Perceived social isolation and cognition

Association between loneliness and suicidality among general populations and persons with depressive and bipolar disorders: A systematic review

BACKGROUND

Loneliness and suicidality are interrelated phenomena. Several studies suggest that they often co-exist, but the magnitude is unclear. This systematic review aims to analyze this association in general population samples of varying age groups and persons with depressive and bipolar disorders.

METHODS

Search terms in this review included words related to loneliness and suicidality among general populations and depressive and bipolar disorders. Databases included PubMed, PsychINFO, and Web of Science. The search occurred up until May 27, 2024. Screening and data extraction were performed independently. Studies were categorized by age group or clinical diagnosis. Quality assessments were conducted using NIH tools.

RESULTS

Fifty-six studies met eligibility criteria: 52 involved general population samples and 4 involved patients with depressive or bipolar disorders. In healthy adults aged 18 to 64, loneliness mainly showed a moderate positive correlation with suicidality (r = 0.26 to 0.59), while correlations in older adults (aged 65+) (r = 0.498) and in adolescents aged 13-17 were weaker. In depressive and bipolar disorders, correlations ranged from weak to moderate (r = -0.06 to 0.40), with associations stronger in unadjusted models (UOR = 2.8 to 7.07). Furthermore, some studies suggested that depressive symptoms mediate the association between loneliness and suicidality.

CONCLUSION

A moderate and positive association was observed between loneliness and suicidality in healthy adults and patients with depressive disorders. However, the role of bipolar disorders in the association remains unclear. Practitioners should routinely evaluate persons living with depressive or bipolar disorders for loneliness as part of a comprehensive assessment.

Suffering in Silence: Loneliness Among Men with Prostate Cancer and the Potential for Exercise as Connection

Prostate cancer can make men feel socially isolated, even from friends and family, leading to feelings of loneliness that negatively impact their health and quality of life. Group-based exercise shows promise in addressing the social, emotional, and physical needs of men with prostate cancer.

Mapping vulnerability factors of chronic emotional and social loneliness: A network analysis

BACKGROUND

Chronic loneliness adversely impacts both mental and physical health. As current interventions are only moderately effective, examining vulnerability factors reflected in interpersonal behavior and their relationships with specific chronic loneliness subtypes may provide insights. The present study explored the associations between loneliness vulnerability factors and two subtypes of chronic loneliness: chronic emotional loneliness (a longing for intimate connections) and chronic social loneliness (dissatisfaction with the quantity and quality of one's social network).

METHODS

The sample consisted of 294 university students who had recently started at a new university. Participants completed surveys across three time points, separated by three-month intervals, including questionnaires on emotional and social loneliness, adult attachment styles, interpersonal behavioral styles, and features of emotional disorders. To explore relationships, we used network analysis by estimating a Mixed Graphical Model (MGM), in which chronic emotional loneliness and chronic social loneliness were dichotomized as binary variables (absence versus presence), while vulnerability factors were treated as continuous variables.

RESULTS

The network analysis demonstrated that chronic loneliness subtypes were differentially linked to vulnerability factors. Chronic emotional loneliness was predominantly linked to features of emotional disorders, whereas chronic social loneliness demonstrated a negative conditional association with secure attachment style.

LIMITATIONS

The assessment of chronic loneliness was based on three time points, which does not capture potential fluctuations between assessments.

CONCLUSIONS

These findings highlight the importance of differentiating between chronic loneliness subtypes when examining vulnerability factors. By distinguishing these subtypes, tailored interventions for loneliness can be developed to enhance prevention.

Latent Classes of Social Isolation and Adverse Experiences Among South Korean Young Adults: Implications for Depression and Mental Health Interventions

This study explored the patterns of social isolation and adverse experiences, and their relationship with depression among young adults. Social isolation was considered in two dimensions: internal isolation and external isolation. Data from 550 South Korean young adults, collected in the Survey on the Status of Socially Isolated Youth in Seoul by the Seoul Metropolitan Government, were used for this study. Latent Class Analysis (LCA) was employed to identify homogeneous and mutually exclusive classes of adverse experiences (such as domestic and school violence, and unemployment) and social isolation. The LCA resulted in three profiles: (a) combined isolation (11.27%), (b) external isolation (47.27%), and (c) internal isolation (41.46%). The combined isolation profile experienced multiple severe adverse experiences throughout life, while the external isolation group was characterized by modest unemployment or difficulty finding a job, challenges in forming interpersonal relationships, and mental health issues. This class had the highest levels of external isolation and no internal isolation. The internal isolation class exhibited similar patterns of adverse experiences, with slight variations in the severity of those experiences. The internal isolation class was characterized by both internal and external social isolation, with the highest level of internal isolation among all classes. Depressive symptoms were found to be highest in the combined isolation group. The study demonstrated that screening for both dimensions of social isolation is important in social work practice and that practitioners and social workers should be aware of the challenges faced by young people with histories of severe multiple adverse experiences.

Do Individuals With Overweight and Obesity Have Reduced Affective and Cognitive Empathy? A Systematic Review and Meta-Analysis

Background and Objectives

Obesity is associated with various interpersonal difficulties. Previous research on empathy has indicated that weight is negatively correlated with empathic skills in children and adolescents. However, few studies have examined this question in adults, and the existing studies have provided inconsistent results.

Methods

This systematic review and meta‐analysis aimed to examine empathic skills among people with overweight and obesity. Six databases were searched to find studies based on performance measures and self‐report questionnaires investigating cognitive and affective empathy in adults with overweight and obesity (BMI > 25 kg/m2) compared with normal‐weight individuals.

Results

Ten studies involving 2648 individuals were included after screening the 6779 references that were initially retrieved from the database. Analyses revealed a significant difference between individuals with overweight/obesity and normal‐weight individuals (k = 11, Hedge's g = −0.52 [−0.97, −0.07], Z = −2.26, p = 0.024). Subgroup analyses revealed no significant difference between people with overweight and people with obesity (Q = 0.36, p = 0.546). However, the effect size for cognitive empathy was higher than that for affective empathy (Q = 7.30, p = 0.007), and the effect size for performances measures was higher than that for self‐report questionnaires (Q = 6.61, p = 0.010).

