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Loneliness and Its Associations With Personality Functioning: Evidence From Longitudinal Inpatient Psychotherapy

Julia I Kunz^1,2, Barbara B Barton^1,2, Niklas Wolfrum¹

¹Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany.

Annals of the New York Academy of Sciences

|February 5, 2026

Summary

Loneliness is linked to personality functioning in individuals with personality disorders (PDs). Treatment improved both loneliness and personality functioning, suggesting interconnectedness and potential for interventions.

Keywords:

alternative model for personality disorders loneliness personality disorders personality functioning

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Area of Science:

Psychiatry and Psychology
Clinical Psychology
Mental Health Research

Background:

Loneliness is prevalent in mental health disorders and can worsen psychopathology.
Individuals with personality disorders (PDs) are particularly vulnerable to loneliness.
Limited understanding exists regarding the link between loneliness and personality functioning (PF).

Purpose of the Study:

To investigate the association between loneliness and facets of personality functioning (PF).
To explore the longitudinal relationship between loneliness and PF in patients undergoing psychotherapy.
To inform clinical practice by clarifying mechanisms linking loneliness and maladaptive functioning.

Main Methods:

Longitudinal study of 87 inpatients in psychotherapy programs.
Loneliness assessed using the UCLA Loneliness Scale.
Personality functioning evaluated via the Semi-Structured Interview for Personality Functioning and the Level of Personality Functioning Scale.

Main Results:

Baseline loneliness positively correlated with self-direction and intimacy.
Changes in loneliness over time were associated with changes in identity and intimacy.
Significant improvements in loneliness and personality functioning, especially self-functioning, were observed during treatment.

Conclusions:

Loneliness is cross-sectionally and longitudinally associated with self- and interpersonal functioning in PD patients.
Findings suggest interconnectedness between loneliness and PF dimensions.
Further research is needed to identify mechanisms for developing targeted interventions to reduce loneliness in PDs.