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All Journal Scientia Psychiatrica Sriwijaya Journal of Obstetrics and Gynecology Sriwijaya Journal of Neurology Sriwijaya Journal of Otorhinolaryngology
Aline Hafidzah
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : Scientia Psychiatrica

 1 
Loneliness as a Lethal Risk Factor: A Five-Year Prospective Survival Analysis of All-Cause Mortality Among Elderly Residents in Indonesian Vertical Public Housing Dedi Sucipto; Brenda Jaleel; Aline Hafidzah; Oliva Azalia Putri
Scientia Psychiatrica Vol. 6 No. 3 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i3.199

Abstract

Introduction: Rapid urbanization in Indonesia has necessitated a shift from horizontal settlements (kampung) to vertical public housing (Rusunawa). While providing shelter, these environments may exacerbate "crowded isolation”. This study investigates the synergistic impact of loneliness, depression, and vertical living constraints on all-cause mortality among the elderly. Methods: We conducted a multi-center, prospective cohort study (2018–2023) involving 1,450 elderly residents (> 60 years) in Jakarta and Surabaya. Loneliness was assessed annually using the UCLA Loneliness Scale, and depression via the GDS-15. The primary environmental exposure was "vertical constraint," defined as living above the 3rd floor (Floors 4–12). We utilized Kaplan-Meier survival curves and Multivariable Cox Proportional Hazards models with time-dependent covariates to estimate Hazard Ratios (HR), adjusting for sociodemographic factors and a composite Socioeconomic Status (SES) index. Results: Of 1,398 baseline participants, 218 deaths occurred over 6,890 person-years (15.6% mortality). Severe loneliness was an independent predictor of mortality (Adjusted HR: 1.89; 95% CI: 1.42–2.51). A significant interaction was observed between loneliness and vertical constraint (p=0.003). While residents on higher floors had lower baseline mortality due to selection bias (the "healthy resident effect"), loneliness in this subgroup amplified mortality risk substantially (Interaction HR: 1.76; 95% CI: 1.21–2.55), effectively negating their physical survival advantage. Conclusion: Loneliness is a potent predictor of mortality in Indonesian vertical slums, with lethality accelerated by the physical entrapment of high-floor living. Structural interventions are urgently required to mitigate this "vertical isolation."
Buffering Effects of Extended Family: A Moderated Mediation Analysis of Maternal Depression, Parenting Stress, and Early Childhood Development in West Java, Indonesia Habiburrahman Said; Novalika Kurnia; Aline Hafidzah; Vania Delma; Fachrudin Sani
Scientia Psychiatrica Vol. 6 No. 2 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i2.201

Abstract

Introduction: In low- and middle-income countries (LMICs), maternal mental health significantly impacts early childhood development (ECD). West Java, Indonesia, presents a unique cultural context where extended family involvement is ubiquitous. This study aims to elucidate the mechanism linking maternal depressive symptoms to early childhood developmental delays, focusing on the mediating role of parenting stress and the moderating role of social support from extended family. Methods: A cross-sectional analytical study was conducted in five regencies of West Java (N = 842 mother-child dyads). Children were aged 12–36 months. We utilized the Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms, the Parenting Stress Index-Short Form (PSI-SF) for stress, the Multidimensional Scale of Perceived Social Support (MSPSS) adapted for extended family, and the Ages and Stages Questionnaire (ASQ-3) for developmental monitoring. A moderated mediation model (Hayes Model 7) was tested using Structural Equation Modeling (SEM) with 5,000 bootstrap samples. Results: High maternal depressive symptoms were significantly associated with lower ECD scores (β = -0.42, p < 0.001). Parenting stress partially mediated this relationship (Indirect Effect = -0.18, 95% CI [-0.24, -0.13]). Crucially, extended family support moderated the path between depression and parenting stress (β = -0.15, p < 0.01). Specifically, the impact of depression on parenting stress was significantly dampened in households with high extended family engagement compared to those with low support. Conclusion: Parenting stress is a critical pathway through which maternal depression compromises child development. However, the collectivist family structure in West Java serves as a protective buffer. Interventions should target not only the mother but also mobilize the extended family network as a resource for 'kalyana mitra' (supportive friends/family).
Co-Authors Badrool Nizham Brenda Jaleel Dedi Sucipto Fachrudin Sani Fatimah Mursyid Habiburrahman Said Istiqomah Putri Lisye Tiur Simanjuntak Novalika Kurnia Oliva Azalia Putri Reisha Notonegoro Reza Andrianto Sophia Lucille Rodriguez Tanvir Ahmed Theresia Putri Sinaga Vania Delma Winata Putri