Conclusion

Adults with overweight or obesity present lower scores of empathy, particularly for cognitive empathy. These results emphasize the need to better understand which specific components of cognitive empathy might be affected and to conduct studies to evaluate affective empathy beyond self‐report questionnaires. Future research should also determine the underlying mechanisms and longitudinally test the role of empathy in the onset and maintenance of obesity.

The status of readiness for hospital discharge of patients with post-stroke cognitive impairment and its relationship with post-discharge social isolation

BACKGROUND

The current status of readiness for hospital discharge (RHD) in patients with post-stroke cognitive impairment (PSCI) is not clear. This study aimed to investigate the current status of RHD in patients with PSCI, identify potential influencing factors, and explore the relationship between RHD and social isolation after discharge.

METHODS

This was an observational study reported according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. We selected patients with post-stroke cognitive impairment from the Department of Neurology at a tertiary hospital in Zhejiang Province, China, from August to December 2023. Data were collected via a general information questionnaire, the Montreal Cognitive Assessment, the Readiness for Hospital Discharge Scale, and the Lubben Social Network Scale.

RESULTS

We surveyed a total of 170 patients, and collected complete data from 155 patients. The total Readiness for Hospital Discharge Scale score ranged from 67 to 111 (mean ± SD: 87.46 ± 9.64), with 58 (37.4%) patients identified as underprepared. Multivariate linear regression analysis of the significant variables identified via univariate analysis revealed that annual household income, residence, and Montreal Cognitive Assessment scores significantly affected RHD. Correlation analysis revealed that National Institutes of Health Stroke Scale scores were significantly negatively correlated with Lubben Social Network Scale scores, whereas Montreal Cognitive Assessment scores were positively correlated. There was also a significant positive correlation between RHD and social isolation.

CONCLUSION

Readiness for hospital discharge among patients with post-stroke cognitive impairment is at a medium level. Patients with higher annual household income, urban residence, and lower Montreal Cognitive Assessment scores had greater readiness for discharge. There is a significant correlation between readiness for discharge and social isolation after discharge. Improving patients' readiness for hospital discharge may help reduce social isolation.

Effects of Adolescent Social Isolation on PFC's β-Catenin Levels and Anxiety-Like Behaviors in Male and Female Rats: Study of the Role of Dopaminergic D2 Receptors

Adolescence is a key period of development when major cognitive and neurobiological changes occur. Results from our lab showed that 5 days of social isolation in adolescent rats led to molecular changes in the Wnt/β-catenin pathway and to higher cocaine responses during adulthood. We assessed whether 5 days of social isolation (SI) during adolescence would impact on β-catenin levels in the prefrontal cortex (PFC) and nucleus accumbens (NAcc) as well as on anxiety-like behaviors in a sex- and time-dependent manner. We also investigated the role of dopaminergic neurotransmission on that impact, by using repeated administration of a D2 antagonist. Male and female Wistar rats were socially isolated between postnatal day (PND)30 to 35 or kept in their home cages (non-isolated), while they were treated with sulpiride (100 mg/kg, ip) or vehicle. Anxiety-like behaviors and exploratory activity were estimated by the open field test at 24 h (PND36) or 9 days (PND44) after isolation. Then, they were euthanized at PND36 or PND45, and β-catenin levels were analyzed by Western blot in PFC and NAcc. Our findings show that a brief SI during adolescence leads to a long-term impact on both β-catenin levels (10 days, PND45) and anxiety-like behaviors (9 days, PND44) with a significant increase and decrease, respectively, in female rats. In contrast, male rats show a rapid decrease in β-catenin levels in the PFC with no changes in anxiety-like behaviors (24 h, PND36). These suggest that adolescent SI induces mostly long-term changes in female while short term changes in male rats. Moreover, these changes seem to be modulated by dopaminergic neurotransmission since a sulpiride treatment during isolation prevented them.

Development of social isolation and social network assessment tool for older adults: A Delphi survey

OBJECTIVE

Social Isolation and network are crucial factors which affect the quality of life and overall health of older adults. Therefore, in the field of health promotion, there's a growing attention to assess and evaluate the social health including social isolation and network of older adults. This study aimed to develop a Social Isolation and Social Network (SISN) evaluation tool that comprehensively measure the social isolation and network of older adults.

METHODS

Between April and June 2024, we gathered insights from 23 experts in lifestyle and health. Based on the previous research, a two-round Delphi survey was conducted to obtain expert consensus on key assessment components. In the initial survey, we collected expert's opinions through open and closed-ended questions about social isolation and social network evaluation items. After the first survey, we corrected several items that didn't meet the Content Validity Ratio (CVR) standard before proceeding. We presented the first survey's findings to an expert panel, leading to a consensus.

RESULTS

The initial Delphi round produced 32 items and the second round resulted in 30 items after adjusting those with CVR scores of 0.37 or less. The final CVR was 0.87 with a convergence of 0.87, a consensus level of 0.31 and stability level of 0.12.

CONCLUSION

This study successfully developed a comprehensive social isolation and social network assessment using a modified Delphi technique. The 30 items are categorized into three sections. The SISN is able to provide a systematic approach to evaluate social isolation and social network of older adults. Future studies should be conducted to examine the reliability and validity.

Loneliness modulates the neural dynamics of language processing in healthy older adults: evidence from event-related potentials

Loneliness, a distressing emotional response to perceived deficiencies in social interactions, has seen a marked increase in prevalence since the COVID-19 pandemic. While previous research has linked loneliness in older adults to affective disorders and cognitive decline, its impact on language comprehension-a crucial aspect of social interaction-remains underexplored. This study addresses this gap by examining the effects of loneliness on semantic retrieval in healthy older adults. Using event-related potentials, we measured participants' neural responses as they verified category membership across three conditions: high typicality, low typicality, and category violations. We found that loneliness was negatively correlated with an N400 amplitude reduction for low-typicality items compared to category violations. Moreover, individuals who reported a high level of loneliness exhibited attenuated and delayed N400 effects within more restricted time windows compared to their less lonely counterparts. These results indicate that loneliness impairs semantic memory retrieval in older adults, potentially compromising language comprehension and further exacerbating social isolation. This research highlights the detrimental impact of loneliness on linguistic abilities, which may contribute to a vicious cycle of increasing social isolation and deepening loneliness.

