title: Trajectories of loneliness in adolescents with congenital heart disease: associations with depressive symptoms and perceived health.
abstract: OBJECTIVE
  Acquiring close peer relationships is an important developmental task in adolescence. This task may be particularly demanding for adolescents with congenital heart disease (CHD), who face disease-specific challenges putting them at risk for social isolation and loneliness. This study compared cross-sectional levels of loneliness in adolescents with and without CHD; examined the longitudinal course of loneliness and identified different developmental trajectory classes in adolescents with CHD; and investigated to what extent these trajectory classes are accompanied by differences in depressive symptoms and perceived health.
  
  
  METHODS
  A total of 429 adolescents with simple to complex CHD participated in the present longitudinal study consisting of three measurement waves with 9-month intervals (M(age) = 15.75 years at T1; 53.4% boys). The control sample at time 1 (T1) consisted of 403 adolescents who were matched in terms of age and sex.
  
  
  RESULTS
  Patients and controls did not differ in loneliness levels at T1. In adolescents with CHD, latent class growth analysis identified five trajectory classes (i.e., chronically high, high decreasing, moderate stable, low increasing, and stable low), which were meaningfully distinguished on depressive symptoms and several domains of perceived health. In general, adolescents in the chronically high loneliness trajectory reported the most depressive symptoms and the poorest perceived health, whereas adolescents in the low stable trajectory reported the opposite pattern.
  
  
  CONCLUSIONS
  Findings demonstrate that chronic feelings of loneliness are associated with worsened perceived health in adolescents with CHD. Intervention programs targeting patients' adjustment should be sensitive to the presence of such feelings.
authors.affiliation: School Psychology and Child and Adolescent Development, KU Leuven, Leuven, Belgium. Janne.Vanhalst@ppw.kuleuven.be
authors.forename: Janne
authors.initials: J
authors.lastname: Vanhalst
authors.forename: Jessica
authors.initials: J
authors.lastname: Rassart
authors.forename: Koen
authors.initials: K
authors.lastname: Luyckx
authors.forename: Eva
authors.initials: E
authors.lastname: Goossens
authors.forename: Silke
authors.initials: S
authors.lastname: Apers
authors.forename: Luc
authors.initials: L
authors.lastname: Goossens
authors.forename: Philip
authors.initials: P
authors.lastname: Moons
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D003863:Depression / Q000523:psychology*; D005260:Female; D006330:Heart Defects, Congenital / Q000523:psychology*; D006801:Humans; D008132:Loneliness / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D012649:Self Concept
keywords: Depressive symptoms; Heart defects, congenital; Loneliness; Perceived health; Trajectories