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. 2025 Sep;60(9):2223-2235.
doi: 10.1007/s00127-025-02888-2. Epub 2025 Apr 7.

The prospective association of adolescent loneliness and low resilience with anxiety and depression in young adulthood: The HUNT study

Nayan Parlikar  1 , Linn Beate Strand  2 , Kirsti Kvaløy  2   3   4 , Geir Arild Espnes  2 , Unni Karin Moksnes  2
Affiliations

The prospective association of adolescent loneliness and low resilience with anxiety and depression in young adulthood: The HUNT study

Nayan Parlikar et al. Soc Psychiatry Psychiatr Epidemiol. 2025 Sep.

Abstract

Background: Loneliness is a recognized risk factor for anxiety and depression, yet research on its interaction with low resilience remains sparse, particularly across the adolescent-to-adult transition. This study investigates how adolescent loneliness, both independently and in interaction with low resilience, influences anxiety and depression in young adulthood.

Methods: This study utilized longitudinal data from The Trøndelag Health Study (HUNT) to track adolescents (13-19 years) from Young-HUNT3 (2006-08) through to HUNT4 (2017-19). Loneliness was assessed via a single-item measure, while resilience was estimated using the Resilience Scale for Adolescents. Anxiety and depression outcomes at the 11-year follow-up were measured using the Hospital Anxiety and Depression Scale. Multivariable logistic regression analyses were done to analyze the associations. Moreover, interaction effects were evaluated using relative excess risk due to interaction (RERI).

Results: Loneliness during adolescence independently predicted anxiety and depression in young adulthood. Adolescents experiencing both loneliness and low resilience showed notably higher risks compared to other groups (highly resilient adolescents without loneliness [reference], highly resilient adolescents with loneliness, and adolescents with low resilience and low loneliness). The combined effect of loneliness and low resilience exhibited a synergistic interaction on the additive scale, although it was not statistically significant (RERI 0.13, 95% CI -2.39-2.65).

Conclusion: Adolescent loneliness and low resilience independently predict anxiety and depression in young adulthood. The interaction between loneliness and low resilience further heightens these risks. This underscores the importance of early interventions that focus on resilience-building during adolescence and reducing the impacts of loneliness on mental health.

Keywords: Adolescence; Anxiety; Depression; HUNT Study; Interaction analyses; Loneliness; Mental health; Prospective study; Resilience.

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Conflict of interest statement

Declarations. Ethical approval: The HUNT Study was approved by the Data Inspectorate of Norway and recommended by the Regional Committee for Ethics in Medical Research. The ethical approval for conducting this study was also obtained from the Regional Committee for Ethics in Medical Research (REK Nord; reference number 286734). Consent for publication: Not applicable. Consent to participate: Informed consent was obtained from all individual participants of all the cohorts included in this study, as well as from legal guardians/next of kin if the student was under 16 years of age. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The risk of anxiety and depression in young adulthood associated with individual and joint exposures of adolescent loneliness and low resilience. Measurement of anxiety and depression levels in the study group, exclusively assessed using the Hospital Anxiety and Depression Scale Total (HADS-T). A HADS-T score of ≥ 19 indicates significant levels of anxiety and/or depression
See this image and copyright information in PMC

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