The Influence of Loneliness, Social Support and Income on Mental Well-Being

Mental well-being is a multifaceted concept that reflects emotional stability, psychological resilience and social connectedness. This study examines how demographic factors, perceived loneliness, and social support influence mental well-being in Spain. Participants were surveyed online and provided personal information along with responses to the University of California, Los Angeles (UCLA) Loneliness Scale, the Medical Outcomes Study Social Support Survey (MOS-SSS), and the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). Our findings support previous research on mental well-being in Spain and again show significant associations between income, loneliness, social support and overall mental health. In particular, perceived loneliness was found to be a strong predictor of mental well-being. Furthermore, income and social support were found to partially mediate the relationship between loneliness and mental well-being. These findings highlight the critical role of social connections and financial stability in promoting mental health. Overall, this research contributes to the growing understanding of the factors influencing mental well-being and provides valuable insights for improving mental health outcomes.

Ambiguity potentiates effects of loneliness on feelings of rejection

For social species, having strong and high-quality social relationships is an important safety cue. Loneliness occurs when an individual perceives they have insufficient relationships resulting in feelings of lack of safety. States of perceived unsafety are linked to an increased tendency to construe ambiguous information - information lacking a unique clear interpretation - as threatening. Here, we explore whether the ambiguity of social cues of interpersonal rejection moderates effects of loneliness on feelings of rejection while undergoing social exclusion. Data were collected in 2021; 144 adults completed a progressive social exclusion paradigm where they were randomly assigned to be equally included, excluded, or over-included. Social exclusion/inclusion cues became more pronounced over the course of multiple rounds of a ball-tossing game (Cyberball) resulting in a scenario where ambiguity was highest in earlier rounds and decreased over time. Participants reported feelings of loneliness prior to the task and feelings of rejection throughout the task. Results demonstrated that higher loneliness predicted increased feelings of rejection regardless of exclusion condition. Notably, this positive relationship was strongest during earlier rounds when social cues were most ambiguous. These findings contribute to our understanding of how loneliness modulates social perception to enable organisms to adequately adapt to changing circumstances.

Diversity of Group Memberships Predicts Well-Being: Cross-Sectional and Longitudinal Evidence

Groups have their health and well-being impacted by satisfying their members' needs and providing resources to help cope with threats. Multiple group memberships serve to accumulate these benefits and also provide resilience to the effects of group loss. However, the additional well-being benefits of belonging to multiple different types of group remain to be determined. In a preregistered cross-sectional survey in Nottingham, England (Study 1, N = 328), we found that group-type diversity predicted well-being and that this effect was fully serially mediated by increased creative self-efficacy, then reduced loneliness. To confirm our hypothesis in a more robust sample we conducted longitudinal analyses on the English Longitudinal Study of Aging (ELSA) dataset (Study 2, N = 5,838) finding that group-type diversity at time one (T1) predicted well-being at T2 (4 years later), even when accounting for wellbeing and loneliness at T1. We discuss the implications for enhancing group-based health interventions.

[A panel model of the relationships between loneliness and depression in older adults]

ANTECEDENTS AND OBJECTIVE

The declining birth rate and increasing life expectancy have led to an aging population, causing challenges at the economic, social and healthcare levels. Ensuring and maintaining high levels of well-being and mental health in older adults is crucial for successful aging. Given that previous literature indicates that perceived loneliness and depressive symptoms constitute significant obstacles to their quality of life, the aim of this study is to examine how perceived loneliness and depression intertwined in community-dwelling older adults over time.

METHODOLOGY

For this purpose, we conducted a longitudinal research study with a total of 46,317 European older adults (57.40% women), using the SHARE database (Survey of Health, Ageing and Retirement in Europe), at waves 6, 7, and 8, spanning a recent four-year period from 2016 to 2020. Several cross-lagged panel models were estimated using the structural equation modeling package Mplus.

RESULTS

The results show that loneliness and depression are bidirectionally related, which is difficult to combat because of their feedback and stability over time.

CONCLUSIONS

We discuss the practical implications of these findings concerning the potential double-edged sword of these reciprocal relationships on treatment and preventive interventions, as well as the study's limitations and future research directions.

Changes in the Emergency Department Visits Among the Older Adults With Dementia Before, and After the Nationwide Social Distancing Measures: An Interrupted Time Series Analysis

OBJECTIVES

Social isolation is a well-known risk factor for dementia, particularly among the older adults. The recent global health crisis, coupled with prolonged social distancing, leading to unprecedented disruptions in social interactions and raising concerns about unforeseen impacts on vulnerable populations, particularly older individuals with dementia. This study examines the impact of extended social isolation on dementia patients receiving emergency care.

METHODS

We conducted a nationwide study of emergency department (ED) visits among dementia patients aged 65+ during various phases of pandemic-related social distancing. Segmented quasi-Poisson regression models were used to determine changes in ED visits during and after social distancing compared to pre-social distancing.

RESULTS

From 2017 to 2022, there were 203,772 ED visits by patients with dementia among older patients. The proportion of ED visits by patients with dementia decreased from 17% pre-pandemic to 15% during social isolation. Interrupted time series analysis revealed a decline in ED visits during social distancing (step change: 0.849, 95% confidence interval [CI] 0.804-0.897; slope change: 1.000, 95% CI 0.996-1.003) followed by a rebound after restrictions were lifted (step change: 1.076, 95% CI 1.024-1.131; slope change: 1.009, 95% CI 0.994-1.025). However, monthly admission and mortality rates increased during social distancing.

CONCLUSION

This study observed a decline in ED visits by patients with dementia among older patients during social distancing, followed by a rebound after restrictions were lifted. However, the social distancing period was associated with increased hospitalization and mortality. These findings underscore the importance of maintaining healthcare accessibility for vulnerable older adults.

