Title: Prevalence and Factors Associated with Loneliness Among Indonesian Female
Adolescents: A Cross-Sectional Study
Version: 0 Date: 08 Feb 2022
Reviewer's report:
Title - Investigating the Prevalence and Associated Factors of Loneliness Among Indonesian
Female Adolescents: A Cross-Sectional Study
Overview – The manuscript presents a study aimed at investigate the prevalence and risk
factors associated with loneliness. The study utilises a large and representative sample – great.
The Introduction provides a clear overview of literature but the aims could be more concise
and highlight the importance of the current study in a more explicit manner. The Discussion
summarises the key results but warrants further exploration into why we would expect to see
these relationships (even in an understudied sample) .
Abstract
The Abstract provides a good overview of the study. As adolescence can cover a large
developmental period, providing an age range within the Abstract would be useful for the reader.
To help highlight the use of recognised measures, including the citation/name/details of the
loneliness measure would also strengthen the Abstract. However, it is a well structure Abstract
and provides a clear overview of the current manuscript
Introduction
To help add context to the study, a clarification as to what “adolescence” is would be useful.
This is a current area of debate so it would be useful to add clarify from the start. It can also vary
between culture and countries depending on societal level aspects.
The Introduction provides a clear overview of loneliness – good.
The novelty, or contributing factor, of the study could be made more explicit – if the sample
(Indonesian female adolescents) is the novelty, then this should be clear. This could be
highlighted through the inclusion of clear hypothesis / research question. The wording of the
current aim is broad and could be more concise.
Method
Using a single item measure of loneliness has been seen before but this needs to be made clear.
Include references to those papers that have utilised single items and include a justification (such
as validity of such a measure). The method also suggests a cut off point of “mostly or always feel
lonely”. To help the reader understand this fully, include the response options (did participants
have 5 response options? What are they?). Also, unlike other measures, there are no published
clinical cut off points for what classes as “Lonely”. How was “mostly or always feeling often”
decided? If this was based on previous research, please include details. If this was based on
median split or other statistical decisions, please include details.
To help the readers understand the nature of questions, it is great you have provided a reference
to the WHO GHSH website. However, to make the paper more accessible, it may be useful
to comment upon whether the other variables were continuous in nature and provide any
statistics relating to their reliability/validity  (such as Cronbach’s alpha level or a sentence stating
“Measures were reported to have high reliability (ref)”).
Results
To help improve flow, remind the reader what test was conducted to support “significantly higher
rate of loneliness was found among…”. Clear overview of regression analysis.
Discussion
The discussion relating to prevalence rates is interesting – particularly considering the
differences across culture. There is a growing body of evidence looking at the role of culture
(and stigma) in the reporting rates of loneliness so this presents an interesting contribution.
As there are many different variables to explore, the discussion lacks cohesion –  drawing links
between constructs or focusing more on possible mechanisms may help prevent the discussion
reading as a list of results.
The Discussion would benefit from an honest reflection of the key strengths and limitations
of the current study. For example, the sample is a clear strength. The lack of covariates may
be explored as a potential limitation. Also, considering the reverse effects – so can increased
sleep disturbances lead to increased loneliness? Including a reflection on possible limitations
and suggesting future avenues for research will help highlight how the current study adds to
current literature (and future directions in the field)