Social isolation after acquired brain injury: Exploring the relationship between network size, functional support, loneliness and mental health

ABSTRACT

Social isolation can be a consequence of acquired brain injury (ABI). Few studies have examined the relationship between social isolation and mental health after ABI. In this cross-sectional and case-control study, we compared 51 ABI survivors and 51 matched healthy controls on measures of social isolation (network size, social support and loneliness) mental health and mental health problems. We explored the relationship between structural, functional and subjective components of social isolation and examined whether they were associated with mental health outcomes. No group differences were found on size of the network and perceived social support. The ABI group exhibited marginally higher levels of loneliness. The ABI group presented higher levels of depression, lower levels of quality of life and emotional wellbeing. In both groups, perception of social support was inversely related to subjective experience of loneliness. The relationship between network size and loneliness was only significant in the ABI group. Only loneliness significantly predicted quality of life, emotional wellbeing, depression and anxiety in people with brain injury. The relationship between social isolation variables in ABI is discussed, as well as the theoretical and clinical implications of focusing on loneliness to improve mental health after brain injury.

KEYWORDS:

• Brain injury
• Social isolation
• Loneliness
• Social network
• Social support
• Mental health

Acknowledgements

We appreciate the valuable work of undergraduate students that collaborated collecting data: Indhira Muñoz, Hector Ureta, Santiago Palmer, Maximiliano Morales, Edgar Villagran, Abigail Diaz, Diego Román, Dafely Zamorano, Mara Agurto, Isidora Cuesta, María Carolina Sánchez, Macarena Vargas. We are also thankful of the many rehabilitation professionals, institutions and brain injury groups that contributed with the recruitment process: Unidad de Medicina Física y Rehabilitación Clínica Dávila, Centro Rehabilitación Comunitaria Recreo (San Miguel), Dirección Salud San Miguel, Departamento de Kinesiología (Universidad de Chile), Departamento de Vinculación con el Medio (Universidad Diego Portales), Rodrigo Moreno (Coordinador Comunal Adulto Mayor, Municipalidad de Pedro Aguirre Cerda), Mónica Acevedo y Amigos de la Esperanza (Pudahuel), Paola Amador (Hospital Clínico Universidad de Chile), Carmen Olbrich (INCA).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Agencia Nacional de Investigación e Innovación (ANID, Chile) through Fondo Nacional de Desarrollo Científico y Tecnológico, (ANID, Chile) under Initiation in Research Grants to Dr Christian Salas [number 11170508] and Dr Daniel Rojas-Líbano [number 11190604] as well as a Doctoral Scholarship Grant to Alvaro Aliaga [number 455307].