Understanding the Role of Loneliness in the Relationships Between Post-Traumatic Stress Symptoms and Both Anxiety and Depressive Symptoms Among University Students: A Mediation Analysis
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Measures
2.2.1. Participant Information
2.2.2. Psychometric Measures
2.2.3. Loneliness
2.3. Statistics
3. Results
3.1. Sample Characteristics
3.2. Clinical Assessment and Loneliness
3.3. The Effect of Loneliness on the Relationship Between PTS and Anxiety Symptoms: Mediation Analysis
3.4. The Effect of Loneliness on the Relationship Between PTS and Depressive Symptoms: Mediation Analysis
3.5. Multivariate Associations Among IES-R Subscales, Loneliness, and Anxiety and Depressive Symptoms: A Path Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
PTS | Post-traumatic stress symptoms |
Unimib | University of Milano–Bicocca |
UoS | University of Surrey |
GAD-7 | Generalized Anxiety Disorder Scale-7 |
PHQ-9 | Patient Health Questionnaire-9 |
IES-R | Impact of Event Scale—Revised |
UCLA | UCLA Loneliness Scale (Version 3) |
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Characteristics | Overall Sample | PTS ** | p-Value * | |
---|---|---|---|---|
N = 2055 | No PTS (N = 944) | PTS (N = 408) | ||
N (%) or Mean (SD) | N (%) or Mean (SD) | N (%) or Mean (SD) | ||
Gender | ||||
Women | 1550 (75.4%) | 722 (76.5%) | 317 (77.7%) | p = 0.25 |
Men | 442 (21.5%) | 193 (20.4%) | 71 (17.4%) | |
Age, years | 22.77 (5.21) | 23.12 (5.54) | 22.76 (4.50) | p = 0.10 |
Years of Study | ||||
First | 664 (32.3%) | 294 (31.1%) | 159 (39.0%) | p = 0.012 |
Second | 634 (38.9%) | 312 (33.1%) | 101 (24.8%) | |
Third | 445 (21.7%) | 220 (23.3%) | 89 (21.8%) | |
Fourth | 119 (5.8%) | 51 (5.4%) | 27 (6.6%) | |
Fifth–Sixth | 126 (6.1%) | 63 (6.7%) | 29 (7.1%) | |
Degree Program Area | ||||
Applied/Natural Sciences 1 | 456 (22.2%) | 215 (22.8%) | 92 (22.6%) | p = 0.002 |
Economic/Legal Sciences 2 | 343 (16.7%) | 139 (14.7%) | 56 (13.7%) | |
Medical Sciences 3 | 517 (25.2%) | 251 (26.6%) | 86 (21.1%) | |
Psychosocial Sciences 4 | 703 (34.2%) | 319 (33.8%) | 166 (40.7%) | |
International Student | 103 (5.0%) | 38 (4.0%) | 30 (7.4%) | p = 0.014 |
Out-of-Town Student | 686 (33.4%) | 315 (33.4%) | 148 (36.3%) | p = 0.29 |
Employment | ||||
Non-worker | 683 (33.2%) | 302 (32.0%) | 137 (33.6%) | p = 0.51 |
Part-time or full-time worker | 1332 (64.8%) | 625 (66.2%) | 261 (64.0%) | |
Marital Status | ||||
Single | 1047 (51.0%) | 475 (50.3%) | 189 (46.3%) | p = 0.26 |
In a committed relationship | 945 (46.0%) | 441 (46.7%) | 201 (49.3%) | |
Accommodation | ||||
With family of origin | 1071 (52.1%) | 494 (52.3%) | 203 (49.8%) | p < 0.001 |
On campus | 302 (14.7%) | 126 (13.4%) | 60 (14.7%) | |
With roommates outside of campus | 375 (18.3%) | 184 (19.5%) | 70 (17.2%) | |
With partner | 164 (8.0%) | 77 (8.2%) | 34 (8.3%) | |
Alone | 103 (5.0%) | 46 (4.9%) | 29 (7.1%) | |
On Track with Exams | 1298 (63.2%) | 629 (66.6%) | 229 (56.1%) | p = 0.002 |
Social Interactions—family | ||||
Daily/more times per week | 1410 (68.6%) | 649 (68.8%) | 275 (67.4%) | p = 0.83 |
Weekly | 251 (12.2%) | 123 (13.0%) | 49 (12.0%) | |
Monthly or less | 349 (17.0%) | 156 (16.5%) | 71 (17.4%) | |
