solitude, as differentiated from loneliness, reflects an inherent desire to be alone (Hipson et al., Reference Hipson, Kiritchenko, Mohammad and Coplan2021). Recent research comparing the emotional content of tweets containing the words “solitude” and “lonely/loneliness” revealed a more optimistic and favorable context for solitude. Consequently, positive solitude (PS) is viewed as a separate phenomenon, not the opposite of loneliness, but rather a different interpretation and response to being alone (Tse et al., Reference Tse, Lay and Nakamura2022). PS is defined as the voluntary choice to be alone, with or without the presence of others, engaging in meaningful activities (Ost-Mor et al., Reference Ost-Mor, Palgi and Segel-Karpas2020). It contributes to emotional regulation and cognitive executive functions, such as decision making and mindfulness (Thomas, Reference Thomas2021). Gender differences in PS are minimal, with slight age-related variations indicating a slight decrease in PS among older adults.
The question arises whether loneliness and PS are opposing forces or can coexist. Daily life involves a range of experiences that influence mood, social interactions, emotional changes, and voluntary and involuntary solitude. Loneliness depletes psychological and physical resources, leaving no room for enjoying PS. However, PS can serve as a resource to counteract loneliness by fostering inner strengths. It can also moderate depressive symptoms and facilitate the return to routine life after crisis (Keisari et al., Reference Keisari, Palgi, Ring, Folkman and Ben-David2022). In the context of older adults, PS is assumed to moderate the association between loneliness and depression. Spending time alone can lead to depression, but engaging in meaningful activities can alleviate distress. PS allows introspection, enjoyment, and mood regulation. During the COVID-19 pandemic, older adults who engaged in PS activities felt resilient and well despite social isolation. Hence, the significance of PS for older adults, especially those at risk of depression due to loneliness, is evident (Segel-Karpas et al., Reference Segel-Karpas, Ayalon and Lachman2018).
The present study
Previous studies have shown the strong relationship between loneliness and depressive symptoms, focused on strategies to manage loneliness (Kharicha et al., Reference Kharicha, Manthorpe, Iliffe, Davies and Walters2018) or on the moderating role of PS in the context of depressive symptoms (Keisari et al., Reference Keisari, Palgi, Ring, Folkman and Ben-David2022). However, to the best of our knowledge, this is the first study to examine the relationship between loneliness and PS with depressive symptoms. The research adds to current discussion about the ability to use PS to cope with difficulties and may enhance practitioners’ ability to craft interventions to combat loneliness.
We hypothesized that higher levels of loneliness will be associated with higher level of depressive symptoms (H1), and that higher level of PS will be related to lower level of depressive symptoms (H2). Finally, PS will moderate the association between loneliness and depressive symptoms, specifically having higher levels of PS will weaken the association between loneliness and depressive symptoms (H3).
Methods
Participants and procedure
The study used random sample (yet not representative) from an online survey company (Ipanel) in Israel, collected in May 2022. All participants from the survey company dataset who were in the adequate age could participate in the study. Participants included 577 older adults aged 67 or above. After omitting those who did not fill the relevant scales for this study, the sample included 520 participants aged 68–87 (Mage = 72.66), almost half of them women (n = 254; 48.8%), most were married (n = 412; 79.2%), and with high education (n = 420, 80.8% with more than 12 years of education). Data collection commenced after receiving IRB approval from the Ethics Committee of the last author’s university. All participants signed an informed consent form before completing the questionnaire. Demographics of the study are presented in Table 1.
Table 1. Descriptive statistics for the study variables
Note. Total N = 520. a= woman. b= currently married or living with a partner. c= ranging on a scale from 1 = no formal education to 6 = high academic education. The correlations for Educations were measured with Spearman’s ρ coefficient.
*p < 0.05, **p < 0.01, ***p < .001.
Measures
Background characteristics included age, gender (although to the best of our knowledge, no major differences between men and women regarding PS experiences were found in a qualitative study), marital status (1= married or living with a partner, 2 = single, divorced, or widowed), and education, measured on a scale ranging from 1 (no formal education) to 6 (high academic education).