Neural Patterns of Social Pain in the Brain-Wide Representations Across Social Contexts

Empathy can be elicited by physiological pain, as well as in social contexts. Although physiological and different social contexts induce a strong subjective experience of empathy, the general and context-specific neural representations remain elusive. Here, it is combined fMRI with multivariate pattern analysis (MVPA) to establish neurofunctional models for social pain triggered by observing social exclusion and separation naturistic stimuli. The findings revealed that both social contexts engaged the empathy and social function networks. Notably, the intensity of pain empathy elicited by these two social stimuli does not significantly differentiate the neural representations of social exclusion and separation, suggesting context-specific neural representations underlying these experiences. Furthermore, this study established a model that traces the progression from physiological pain to social pain empathy. In conclusion, this study revealed the neural pathological foundations and interconnectedness of empathy induced by social and physiological stimuli and provide robust neuromarkers to precisely evaluate empathy across physiological and social domains.

The lonely brain: Aligning theories of loneliness with data from neuroimaging studies

Although loneliness is an unpleasant subjective experience associated with negative consequences, decades of research suggest loneliness is accompanied by adaptive cognitive changes that promote self-preservation and attempts for social reconnection. This review summarizes theoretical accounts that elaborate how loneliness alters attention and social information processing, then reviews whether findings from functional magnetic resonance imaging (fMRI) studies align with these hypothesized effects. We first examined the hypothesis that loneliness should increase general attention to monitor for potential environmental threats. Findings from resting-state studies suggested that loneliness corresponds to greater baseline activity in attention-related regions. Next, we examined the hypothesis that loneliness heightens sensitivity to the social world to protect against social threats and motivate reconnection. Here, studies showed sensitivity toward negative social information increased, whereas sensitivity toward positive social information was stimulus dependent (e.g., strangers, close others). Finally, we examined the hypothesis that loneliness enhances mentalizing to better predict social situations. Although many studies support this hypothesis, the research here is limited. However, studies do find that lonely individuals show idiosyncratic processing of the self and others. To conclude, we lay out future directions addressing some shortcomings of current fMRI studies of loneliness, and provide additional avenues to expand our knowledge of the "lonely brain."

Revisiting the cognitive and behavioral aspects of loneliness: Insights from different measurement approaches

Loneliness is increasingly recognized as a critical public health issue that profoundly affects psychological well-being and social functioning. This study evaluates cognitive and behavioral differences associated with different facets of loneliness. We classified 790 German-speaking adults (MAge = 31.86 (12.48), 81% female) as lonely or not lonely based on three dimensions - loneliness frequency, distress, and chronicity - and tested for group differences regarding cognitive and behavioral aspects, as proposed by the cognitive model of loneliness, while controlling for depressive and social anxiety symptoms. The results indicate fair to substantial agreement between the three classification methods. Further, we found significant group differences regarding all components, such as interpretation bias, social avoidance, and self-esteem, with each loneliness classification method. Our findings highlight the multifaceted nature of loneliness and underscore the importance of applying diverse methods to fully capture its complexity. This study contributes to a more nuanced understanding of loneliness and its implications, suggesting that interventions should consider the specific dimensions of loneliness to effectively address its cognitive and behavioral ramifications.

Studying the influence of single social interactions on approach and avoidance behavior: A multimodal investigation in immersive virtual reality

When studying spontaneous or learned emotional responses to social stimuli, research has traditionally relied on simplified stimuli repeatedly presented on a computer screen in standardized laboratory environments. While these studies have provided important insights into social perception and cognition, their restricted ecological validity may impede the extrapolation of findings to everyday social contexts. Here, we developed a novel immersive virtual reality scenario that permits the examination of social approach and avoidance behavior under naturalistic circumstances while at the same time maintaining full experimental control. Using a combination of a social conditioning procedure with a social approach-avoidance test, we conducted two experiments (both with N = 48 female participants) to investigate how individuals differing in trait social anxiety adapt their behavior after a single encounter with an either friendly or unfriendly virtual agent. In addition to overt approach and avoidance behavior, we acquired subjective ratings, eye-tracking data, and autonomic responses. Overall, we observed significant effects of the social conditioning procedure on autonomic responses and participants' exploration behavior. After initially increased attention, participants exhibited avoidance of social threats as indicated by a higher interpersonal distance and decreased visual attention towards the negatively conditioned virtual agent in the test phase. We found no association between hypervigilance and trait social anxiety but observed higher fear ratings and enhanced avoidance of social threats in participants with elevated anxiety levels. Altogether, this study demonstrates the potential of immersive virtual environments for examining social learning processes under conditions resembling real-life social encounters.

The impact of social participation on mental health among the older adult in China: an analysis based on the mental frailty index

Objectives

Social participation and the psychological well-being of the older adult are correlated. A substantial body of research has delineated the relationship between social participation and the mental health of older adults, while the indicators for assessing the mental health of the older adult are not sufficiently systematic or comprehensive. This study aims to further explore the relationship between social participation and the mental health of older adults from the perspective of mental frailty, providing a reference for the improvement of health among the older adult population.

Methods

We selected 9,208 older adults aged 60 years and older from the China Health and Retirement Longitudinal Study (CHARLS) 2013-2018 database. The mental frailty index was constructed, which integrates both depression and cognitive status to assess the mental health status of the older adult. By using a fixed-effects model, we analyzed the impact of social participation on the mental health of the older adult and compared gender, residence and marriage difference. Meanwhile, the instrumental variables method was used to conduct endogeneity tests.

Results

Overall, 65.8% of the respondents had low social participation. Social participation had a significant enhancement effect on mental health in the older adult (β = -0.013, p < 0.001). In specific types of social participation, cultural and sports activities (β = -0.006, p < 0.001), communication and educational activities (β = -0.002, p < 0.05), and skill-enhancing (β = -0.006, p < 0.001) activities were negatively correlated with the index of mental frailty of the older adult, whereas volunteering activities (β = 0.002, p < 0.05) was positively correlated with the index of mental frailty of the older adult.

