Loneliness and Cardiovascular Disease Risk in the United States and Japan: The Moderating Effects of Nationality and Collectivism

• Main Author: Kapoulea, Eleni A
• Format: Others
• Published: ScholarWorks@UMass Amherst 2021
• Subjects: loneliness; collectivism; cardiovascular disease; gender; cross-cultural differences; Clinical Psychology
• Online Access: https://scholarworks.umass.edu/masters_theses_2/1126; https://scholarworks.umass.edu/cgi/viewcontent.cgi?article=2142&context=masters_theses_2

Loneliness is a widespread public health concern. Loneliness may be less frequent but have more severe consequences for cardiovascular disease (CVD) in a collectivist (e.g., Japanese) versus individualist (e.g., United States [U.S.]) culture but little is known about cross-cultural associations of loneliness. This study determined if loneliness would be higher in the U.S. and in persons lower in collectivism. We also studied if loneliness would be positively associated with CVD indicators and if these associations would be stronger in (1) Japan than the U.S. and (2) individuals higher in collectivism. U.S. (n = 529) and Japanese (n = 292) adults from the Midlife in the United States Series, aged 36 to 78, completed psychosocial questionnaires, provided blood samples, and underwent a physical exam. Logistic regression and path analyses using structural equation modeling determined individual differences in loneliness, whether loneliness predicted CVD indicators (e.g., metabolic dysregulation, inflammation, blood pressure, and sleep dysfunction), and whether nationality and collectivism moderated these associations. Japanese adults reported less loneliness compared to the U.S. Unexpectedly, loneliness did not predict any CVD indicators. For U.S. adults with low interdependence, loneliness was associated with elevated metabolic dysregulation. For Japanese adults, loneliness was associated with decreased metabolic dysregulation. We decided to test additional models that included gender as a moderator of the association between loneliness and CVD indicators. Complex associations between gender, nationality, interdependence, and loneliness were found. Clinicians should consider addressing metabolic dysregulation and sleep in lonely patients, especially males and U.S. females. Future work could investigate how loneliness is appraised by Japanese men and U.S. women, and how loneliness affects the health behaviors and eating patterns of these groups.