Loneliness is associated with retrospective self-reports of adverse childhood experiences – A replication study in Ethiopia

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Abstract Loneliness and adverse childhood experiences constitute major risk factors for mental disorders, and current research highlights the role of loneliness in the interaction between early life adversities and current psychopathology. However, most studies have been conducted in high-income and highly individualistic countries. Therefore, this study investigates the interplay between adverse childhood experiences, loneliness, social network size, and mental health problems in the low-income and collectivistic country of Ethiopia. The study sample consists of 125 psychiatric outpatients at Jimma University Medical Center, South-West of Ethiopia, suffering from major depressive disorder, bipolar disorder, or psychotic disorders, and 131 non-clinical study participants. Led by an interviewer, participants completed the UCLA Loneliness Scale, the Childhood Trauma Questionnaire, the Social Network Index, and the WHO-5 Well-Being Index. We used Mann-Whitney U Tests, partial correlation, and mediation analysis for data analysis. We found mild to moderate correlations between loneliness and adverse childhood experiences, and loneliness fully mediated the association between adverse childhood experiences and depressive symptoms in both groups. In contrast, social network size was neither correlated with adverse childhood experiences nor did it mediate the association between adverse childhood experiences and depressive symptoms in either group. This study replicates previous findings that loneliness, rather than social network size, is associated with adverse childhood experiences and mediates the pathway to depressive symptoms. This replication supports the transcultural and transdiagnostic generalizability of these findings, even in more collectivistic and low-income settings.

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