Conclusion

Social participation has a positive effect on the mental health of the older adult in China, and the effect varies for the older adult with different characteristics, which suggests that social participation may be a protective factor for the mental health of the older adult population. Targeting differentiated population characteristics, individualized policies should be developed for different groups of older persons.

Revealing the protective mindfulness-moderation on loneliness, depression, and quality of life among spinal cord injury survivors in a mixed-methods study

PURPOSE

Loneliness, prevalent in people with spinal cord injuries (SCI), is negatively associated with mental health and quality of life. Mindfulness is a potential moderator that may buffer the negative impact of loneliness. This study aimed to explore the moderation effects of mindfulness on the relationship between loneliness, depression, and quality of life among people with SCI.

METHODS

We conducted an explanatory sequential mixed-methods study on SCI survivors in Hong Kong. Survey data (n = 72) including socio-demographics, mindfulness, loneliness, depression, and quality of life were analyzed using moderated regression with the SPSS PROCESS macro. Focus group interviews (n = 15) were analyzed using thematic analysis.

RESULTS

Mindfulness significantly moderated the positive association between loneliness and depression (B= -0.060, p = 0.006), and a cutoff value (>116.569) for moderation was identified. The mindfulness moderation on the relationship between loneliness and quality of life was insignificant. Three themes were generated: connectedness contributes to subjective well-being, mindful perceptions foster emotional resilience and happiness, and mindful perceptions enhance physical health and social connections.

CONCLUSIONS

This study revealed the protective moderation mechanism of mindfulness in buffering the negative impacts of loneliness on depression, providing a strong theoretical foundation for the use of mindfulness-based interventions in improving mental well-being among SCI survivors.

Attitude towards aging and anxiety in the relationship between social alienation and depression in Chinese rural empty-nest older adults: a chained mediation modeling analysis

BACKGROUND

Depression among rural empty-nest older adults has emerged as a significant global and Chinese concern in recent years. Studies have identified associations between depression in rural empty-nest older adults and factors such as social alienation, attitudes towards aging, and mental health. However, the intricate mechanisms underlying these relationships remain incompletely understood. Therefore, this study seeks to investigate the intricate connections between social alienation and depression among Chinese rural empty-nest older adults, aiming to shed light on the underlying mechanisms contributing to depression in this demographic.

METHODS

The study data were gathered from a sample of rural empty-nest older adults (N = 1025) residing in the cities of Chaoyang, Liaoning Province, China. Depression served as the primary outcome variable, with social alienation as the predictor variable. Attitude towards aging and anxiety symptoms were examined as potential mediators in the relationship between social alienation and depression. Mediation and chained mediation modeling analyses were conducted to analyze the data and explore the proposed relationships.

RESULTS

(1) Social alienation positively predicted attitude towards aging (β = 0.109, P < 0.001), anxiety symptoms (β = 0.076, P < 0.001), and depression (β = 0.021, P < 0.001). Attitude towards aging positively predicted anxiety symptoms (β = 0.390, P < 0.001) and depression (β = 0.006, P < 0.001). Anxiety symptoms also positively predicted depression (β = 1.207, P < 0.001). (2) Social alienation mainly affects depression through three indirect effects: (1) Social alienation → attitude towards aging → depression; (2) Social alienation → anxiety symptoms → depression; (3) Social alienation → attitude towards aging → anxiety symptoms → depression.

CONCLUSION

Our findings suggest that social alienation impacts depression among Chinese rural empty-nest older adults through the pathways of attitude towards aging and anxiety symptoms. Consequently, efforts aimed at preventing depression rooted in social alienation among this demographic should address both attitudes towards aging and mental health concerns.

Perceived social support and relationship quality predict loneliness in older adults: a social network approach

OBJECTIVES

Loneliness negatively impacts older adults' mental and physical health. Though loneliness is associated with perceived social support, its relationship to received support is unclear. This might be because received support has been defined sparsely, overlooking types of support and overall relationship quality. The current study addressed this gap.

METHOD

Older adults recruited from the community (N = 142) and the Indiana Alzheimer's Disease Research Center (ADRC) (N = 176) completed an expanded PhenX social network interview to identify social network size, types of received support (emotional, instrumental), and relationship quality (network closeness, contact frequency). They also completed well-validated measures of loneliness and perceived social support. Data were analyzed with hierarchical linear regressions.

RESULTS

In both samples, loneliness was negatively related to perceived social support but was not related to either received support type. Contact frequency predicted loneliness in both samples, but network closeness predicted loneliness in the ADRC sample only. Dementia status did not affect results.

CONCLUSION

Social network size, emotional received support, and instrumental received support were not related to loneliness, but perceived social support and relationship quality were. These findings suggest that loneliness is influenced by perceived social support and some types of received support.

Can social isolation alleviate symptoms of anxiety and depression disorders?

This study examines the complex interplay between social behavior and mental health, focusing on the neurobiological mechanisms underlying human interactions and their alterations associated with anxiety and depression disorders. These conditions are characterized by heightened threat perception, pervasive worry, physiological responses, emotional dysregulation, and maladaptive behaviors. Through narrative review, this study examines both aspects, addressing social isolation as both a risk factor and an avoidance behavior that may provide temporary relief but ultimately perpetuate the clinical condition in the long term. The findings offer valuable insights for clinical practice, emphasizing interventions that enhance cognitive flexibility to foster stable and supportive interpersonal relationships.

Moderated mediation of physical activity through depression on the relationship between loneliness and cognitive function in older adults

OBJECTIVES

This study examined the mediating effects of depression on the relationship between loneliness and cognitive function. It also aimed to test whether this mediating effect varied with the level of physical activity.

METHOD

Data were obtained from the English Longitudinal Study of Aging (ELSA) and responses of 3,537 adults aged 65 years or older were analyzed.

RESULTS

Analysis using the PROCESS Macro 7 model showed that loneliness had a negative effect on cognitive function. Also, the mediating effect of depression on the association between loneliness and cognitive function and the moderated mediating effect of physical activity were significant. That is to say, loneliness influenced cognitive function decline mediating depression, and the mediating effect of depression varied according to the level of physical activity.

