Characterizing the mechanisms of social connection

The impact of the COVID-19 pandemic on symptoms of depression and anxiety among older adults: the MYHAT study

OBJECTIVES

To identify subgroups of older adults whose mental health was affected by the COVID-19 pandemic.

METHODS

Interrupted time series (ITS) analyses were used to measure the long-term impact of the COVID-19 pandemic on symptoms of depression (mCES-D) and anxiety (GAD-7) among participants aged 65 years and older (n = 708) from a prospective, longitudinal cohort study.

RESULTS

Symptoms of depression, but not anxiety, significantly increased at the start of the pandemic, while long-term trends in depression and anxiety during the pandemic were similar to pre-pandemic trends. Participants aged 75 years and older exhibited a more rapid decline in depression symptoms over time than expected after an initial increase. Women experienced a greater immediate increase in anxiety that decreased over time, while men's anxiety increased over time. Cognitively normal participants experienced a greater than expected immediate increase in symptoms of depression that decreased over time, while symptoms were unchanged by the pandemic for those with cognitive impairment.

CONCLUSION

Despite an initial increase in depression symptoms, the pandemic did not result in elevated symptoms of depression and anxiety long-term. The impact of the pandemic on mental health varied by age, gender, and cognitive status, suggesting some groups may have been more vulnerable than others.

Affective and Social Predictors of Food Consumption During the COVID-19 Lockdown

BACKGROUND

COVID-19 lockdowns were linked to a surge in unhealthy food-related behaviors, potentially as an attempt to cope with disrupted social homeostasis. Here, we tested bidirectional associations between momentary psychological states and prospective food consumption and the moderation of these associations by quality and quantity of social interactions.

METHODS

We conducted a preregistered ecological momentary assessment study in Austria, Italy, and Germany during the first COVID-19 lockdown. Multiple times a day for 7 consecutive days, 798 participants (557 women, mean age = 31.88 years) reported on momentary stress; mood; wanting of food rich in sugar, fat, and salt; consumption and enjoyment since the last prompt; and quantity and quality of social interactions since the last prompt.

RESULTS

Momentary stress was positively linked to food wanting, but not to prospective food consumption. Mood valence and energetic arousal positively predicted prospective food consumption and enjoyment. The effect of mood valence was especially prominent when participants reported having more social interactions. Food consumption was linked to a prospective reduction in stress and an increase in calmness, suggesting that it has regulatory functions for affective states. Exploratory findings showed that some of these effects generalize to other reward types.

CONCLUSIONS

During the lockdown, food may have been used to maintain an already positive affective state rather than upregulating an aversive state. Social facilitation of eating may have been especially prominent due to the prioritization of social needs at the start of an extraordinarily challenging period, possibly orchestrated by the postulated social homeostasis system.

Loneliness and social conformity: A predictive processing perspective

For social creatures like humans, loneliness-which is characterized by a perceived lack of meaningful social relationships-can result in detrimental health outcomes, especially when experienced over an extended period of time. One potential way to pursue rewarding social connections could be social conformity, the tendency to align one's behavior and opinions to those of others. In this perspective article, we give a broad overview of common and distinct neural mechanisms underlying loneliness and social conformity, and the involvement of the oxytocinergic system therein. Additionally, we consider how loneliness can be understood within a predictive processing framework. Specifically, negative expectations could be related to altered representations of the self and others in the medial prefrontal cortex, whereas diminished bottom-up signals from the insula may contribute to reduced precision in the perception of the social environment. This negatively skewed internal model may perpetuate loneliness and lead to chronicity over time. While acute isolation and loneliness could drive people toward reconnection and increased social conformity, chronic loneliness may lead to distrust and avoidance, eventually resulting in nonconformity. We suggest different mediating mechanisms and moderating factors that warrant further investigation in future research.

Age-induced changes in affective prosody comprehension and its relationship with general cognitive ability and social support utilization among older adults

Aging can impact emotional recognition, affecting older adults' mental health and social function. This study examined how aging affects affective prosody comprehension (APC: understanding emotions through speech) across seven emotions (happiness, surprise, sadness, anger, fear, disgust, and neutrality) and its relationship with cognitive function (via the Montreal Cognitive Assessment) and social support (via the Social Support Rating Scale) in 199 cognitively normal older adults. We found that older adults had lower APC accuracy and more errors, often mistaking negative emotions for neutral or positive ones. APC accuracy was significantly associated with social support, and a partial least squares (PLS) cognitive component fully mediated the relationship between the APC component and social support utilization, explaining 61.7% of the total effect. These results suggest that declines in APC during aging are linked to social support utilization through cognitive function, offering insights for interventions to improve social and cognitive health in older adults.