Social Interactions—partner | ||||
Daily/more times per week | 616 (30.0%) | 284 (30.1%) | 128 (31.4%) | p = 0.46 |
Weekly | 152 (7.4%) | 78 (8.3%) | 27 (6.6%) | |
Monthly or less | 287 (14.0%) | 130 (13.8%) | 63 (15.4%) | |
Social Interactions—friends | ||||
Daily/more times per week | 646 (31.4%) | 291 (30.8%) | 130 (31.9%) | p = 0.56 |
Weekly | 689 (33.5%) | 331 (35.1%) | 149 (36.5%) | |
Monthly or less | 693 (33.7%) | 315 (33.4%) | 123 (30.2%) | |
Social Interactions—classmates | ||||
Daily/more times per week | 901 (43.8%) | 421 (44.6%) | 179 (43.8%) | p = 0.70 |
Weekly | 233 (11.3%) | 106 (11.2%) | 51 (12.5%) | |
Monthly or less | 801 (39.0%) | 365 (38.7%) | 149 (36.5%) | |
Anxiety Symptoms (GAD-7) | 9.38 (5.32) | 8.31 (4.52) | 13.18 (5.13) | p < 0.001 |
Depressive Symptoms (PHQ-9) | 9.83 (6.21) | 8.45 (5.32) | 14.09 (6.18) | p < 0.001 |
Loneliness (UCLA) | 48.78 (12.31) | 46.80 (11.91) | 54.43 (10.65) | p < 0.001 |
2(a) GAD-7 | Coefficient | Standard Error | 95% CI | β a | p-Value |
Loneliness | 0.14 | 0.01 | 0.12; 0.16 | 0.33 | <0.001 |
PTS | 3.66 | 0.28 | 3.12; 4.22 | 0.32 | <0.001 |
Test of mediation | |||||
Indirect effect | 1.04 | 0.23 | 0.59; 1.48 | <0.001 | |
Direct effect | 3.73 | 0.35 | 3.05; 4.45 | <0.001 | |
Total effect | 4.77 | 0.32 | 4.15; 5.40 | <0.001 | |
2(b) PHQ-9 | Coefficient | Standard Error | 95% CI | β b | p-Value |
Loneliness | 0.21 | 0.01 | 0.19; 0.23 | 0.42 | <0.001 |
PTS | 3.90 | 0.32 | 3.27; 4.52 | 0.29 | <0.001 |
Test of mediation | |||||
Indirect effect | 1.81 | 0.30 | 1.22; 2.39 | <0.001 | |
Direct effect | 3.72 | 0.36 | 3.02; 4.42 | <0.001 | |
Total effect | 5.53 | 0.38 | 6.79; 6.27 | <0.001 |
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Riboldi, I.; Crocamo, C.; Capogrosso, C.A.; Bartoli, F.; Armes, J.; Taylor, C.; Carrà, G. Understanding the Role of Loneliness in the Relationships Between Post-Traumatic Stress Symptoms and Both Anxiety and Depressive Symptoms Among University Students: A Mediation Analysis. Brain Sci. 2025, 15, 787. https://doi.org/10.3390/brainsci15080787
Riboldi I, Crocamo C, Capogrosso CA, Bartoli F, Armes J, Taylor C, Carrà G. Understanding the Role of Loneliness in the Relationships Between Post-Traumatic Stress Symptoms and Both Anxiety and Depressive Symptoms Among University Students: A Mediation Analysis. Brain Sciences. 2025; 15(8):787. https://doi.org/10.3390/brainsci15080787
Chicago/Turabian StyleRiboldi, Ilaria, Cristina Crocamo, Chiara Alessandra Capogrosso, Francesco Bartoli, Jo Armes, Cath Taylor, and Giuseppe Carrà. 2025. "Understanding the Role of Loneliness in the Relationships Between Post-Traumatic Stress Symptoms and Both Anxiety and Depressive Symptoms Among University Students: A Mediation Analysis" Brain Sciences 15, no. 8: 787. https://doi.org/10.3390/brainsci15080787
APA StyleRiboldi, I., Crocamo, C., Capogrosso, C. A., Bartoli, F., Armes, J., Taylor, C., & Carrà, G. (2025). Understanding the Role of Loneliness in the Relationships Between Post-Traumatic Stress Symptoms and Both Anxiety and Depressive Symptoms Among University Students: A Mediation Analysis. Brain Sciences, 15(8), 787. https://doi.org/10.3390/brainsci15080787