CONCLUSION

This study revealed the psychological mechanism by which loneliness influences cognitive decline in older adults, and suggests that physical activity can be a preventive and therapeutic intervention for cognitive decline.

The moderating effect of frailty on the network of depression, anxiety, and loneliness in community-dwelling older adults

OBJECTIVES

Comorbidities of depression, anxiety and loneliness may be more prevalent in frail older adults, which may lead to an accelerated deterioration of psychological symptoms. This study was aimed to assess the moderating effect of frailty on the network of depression, anxiety, and loneliness symptoms in community-dwelling older adults.

METHODS

A sample of 4253 older adults were recruited from the Psychology and Behavior Investigation of Chinese Residents (PBICR). Frailty, depression, anxiety, and loneliness were assessed using the FRAIL scale, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder 7-item scale, and the Three-Item Loneliness Scale, respectively. Covariates of age, gender, education level, living status, marital status, and monthly family income were also collected.

RESULTS

The prevalence of combined depression, anxiety and loneliness was 36.49 % in (pre)frail (i.e., frail or prefrail) older adults. Using the moderated network model, we found that (pre)frail older adults were more likely to experience "sad mood", "appetite changes", and "feel left out" than non-frail older adults. In addition, (pre)frail older adults had stronger correlations between "feel left out" and "feel isolated from others", "feel isolated from others" and "lack companionship", "nervousness or anxiety" and "feel left out", "nervousness or anxiety" and "feel isolated from others", and "sleep difficulties" and "feel left out" than non-frail older adults, while non-frail older adults had stronger correlations between "feel worthlessness" and "psychomotor agitation/retardation" than (pre)frail older adults.

CONCLUSIONS

(Pre)frail older adults may experience more comorbidities of depression, anxiety and loneliness due to more symptoms and stronger correlations between specific symptoms in the network. Future studies should target these symptoms to eliminate comorbidities of depression, anxiety and loneliness in (pre)frail older adults.

Lost in Thought or Just Lonely? Everyday Cognitive Competence in Middle Adulthood

Everyday cognitive competence refers to the ability to manage cognitively demanding tasks essential for maintaining functional independence. While cognitive abilities are well explored in explaining individual differences in everyday cognitive competence, growing attention has been directed toward the impact of non-cognitive factors like loneliness. This study aims to investigate how executive function (EF) components-updating, inhibition, and task shifting-predict everyday cognitive competence and whether loneliness explains the additional variance beyond EF processes. To account for the multifaceted nature of everyday cognitive competence, both performance-based (Everyday Problems Test-EPT) and self-reported measures (Cognitive Failures Questionnaire-CFQ) were administrated. The sample included 176 middle-aged adults (ages 43-65), a group suitable for investigating predictors of everyday cognitive competence in the early stages of cognitive aging. The findings reveal that updating is a significant predictor of the performance on the EPT, while loneliness is not. When self-reported cognitive lapses are considered, loneliness emerges as a significant predictor. The lack of a relationship between the EPT and CFQ, along with their differing associations with EF, loneliness, and sociodemographic factors, suggests they assess distinct aspects of everyday cognitive competence. This highlights the need for a multidimensional assessment framework to gain a comprehensive understanding of everyday cognitive competence in middle-aged adults.

Cochlear Implantation Is Associated With Reduced Incidence of Dementia in Severe Hearing Loss

OBJECTIVES

Hearing loss is recognized as a potentially modifiable risk factor for dementia in midlife. This study aimed to investigate the association between rehabilitation methods and dementia risk in patients with severe to profound hearing loss.

DESIGN

Using the nationwide population data from South Korea, individuals with severe to profound hearing loss were identified. Individuals aged 40 to 79 were then divided into 3 groups according to the type of auditory rehabilitation they received in the period between 2005 and 2010, namely cochlear implant (CI), hearing aid (HA), or no rehabilitation (NR). No hearing loss (NHL) group (with normal hearing) consisted of individuals without hearing loss. Dementia incidence was followed up to 2022.

RESULTS

The study involved 649 individuals in the CI group, 35,076 in the HA, 16,494 in the NR, and 1,280,788 in the NHL group. The groups that received auditory rehabilitation (HA and CI groups) had a significantly reduced risk of dementia compared with the NR group, with the CI group showing the most pronounced reduction. The CI group demonstrated a lower risk of dementia than the HA group and had a similar dementia risk to the NHL group.

CONCLUSIONS

In individuals with severe to profound hearing loss, rates of dementia were lower in CI users than in HA users. Moreover, the risk of dementia in those undergoing CI surgery is comparable to that of individuals with normal hearing.

The Relationships Between Loneliness, Emotional Intelligence, and Depression Among Turkish Emerging Adults: A Moderated Moderation Model in the Gender Context

Loneliness is a common public health problem that can influence individuals' depression outcomes. The incidence of loneliness among emerging adults is high. From this perspective, this study would serve two primary aims in Turkish emerging adults. The first was to examine the moderating effect of emotional intelligence on the relationship between loneliness and depression. The second was to test whether gender moderated this moderating effect. The study sample consisted of 456 (213 females and 243 males) university-attending emerging adults, 18-25 years old. Firstly, the findings demonstrated that loneliness was positively associated with depression. Secondly, the results showed that emotional intelligence moderated the relationship between loneliness and depression, indicating that high emotional intelligence functioned as a buffer for the contribution of loneliness to depression. In contrast, higher levels of loneliness were significantly associated with a greater risk of depression among emerging adults with low or moderate emotional intelligence. Lastly, gender did not moderate the moderating effect of emotional intelligence on the relationship between loneliness and depression. This study concluded with limitations, recommendations for future research, and practical and theoretical implications for practitioners.

