Emotional vs. social loneliness and prolonged grief: a random-intercept cross-lagged panel model

Background: Bereavement following death, with loneliness as a prominent feature, can result in enduring stress and compromised health.Objective: Building on Weiss's ([1973]. Loneliness: The experience of emotional and social isolation. MIT Press) proposal of two distinct types of loneliness, this study investigated within-person associations between emotional loneliness (EL) and prolonged grief symptoms (PGS) (aim 1), as well as social loneliness (SL) and PGS (aim 2) over four years following spousal loss. Additionally, we examined the impact of gender, age, and education on the main factors.Methods: We used random-intercept cross-lagged panel modelling (RI-CLPM) to analyse self-reported data from 338 Danish spousal-bereaved adults (58% female; mean age = 72.1; range 65-81 years) on EL and SL (single-item questions) and PGS (Inventory of Complicated Grief, short version) at 6, 13, 18, and 48 months post-loss.Results: We found (1) within-person associations between EL and PGS; (2) no within-person associations between SL and PGS. In our model, PGS predicted EL over time, with no reciprocal effect. In contrast, PGS and SL were unrelated. Age did not link with EL, SL, or PGS. More years of education were associated with less EL and SL, but not with PGS. Gender influenced the association between SL and PGS.Conclusions: This study enhances our understanding of longitudinal, within-person associations between EL, SL, and PGS. Consistent with Weiss's (1973) relational theory of loneliness in widowhood, results highlight the unique role of EL. While replication is needed due to limitations like single-item measures and varying intervals, these findings emphasize EL's importance in widowhood and offer a basis for better understanding and addressing PGS. Monitoring the relationship between loneliness and grief may help healthcare providers offer timely, targeted interventions.