Loneliness Among People With Spinal Cord Injury: Exploring the Psychometric Properties of the 3-Item Loneliness Scale

Objectives: To (1) examine a measure of loneliness and its correlates in people with spinal cord injury (SCI) to enhance our understanding of loneliness, which has received limited scientific study in the context of SCI; and (2) conduct preliminary analyses of the reliability and validity of the measure, including an evaluation of the unique impact of loneliness on psychological health.

Design: Cross-sectional.

Setting: Spinal Cord Injury Model Systems.

Participants: People with SCI (N=175) participating in Spinal Cord Injury Model Systems follow-up interviews at 1 study site between April 2014 and June 2015.

Interventions: Not applicable.

Main outcome measure: The 3-item Loneliness Scale.

Results: Examination of individual items showed that approximately 40% of the sample reported that they felt they lacked companionship, felt left out, and felt isolated from others either some of the time or often. Mean scores in our sample were elevated compared with published data on middle-aged and older adults. Results provided evidence of internal consistency, comparable to that reported in the literature, and preliminary evidence of convergent and divergent validity. Loneliness was related to psychological health even after controlling for measures of demographics, disability, and social integration, suggesting that loneliness captures more than just social isolation or social integration in people with SCI.

Conclusions: Loneliness, which may be more common among people with SCI, is related to poorer psychological health. Given the serious physical and psychological health consequences of loneliness documented in the general literature, it is imperative that the experience of loneliness among people with SCI be given serious and systematic attention in the literature as well as in clinical practice.