Plasma proteomic signatures of social isolation and loneliness associated with morbidity and mortality

The biology underlying the connection between social relationships and health is largely unknown. Here, leveraging data from 42,062 participants across 2,920 plasma proteins in the UK Biobank, we characterized the proteomic signatures of social isolation and loneliness through proteome-wide association study and protein co-expression network analysis. Proteins linked to these constructs were implicated in inflammation, antiviral responses and complement systems. More than half of these proteins were prospectively linked to cardiovascular disease, type 2 diabetes, stroke and mortality during a 14 year follow-up. Moreover, Mendelian randomization (MR) analysis suggested causal relationships from loneliness to five proteins, with two proteins (ADM and ASGR1) further supported by colocalization. These MR-identified proteins (GFRA1, ADM, FABP4, TNFRSF10A and ASGR1) exhibited broad associations with other blood biomarkers, as well as volumes in brain regions involved in interoception and emotional and social processes. Finally, the MR-identified proteins partly mediated the relationship between loneliness and cardiovascular diseases, stroke and mortality. The exploration of the peripheral physiology through which social relationships influence morbidity and mortality is timely and has potential implications for public health.

Trends, transitions and patterning in social activity over time among aging women and men: A secondary analysis of the Canadian Longitudinal Study on Aging (CLSA)

Social isolation matters for health and longevity, but little research examines transitions into or out of social isolation or whether transitions are gendered or socially patterned. We described gender-specific trends in breadth and lack of social participation over 6 years overall and by age, country of origin, geographic location, education, wealth, and household income. We used three waves of CLSA data to evaluate changes in social isolation (0-1 activities) and broad social participation (5+ activities) in adults aged 45-75 (n = 24,788), by gender and socio-demographics, in linear and multinomial logistic regressions with post-estimated predicted probabilities. The number of social activities decreased over time, with greater declines for women. About half the sample (more men than women) stayed not highly socially active (<5 activities) and almost 1 in 5 became not highly socially active. Most adults (77 %) remained not socially isolated and 14 % became or remained socially isolated. Women were more likely than men to remain not highly socially active and less likely to have multiple social isolation transitions. Broad social participation changed over time for several subgroups of women and men, with gender differences notable for income levels. Social disparities in social isolation transitions differed by gender only for education. Older age and socioeconomically disadvantaged adults had higher probabilities of becoming socially isolated or becoming less socially active. Findings indicated the diversity of social activities declined as Canadians age into later life and transitions in both social isolation and social participation differed between genders, especially for specific vulnerable subpopulations.

Emotion Regulation Under Stress: A Social Processing and Memory Perspective

Research on emotion regulation often focuses on cognitively effortful self-regulation strategies, but exposure to stress has been shown to interfere with the underlying mechanisms supporting such processes. Understanding alternative strategies that potentially bolster emotion regulation under stress is an important topic of investigation. Two potential alternatives involve everyday occurrences of social processing and memory recall. Social support and past emotional experiences may help in guiding us toward appropriate neurophysiological responses through overlapping circuitry with stress and reward systems, while also buttressing cognitive regulation strategies by expanding one's perspective and allowing multiple opportunities to regulate retrospectively. In recognition that ongoing social and emotional events are often at the beginning of a cascade of both emotion regulation and memory processes, this chapter focuses on the emerging role of social relationships and autobiographical memory recall in regulating emotions under stress, highlighting opportunities and challenges associated with this process.

How adolescents learn to build social bonds: A developmental computational account of social explore-exploit decision-making

Building social bonds is a critical task of adolescence that affords opportunities for learning, identity formation, and social support. Failing to develop close relationships in adolescence hinders adult interpersonal functioning and contributes to problems such as loneliness and depression. During adolescence, increased reward sensitivity and greater social flexibility both contribute to healthy social development, yet we lack a clear theory of how these processes interact to support social functioning. Here, we propose synthesizing these two literatures using a computational reinforcement learning framework that recasts how adolescents pursue and learn from social rewards as a social explore-exploit problem. To become socially skilled, adolescents must balance both their efforts to form individual bonds within specific groups and manage memberships across multiple groups to maximize access to social resources. We draw on insights from sociological studies on social capital in collective networks and neurocognitive research on foraging and cooperation to describe the social explore-exploit dilemma faced by adolescents navigating a modern world with increasing access to diverse resources and group memberships. Our account provides important new directions for examining the dynamics of adolescent behavior in social groups and understanding how social value computations can support positive relationships into adulthood.

Considering information-sharing motives to reduce misinformation

Misinformation has risen in recent years, negatively affecting domains ranging from politics to health. To curb the spread of misinformation it is useful to consider why, how, and when people decide to share information. Here we suggest that information-sharing decisions are value-based choices, in which sharers strive to maximize rewards and minimize losses to themselves and/or others. These outcomes can be tangible, in the form of monetary rewards or losses, or intangible, in the form of social feedback. On social media platforms these rewards and losses are not clearly tied to the accuracy of information shared. Thus, sharers have little incentive to avoid disseminating misinformation. Based on this framework, we propose ways to nudge sharers to prioritize accuracy during information-sharing.