Depressive symptoms were measured using the 9-items scale (PHQ-9, Kroenke & Spitzer, 2002). Participants rated how often they felt depressive symptoms in the last month, on a four-point Likert scale from 1 (not at all) to 4 (nearly every day). For example, “Over the last 2 weeks, how often have you been bothered by any of the following problems? Feeling down, depressed or hopeless.” Scores were computed by summing the items, and ranged from 0 to 28, with higher scores reflecting higher levels of depressive symptoms. Cronbach’s α in the current study was 0.852.
Loneliness was measured with the short version of the Revised UCLA loneliness scale (UCLA-8) (Hays and DiMatteo, Reference Hays and DiMatteo1987). This scale includes 8 items that measure the participants’ level of discrepancy between their expectation and their actual social relationships, on a scale ranging from 1 (never) to 4 (very often). For example, “I lack companionship.” Scores were computed by the sum of the item scores, with higher scores indicating greater loneliness. Cronbach’s α in the current study was 0.806.
PS was measured with the Positive Solitude Scale (Palgi et al., Reference Palgi, Segel-Karpas, Ost-Mor, Hoffman, Shrira and Bodner2021). This scale includes 9 items that assess to what degree participants report that they have beneficial experiences when they volitionally choose to be by themselves, such as: “I like carving out time to enjoy being by myself in a pleasant place/environment,” on a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (completely agree). Score was computed by the mean of scores, with higher scores reflecting higher PS. Cronbach’s α in the current study was 0.910.
Data analysis
All predictors were mean centered before the analyses and background characteristics were controlled for. Using multiple hierarchical linear regression, depressive symptoms were regressed according to the hypothesis. Demographics were entered in the first step (age, gender, marital status, and education). Loneliness and PS were entered in the second step, and finally, the interaction between loneliness and PS was added in the third step. The interaction term was probed with the PROCESS computational tool (Model 1) in order to test the significance of simple slopes at two different levels (−1 and + 1 SD) from the mean of PS.
Results
Table 1 presents means, standard deviations, and correlations for all study variables. Loneliness was positively correlated with depressive symptoms r = 0.53, p<0.001 and negatively correlated with PS r = −0.18, p<0.001. PS was negatively correlated with depressive symptoms r = −0.20, p<0.001.
Following our main hypothesis, we entered the demographic variables in Step 1 (age, gender, marital status, and education) accounting for 4.7% of the variance in depressive symptoms. Next, in Step 2, we examined the main effects of loneliness and PS, accounting for an additional 27.8% of the variance. Loneliness and PS were both associated with depressive symptom (β = 0.50, t[520] = 13.42, p < 0.001; β =−0.11, t[520] = −2.89, p < 0.01, respectively).
In Step 3, we entered the interaction between loneliness and PS. The interaction was significantly associated with depressive symptoms (B = −0.13, β =−0.12 t[520] = −3.36, p < 0.001). Simple slopes analysis suggested the association between loneliness and depressive symptoms is stronger among those with lower levels of PS. For participants who reported −1 SD level of PS, each additional loneliness score was associated with a significant increase of 0.55 points in depressive symptoms, (B = 0.55, t[520] = 13.36, p < 0.000), comparing to 0.36 points (B = 0.36, t[520] = 7.29, p < 0.000) among participants who reported + 1 SD level of PS. The interaction accounted for an additional 1.5% of the variance. For further information, see Figure 1.
Figure 1. The moderating role of positive solitude in the association between loneliness and depressive symptoms.
Finally, as this study is cross-sectional we also ran the interaction with the same variables when PS is the dependent variable and depressive symptoms is the moderator. The association remained significant (B = -0.005, t[520] = -3.43, p < 0.001) suggesting that it is possible that these relations might be bidirectional.
