Evaluating the Effectiveness of Interventions to Reduce Loneliness in Chinese Young Adults

Group-Based Positive Affect Intervention for Loneliness Reduction: A Randomized Controlled Trial in Chinese Young Adults

This study aims to evaluate the effectiveness of a group-based Positive Affect (PA) intervention compared to an active control condition, Social Skills Training (SST), in reducing loneliness among young adults in Hong Kong and mainland China. It further examines the psychological mechanisms underlying intervention effects, specifically the roles of positive affect and perceived social support as mediators, and rejection sensitivity as a moderator influencing both treatment responsiveness and outcome translation.

Loneliness among young adults has become a growing public health concern, linked to depression, anxiety, low self-esteem, and reduced life satisfaction. Unlike older adults, whose loneliness is often tied to social isolation, loneliness in young adulthood is shaped by developmental transitions, shifting relational needs, and heightened sensitivity to social evaluation. Existing interventions largely target older populations and often fail to address the emotional and cognitive processes central to loneliness in younger groups.

This study addresses these gaps by adopting a multi-theoretical framework that integrates the Social Needs Perspective, Weiss's Multidimensional Theory, the Cognitive Discrepancy Model, and the Reaffiliation Motive Model. Together, these perspectives conceptualize loneliness as arising from unmet needs for meaningful connection, discrepancies between desired and actual relationships, and maladaptive cognitive and behavioral responses that hinder reconnection.

The study employs a two-arm randomized controlled trial design. A total of 100 college students in Hong Kong and mainland China who report elevated loneliness will be recruited and screened using the UCLA Loneliness Scale. Eligible participants will be randomly assigned to either the group-based Positive Affect (PA) intervention or the group-based Social Skills Training (SST) active control condition. Both interventions will be delivered in four weekly group sessions lasting 45-60 minutes.

• The PA Intervention: Grounded in the Broaden-and-Build Theory and revised Stress and Coping Theory. It adopts a multi-skill approach to enhance positive emotions through practices such as savoring positive events, gratitude, mindfulness, positive reappraisal, strengths identification, goal setting, and acts of kindness. These skills are expected to increase positive affect, promote social engagement, and strengthen psychological resources, thereby reducing loneliness.
• The SST Intervention: Serves as an active control and focuses on improving interpersonal competence. It includes training in social behavior styles (assertive, shy, and aggressive), initiating and maintaining social interactions, setting boundaries, giving and receiving feedback, and conflict resolution. Improvements in interpersonal competence are expected to enhance perceived social support, which in turn reduces loneliness.

Primary outcomes will be assessed using the UCLA Loneliness Scale, with additional measures capturing positive affect, perceived social support, social network discrepancy, mindfulness, emotion regulation, self-efficacy, and rejection sensitivity. Data will be collected at baseline, with follow-ups at 1 and 3 months. Linear mixed-effects models will be used to examine intervention effects over time, while mediation and moderated mediation analyses will test the proposed mechanisms.

A key innovation of this study lies in its examination of mechanisms. Positive affect and perceived social support are hypothesized as mediators, reflecting emotional and relational pathways to loneliness reduction. Rejection sensitivity is modeled as a moderator that influences both how participants respond to the intervention and how gains translate into reduced loneliness. Individuals with high rejection sensitivity may show weaker intervention effects due to heightened threat perception and social withdrawal tendencies.

This research contributes to both theory and practice by testing a developmentally appropriate, mechanism-driven intervention for young adults. It advances understanding of how emotional and social processes interact in loneliness reduction and provides evidence for scalable, group-based interventions that can be implemented in university and community settings.

Inclusion Criteria:

• aged 18 to 30 years
• proficiency in Chinese (Cantonese or Mandarin)
• experiencing loneliness (defined as a score of ≥ 6 on the 3-item UCLA Loneliness Scale)

Exclusion Criteria:

• cognitive impairments
• psychiatric disorders, learning disabilities, or active suicidal ideation
• currently participating in other psychotherapy or psychosocial interventions aimed at enhancing well-being