Strengthening Neuroplasticity in Substance Use Recovery Through Lifestyle Intervention

The incidence of substance use and behavioral addictions continues to increase throughout the world. The Global Burden of Disease Study shows a growing impact in disability-adjusted life years due to substance use. Substance use impacts families, communities, health care, and legal systems; yet, the vast majority of individuals with substance use disorders do not seek treatment. Within the United States, new legislation has attempted to increase the availability of buprenorphine, but the impact of substance use continues. Although medications and group support therapy have been the mainstay of treatment for substance use, lifestyle medicine offers a valuable adjunct therapy that may help strengthen substance use recovery through healthy neuroplastic changes.

Loneliness and brain rhythmic activity in resting state: an exploratory report

Recent studies using resting-state functional magnetic resonance imaging have shown that loneliness is associated with altered blood oxygenation in several brain regions. However, the relationship between loneliness and changes in neuronal rhythm activity in the brain remains unclear. To evaluate brain rhythm, we conducted an exploratory resting-state electroencephalogram (EEG) study of loneliness. We recorded resting-state EEG signals from 139 participants (94 women; mean age = 19.96 years) and analyzed power spectrum density (PSD) and functional connectivity (FC) in both the electrode and source spaces. The PSD analysis revealed significant correlations between loneliness scores and decreased beta-band powers, which may indicate negative emotion, attention, reward, and/or sensorimotor processing. The FC analysis revealed a trend of alpha-band FC associated with individuals' loneliness scores. These findings provide new insights into the neural basis of loneliness, which will facilitate the development of neurobiologically informed interventions for loneliness.

Application of an egocentric social network approach to examine changes in social connections following treatment for anxiety and depression: A novel measurement tool for clinical trials research?

The epidemic of loneliness and social isolation has been recognized as a public health crisis warranting the same prioritization as other public health issues today, such as obesity, substance use disorders, and tobacco use. Social disconnection is particularly prevalent and disabling among individuals with anxiety and depression, yet it is inadequately evaluated and addressed in most clinical psychology treatment research. Studies generally employ global measures of perceived connectedness, loneliness, or relationship satisfaction, limiting understanding about elements of one's social network that may change with treatment. This study examined changes in the degree (number of people nominated) and quality of one's social network from pre-to post-treatment using an egocentric social network approach in 59 adults (mean age = 30.8 years, range = 18 to 54) with clinically elevated anxiety or depression who were randomized to a cognitive and behavioral positive valence treatment versus waitlist. Participants (egos) named people in their lives (alters) with whom they discussed important issues or spent free time. For each alter, participants rated how close they felt, how close they thought the alter felt to them, and how frequently they communicated. Linear regressions, which included treatment group as a predictor, revealed no group differences in changes in network degree, perceived alter feelings of closeness, or communication frequency, despite prior findings from this sample indicating larger increases in perceived global connectedness in the treatment group. Unexpectedly, the control group reported a greater increase in perceived closeness to alters. Post-hoc analyses revealed this was explained by the treatment group identifying more distal social ties (e.g., extended family, colleagues, roommates) as alters following treatment - an outcome positively associated with global improvements in connectedness. This proof-of-concept study suggests egocentric social network surveys may provide unique information on treatment-related changes in social functioning. Suggestions are provided for adaptations to facilitate application of social network surveys to mental health treatment research.

Fostering wellbeing and healthy lifestyles through conviviality and commensality: Underappreciated benefits of the Mediterranean Diet

Among the often-neglected features of healthy diets, such as the Mediterranean diet, is the preparation and sharing of food, which is (or was) done in a social environment governed by social rules rather than by time constraints. The act of eating is a daily human practice that is not limited to meeting nutritional and energy needs but also involves a constructed social dimension of sharing meals that is part of the process of human civilization and food cultures around the world. In this narrative review, we outline the importance of conviviality in steering part of the health effects of healthful diets, with special reference to the Mediterranean diet. Based on the available evidence, we suggest that public health initiatives (such as nudging to promote conviviality) to improve people's eating and living styles, reduce loneliness, and promote the sharing of meals could improve health. Interventions aimed at directly increasing/improving people's social relationships, networking, and conviviality can-directly and indirectly-improve both psychological well-being and general health.

The missing hallmark of health: psychosocial adaptation

The eight biological hallmarks of health that we initially postulated (Cell. 2021 Jan 7;184(1):33-63) include features of spatial compartmentalization (integrity of barriers, containment of local perturbations), maintenance of homeostasis over time (recycling & turnover, integration of circuitries, rhythmic oscillations) and an array of adequate responses to stress (homeostatic resilience, hormetic regulation, repair & regeneration). These hallmarks affect all eight somatic strata of the human body (molecules, organelles, cells, supracellular units, organs, organ systems, systemic circuitries and meta-organism). Here we postulate that mental and socioeconomic factors must be added to this 8×8 matrix as an additional hallmark of health ("psychosocial adaptation") and as an additional stratum ("psychosocial interactions"), hence building a 9×9 matrix. Potentially, perturbation of each of the somatic hallmarks and strata affects psychosocial factors and vice versa. Finally, we discuss the (patho)physiological bases of these interactions and their implications for mental health improvement.