Heart rate increases during social isolation: Matter of depressive mood and self-reported infection symptoms

While the mental health challenges posed by quarantine are well-documented, its physiological effects remain less understood. We examined cardiovascular trajectories over a 6-day quarantine following common cold infection, utilizing data from the Pittsburgh Cold Study 3 (n = 213, 2007-2011). Specifically, we explored the relationship between depressive mood and heart rate (HR) patterns, hypothesizing that individuals prone to depressive mood might experience altered arousal during quarantine. We conducted similar analyses for blood pressure (BP) as well. Our findings revealed that, on average, HR increased during quarantine. Notably, individuals reporting higher depressive mood levels exhibited lower initial HR but experienced a sharper increase throughout the quarantine period. In contrast, no significant linear or quadratic changes were observed in systolic blood pressure (SBP). However, initial analyses did identify significant linear changes in diastolic blood pressure (DBP) and mean arterial pressure (MAP). These changes in DBP and MAP were not influenced by depressive mood and lost significance in sensitivity analyses that accounted for infection-related factors, health behaviors, and socio-demographic variables. Interestingly, HR trajectories remained significant in sensitivity analyses but lost significance when self-reported symptoms were included. Self-reported symptoms partially mediated the relationship between depressive mood and HR increases, suggesting that individuals with higher depressive tendencies also reported more infection-related symptoms, contributing to increased HR. These findings highlight how midterm social isolation can elevate HR, particularly in individuals prone to depressive mood. However, the absence of a control group limits broader interpretations, emphasizing the need for further research.

The perception of eye contact is associated with men's need to belong, self-esteem, and loneliness

The present study (N =  367) investigated the association of the cone of direct gaze (CoDG; a range within which slightly averted gaze is accepted as direct gaze) width with the need to belong (NTB) and the possible further influence of NTB on self-esteem and loneliness. Results showed that: (i) men's CoDG width predicted the NTB, self-esteem, and loneliness; (ii) men's narrow CoDG predicted high loneliness via a high NTB and low self-esteem; (iii) a narrow CoDG was associated with low self-esteem via high loneliness only in high-NTB men. Among women, the CoDG width was not associated with the NTB, self-esteem, and loneliness. The findings are discussed considering the formation and maintenance of relationships together with gender differences.

Chronic loneliness and longitudinal changes in cognitive functioning

BACKGROUND

Loneliness is a worldwide concern with significant health implications that may be a significant risk factor for Alzheimer's disease and related dementias. In light of the importance of detecting early cognitive changes and risk factors influencing cognitive health, this study examined whether chronic loneliness predicted cognitive changes among young and middle-aged adults.

METHODS

This study utilizes data from a longitudinal measurement burst study spanning over two years, comprising three waves of data collection. A systematically recruited young to mid-life adult sample (25- 65 years) included 172 racially and economically diverse participants who provided information about loneliness for at least two consecutive waves. Chronic loneliness was defined based on the validated multi-item PROMIS Social Isolation scale. We assessed working memory, processing speed, and spatial memory in a measurement burst design using mobile cognitive assessments. Multilevel growth models were conducted to examine whether chronic loneliness was associated with changes in cognitive performance during the study period of up to two years.

RESULTS

Results revealed that chronic loneliness was not associated with baseline performance of working memory, processing speed, spatial memory or global cognitive performance, but chronic loneliness was associated with differential cognitive trajectories, specifically a lack of retest related improvement. There were no significant changes in cognitive performance for the chronic loneliness group across waves, whereas significant improvements were observed in those who were not chronically lonely.

CONCLUSIONS

This study offers insights into the impact of chronic loneliness on cognitive changes in young and middle-aged adults, revealing that chronically lonely individuals did not exhibit the practice-related improvements that are commonly observed in longitudinal studies. Findings suggest the potential significance of identifying and addressing chronic loneliness promptly to prevent potential cognitive consequences of chronic loneliness.

A meta-analysis of behaviour change techniques in social interventions targeting improved cognitive function in older adults

BACKGROUND

Limited social networks in older adults are linked with increased dementia risk. However, there is a lack of knowledge on whether socially-based behavioural interventions (i.e., programs designed to increase individual's social opportunities, engagement or networks) can improve cognitive function, as well as the role of applied behaviour change techniques (BCTs) in effective interventions. This systematic review and meta-analysis aimed to (i) quantify the effectiveness of social-based behavioural interventions in improving cognition in older adults, and (ii) identify which BCTs increase social activity behaviour of older adults.

METHODS

Six electronic databases were searched with restrictions for age (>65 years) and English language from inception to July 2023 (PROSPERO:CRD42021283382) for articles reporting social-based behavioural randomised controlled trials and using a measured outcome of cognitive function. Behaviour change techniques were mapped to the BCT V1 model and risk of bias was assessed. Pooled effect sizes from eligible studies were synthesised using RevMan.

RESULTS

We identified 9528 records and included 15 studies (N=1785 participants). Meta-analyses showed that social-based interventions had a medium effect on global cognition (d=0.80, 95% CI 0.58 to 1.02, p<0.01), but not executive function. The most frequently used intervention components were social-based communication (e.g., chatting, boosting social engagement), group arts-based tasks (e.g., knitting, music, craft) and guided reminiscence. The BCT demonstration of behaviour predicted significant cognitive effects and explained 94.6% of inter-study variation.

DISCUSSION

Findings carry implications for developing comprehensive strategies to promote social initiatives supporting cognitive health, particularly in addressing the challenges faced by older adults.

Interpersonal sensitivity and its associated factors among nursing students during the COVID-19 pandemic: a network analysis

BACKGROUND

Interpersonal sensitivity is a crucial individual characteristic, particularly for young nursing students. However, limited research has specifically examined interpersonal sensitivity in nursing students. This study aimed to employ network analysis to investigate the interconnectedness of interpersonal sensitivity and its associated factors among nursing students during the COVID-19 pandemic.

METHODS

Network analysis was employed to explore the network structure. The first network model was developed to evaluate interpersonal sensitivity. The second network model was constructed to investigate the associations between interpersonal sensitivity and variables that were found to be statistically significant in the multivariable linear regression model.

RESULTS

A total of 864 nursing students participated in the study. The strongest nodes in assessing interpersonal sensitivity among nursing students encompass three distinct aspects: compliments, genuine understanding, and criticism. The multivariate linear regression analysis revealed significant associations between interpersonal sensitivity and various factors, including openness (β = 0.67), anxiety symptoms (β = 0.45), well-being (β = -0.63), loneliness (β = 1.55), and perceived social support (β = 0.66).

