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Cultural Dimensions Moderate the Association between Loneliness and Mental Health during Adolescence and Younger Adulthood: A Systematic Review and Meta-Analysis

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Abstract

Cultural factors, such as country or continent, influence the relationship between loneliness and mental health. However, less is known about how cultural dimensions moderate this relationship during adolescence and younger adulthood, even if these dimensions manifest as country or continent differences. This study aims to examine the potential influence of Hofstede’s cultural dimensions on this relationship using a three-level meta-analysis approach. A total of 292 studies with 291,946 participants aged 10 to 24 were included in this study. The results indicate that cultural dimensions, such as individualism vs. collectivism, indulgence vs. restraint, power distance, and long-term vs. short-term orientation, moderated the associations between loneliness and social anxiety, stress, Internet overuse, and negative affect. The association between loneliness and mental health was not moderated by cultural dimensions, such as masculinity and uncertainty avoidance. These findings suggest that culture’s influence on the association between loneliness and mental health is based on a domain-specific mechanism.

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Acknowledgements

We would like to thank all the researchers who contributed to this research sincerely. Their support and insights have been invaluable in shaping the outcomes of this study. We are also grateful to the funding agencies for their financial assistance.

Funding

This research is supported by the National Key Research and Development Program of China (2021YFC2501500) and the Fundamental Research Funds for the Central Universities (grant number SWU2209240).

Data Sharing Declaration

The datasets generated and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Authors and Affiliations

Authors

Contributions

J.A.W. conceived the study, participated in its design, wrote the protocol, curated the data, appraised the study quality of included articles, and analyzed formal data; H.F.W. participated in the coordination and helped to curate the data; B.C. participated in the coordination and helped to draft the manuscript; X.L. conceived the study, participated in its conceptualization; C.Q.L. conceived the study, participated in its design and coordination, and helped to the draft the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Changquan Long.

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The authors report no conflict of interest. The authors have adhered to academic integrity and ethical principles in writing this manuscript. Throughout the literature search and selection process, we have strived to ensure an objective and impartial evaluation of the selected literature while minimizing potential biases. This article does not necessarily reflect the stance of any institution or organization. We commit to being accountable for the content of this article and welcome any constructive criticism and feedback on our research. During the preparation of this work, we used DeepL (https://www.deepl.com/write) to check and correct potential grammar mistakes and enhance readability, because English is not our native language. After using this tool, we reviewed and edited the content as needed and take full responsibility for the content of the publication.

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Appendices

Appendix

Keywords and Full Search String in the Current Meta-Analysis

Full Search String in the Current Meta-analysis

Chinese Version (e.g., CNKI)

TKA=(‘抑郁’+’焦虑’+’恐惧’+’压力’+’双相’+’躁狂’+’自杀’+’情绪失调’+’非自杀性自伤’+’消极情绪’+’人格障碍’+’边缘性人格障碍’+’网络成瘾’+’饮食障碍’ +’躯体变形障碍’+’厌食’+’暴食’+’多动’+’精神分裂’+’物质滥用’+’成瘾’+’睡眠障碍’+’发育障碍’+’认知障碍’+’虐待’+’述情障碍’+‘错失恐惧’+’外化问题’+‘心理健康’+‘情绪调节’+‘霸凌’+‘错失恐惧’+’外化问题’+‘心理健康’+‘情绪调节’+‘霸凌’) and TKA=('青少年'+'成年早期') and TKA=('孤独感' + '社会排斥' + '独处')

English Version (e.g., PubMed)

(Depress*[Title/Abstract] OR Anxiety[Title/Abstract] OR Phobia[Title/Abstract] OR distress*[Title/Abstract] OR Bipolar[Title/Abstract] OR Mania[Title/Abstract] OR Suicide[Title/Abstract] OR “Emotion Dysregulation”[Title/Abstract] OR “Non-suicidal self-injury”[Title/Abstract] OR “Negative feeling”[Title/Abstract] OR “Negative affect”[Title/Abstract] OR “Personality disorder”[Title/Abstract] OR “Borderline personality”[Title/Abstract] OR “Internalizing problems”[Title/Abstract] OR “Binge eating”[Title/Abstract] OR Bulima[Title/Abstract] OR “eating disorder”[Title/Abstract] OR “body dysmorphic disorder”[Title/Abstract] OR anorexia[Title/Abstract] OR ADHD[Title/Abstract] OR Hyperactiv*[Title/Abstract] OR Schizophrenia[Title/Abstract] OR “Psychotic disorder”[Title/Abstract] OR Inattentive[Title/Abstract] OR “Substance use”[Title/Abstract] OR “Alcohol use”[Title/Abstract] OR “Alcohol dependence”[Title/Abstract] OR “Drug use”[Title/Abstract] OR “Drug dependence”[Title/Abstract] OR “internet Addiction”[Title/Abstract] OR “Sleep disorder”[Title/Abstract] OR “Pervasive developmental disorder”[Title/Abstract] OR “Cognitive Dysfunction”[Title/Abstract] OR “Psychological maltreatment”[Title/Abstract] OR Alexithymia[Title/Abstract] OR “Fear of Missing out”[Title/Abstract] OR FOMO[Title/Abstract] OR “mental health”[Title/Abstract] OR “Externalizing problems”[Title/Abstract] OR “emotion regulation”[Title/Abstract] OR bully [Title/Abstract]) AND (lone*[Title/Abstract] OR “social* isolate*”[Title/Abstract] OR “social* separate*”[Title/Abstract] OR “social* ostracis*”[Title/Abstract] OR “social* reject*”[Title/Abstract] OR solitude[Title/Abstract] OR alone*[Title/Abstract]) AND (adolescen*[Title/Abstract] OR Teens[Title/Abstract] OR teenagers*[Title/Abstract] OR youth*[Title/Abstract] OR “young adult*”[Title/Abstract])

Appendix

Table 4

Table 4 Detailed characteristics of included studies

Appendix

Fig. 3

Fig. 3
figure 3figure 3figure 3

Results of sensitive analyses. Outlier and influence analyses for the outliers results of the correlation between loneliness and mental health outcomes. Analysis for the correlation between loneliness and (A) sleep problem. B Negative problem. C Substance use. D Phobia. E General mental health. F Fear of missing out. G Depression. H General anxiety. I Social anxiety. J Internet overuse. K psychological maltreatment. L Internalizing problem. M Suicide. N Stress. O Internet externalizing problem. P Emotion regulation. Q Non-suicide self-injury

Appendix

Table 5

Table 5 Quality assessment

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Wang, JA., Wang, HF., Cao, B. et al. Cultural Dimensions Moderate the Association between Loneliness and Mental Health during Adolescence and Younger Adulthood: A Systematic Review and Meta-Analysis. J. Youth Adolescence (2024). https://doi.org/10.1007/s10964-024-01977-w

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