Discussion
This study examined the relationship between loneliness and PS with depressive symptoms in older adults residing in the community. Specifically, the study is the first to examine the interaction between loneliness, PS, and their impact on depressive symptoms in this population.
Consistent with the first and second hypotheses, we found a positive association between loneliness and depressive symptoms, and a negative association between PS and depressive symptoms. These results align with previous research demonstrating a moderate to strong positive correlation between loneliness and depressive symptoms.
While the negative association between PS and depressive symptoms may seem intuitive, empirical studies on this topic are limited. The present study suggests that several factors contribute to this negative association. Firstly, PS is characterized by nourishment and joy, whereas depressive symptoms impose inner boundaries and deplete one’s mental and cognitive resources (Perini et al., Reference Perini, Cotta Ramusino, Sinforiani, Bernini, Petrachi and Costa2019). Secondly, PS requires specific skills that may be adversely affected by depression, and individuals experiencing depressive symptoms may lack the emotional and cognitive resources necessary to engage in PS. Consequently, the absence of PS skills (such as finding emotional regulation or heeding to signals to enter a state of PS) and experiences can lead to feelings of loneliness and the emergence of depressive symptoms. These findings were supported by the significant results obtained when analyzing the interaction between PS and depressive symptoms in both directions. Further research is warranted to explore the longitudinal and causal relationships between PS and depressive symptoms. Regarding the third hypothesis, the findings indicated that PS moderated the relationship between loneliness and depressive symptoms. High levels of loneliness were positively associated with elevated levels of depressive symptoms, but the strength of this relationship diminished when PS levels were high. This suggests that engaging in PS may potentially mitigate some of the detrimental consequences of loneliness. Furthermore, PS may contribute to lower levels of depression by serving as an internal resource that fosters self-connectedness, awareness, flexibility, and creativity.
This study’s innovation lies in recognizing that older adults can utilize PS as an inner resource to navigate the challenges of loneliness and subsequent depressive symptoms. Promoting the cultivation of these inner resources and encouraging engagement in PS may transform the approach to combating loneliness in older adults. Additionally, incorporating PS skills training into national health promotion programs for older adults could enhance resilience. We recommend implementing PS skill development programs through group meetings that aim to understand the concept of PS, by recognizing and negotiating for the need for alone time and emphasizing the significance of exercising at home.
Despite its significance, this study has several noteworthy limitations that should be addressed. Firstly, its cross-sectional design precludes causal inferences, and it remains unclear whether PS predicts depressive symptoms or vice versa. Secondly, the majority of participants (79.2%) were married, potentially introducing bias. However, even in committed relationships, individuals may still experience some degree of loneliness, albeit to a lesser extent than unmarried individuals. Lastly, the sample consisted mostly of educated individuals, which may introduce bias as education acts as a protective factor against loneliness. Additionally, online data collection may have further biased the sample by recruiting more technologically oriented and socially connected older adults. However, this suggests that in a more representative sample, loneliness levels may be higher, thereby rendering the moderating effect of PS more meaningful.
Further research focusing on loneliness, depressive symptoms, and the moderating role of PS is warranted, particularly in diverse populations such as home-dwelling older adults and nursing facility residents. In conclusion, this study expands our understanding of the complex relationships between loneliness, depressive symptoms, and PS, highlighting the importance of considering the interaction between loneliness and PS. PS serves as a valuable capability for coping with the psychological implications of loneliness.
Conflict of interest
None.
Description of authors’ roles
Menachem Ben-Ezra, Yaira Hamama-Raz, Shacham Maayan, Dikla Segel-Karpas, Yuval Palgi, and Sharon Ost-Mor: Formulated the research questions and designed the study.
Lee Greenblatt Kimron and Dikla Segel-Karpas: Carried it out and supervised the data collection.
Yuval Palgi: Supervised data collections and analyzed the data.
Sharon Ost-Mor: Wrote the paper.
Acknowledgements
This study was supported by a research grant from Ariel University given to the last researcher.
This project is a part of the first authors’ Post Doctorate under the supervision of the second author.
Open access