CONCLUSIONS

This study yields valuable insights into the phenomenon of interpersonal sensitivity among nursing students amid the COVID-19 pandemic. These findings emphasize the significance of incorporating targeted interventions addressing these factors into nursing education curricula.

Loneliness and mental burden among German medical students during the fading COVID-19 pandemic: a mixed-methods approach

Introduction

Medical students experience significantly more mental burdens compared to the general public. This circumstance was further exacerbated by the pandemic, particularly with regard to loneliness. While previous studies have identified risk factors for loneliness among students of different subjects, recent data focusing on medical students during the late stages of the pandemic remain insufficient. This study aims to address this gap.

Methods

We performed a cross-sectional study at a German Medical School, consisting of two online surveys conducted in winter 2021/22 and summer 2022. The study sample, composed of 283 undergraduate students in winter 2021/22 (231 in summer 2022), answered five well-established scales for measuring loneliness (R-UCLA3), distress (DT-NCCN), anxiety (GAD-2), depression (PHQ-2), and perceived stress (PPS-4). Additionally, we evaluated burdensome aspects of students' current situation through qualitative analysis. Longitudinal analyses were conducted for 80 medical students who participated in both surveys.

Results

Around 20% of all students responded to each survey. In winter 2021/22, 55.1% of students reported loneliness above the cut-off (M = 5.77 [2.02]; decreasing to 45.0% by summer 2022 (M = 5.22 [1.90]). Lonely students reported significantly higher levels of depression, anxiety, and self-perceived stress in both survey periods. Overall distress increased substantially throughout our study (Cohen's d = -0.54). Binary regression models indicated a shift in loneliness risk factors: in winter 2021/22, being single, higher self-perceived stress levels, and decreased study motivation were associated with increased loneliness. Lower peer connectedness emerged as the sole significant factor associated with loneliness in summer 2022. While the pandemic-related burden on students' study motivation lessened, issues related to exam preparation and lack of study organization through the faculty increased, varying significantly depending on students' study year.

Conclusion

Our data suggest that loneliness among German medical students decreased in the late stages of the COVID-19 pandemic. However, other mental burdens persisted at high levels compared to other data in the general public and medical students. Students' responses underscore the need for improved academic support by eased study program structure, improved counseling, and tailored services for students of different study years.

Befriending, Loneliness, and Quality of Life of Older Adults: A Pilot Evaluation Study

OBJECTIVES

An aggregated interventional N-of-1 or single-case design was used to assess the impact of a befriending intervention on a) health-related quality of life (HR-QoL), and b) the association between loneliness on HR-QoL among older adults.

METHODS

Participants were n = 33 new users of the service, aged 60 + . Outcomes were measured at 13 timepoints across 26 weeks, and data were analyzed using generalized additive modeling (GAM) with a subset of data analyzed using supplementary visual analysis.

RESULTS

Results indicate that the befriending service may reduce decline of HR-QoL (i.e. HR-QoL declined in the baseline phase over time: edf = 3.893, F = 3.0, p = .002, while in the treatment phase, HR-QoL remained more stable: edf = 5.98, F = 2.98, p = .008). The intervention also suppressed the impact of loneliness on HR-QoL.

CONCLUSIONS

Befriending interventions may prevent declines in HR-QoL, and may moderate the impact of loneliness on HR-QoL.

CLINICAL IMPLICATIONS

Our preliminary findings suggest that befriending services may be useful if clinicians have concerns about the health impacts of loneliness for older people. It is difficult to evaluate community-based services, and we consider the challenges we faced, with a view to assisting others planning similar evaluations.

Epistemic Trust, Mistrust and Credulity Questionnaire (ETMCQ) validation in French language: Exploring links to loneliness

The concept of epistemic trust is gaining traction in the mental health field. Epistemic trust is thought to play a foundational role as a resilience factor against the development and maintenance of psychopathology by fostering social learning. The primary aim of this study was to validate the French-language version of the Epistemic Trust, Mistrust and Credulity Questionnaire (ETMCQ). We further sought to replicate previously reported associations with key developmental and psychological factors (childhood trauma, mentalizing and attachment) and test for epistemic trust's potential mediating roles between childhood traumatic experiences and psychopathology, and between loneliness and psychopathology. A total of 302 participants were recruited via the online survey platform Prolific. Confirmatory factor analysis and generalized linear models of mediation were conducted. Our findings suggest that the ETMCQ is a valid instrument to assess epistemic trust in the French language. Satisfactory psychometric properties were found to replicate the original three-factor solution in a Francophone population with a 12-item version of the questionnaire, with criterion-related validity similar to that previously published in validations of the ETMCQ in other languages. We also replicate previous findings reporting differential associations between epistemic stances (trust, mistrust and credulity) and attachment dimensions and styles, while also replicating mediation analyses showing the role of epistemic stances in the relationship between childhood traumatic experiences and psychopathology. Finally, we report preliminary evidence suggesting that epistemic trust mediates the well-described association between loneliness and psychopathology. Future research should investigate the ETMCQ in clinical populations in which psychopathological expressions are severe, enduring and co-occurring, where identifying potential mediators could help target and personalize psychosocial interventions.

Exploring the Association Between Physical Activity, Regulatory Emotional Self-Efficacy, Perceived Self-Burden, and Social Isolation Among Older Adults in China

Background: As people age, their physical functions decline, and changes in social roles and life experiences put older adults at a higher risk of social isolation. Methods: In this study, we employed both snowball and purposive sampling techniques to collect valid data from 237 seniors aged 60 to 75 residing in Hunan Province. Using structural equation modeling (SEM) with the partial least squares (PLS) method, we examined the relationship between physical activity and social isolation among this elderly population. Result: Findings from this study indicate a positive association between physical activity and regulatory emotional self-efficacy, while revealing a negative association with the perception of being a burden to others. Moreover, a higher regulatory emotional self-efficacy is linked to reduced social isolation, whereas an increased sense of self-perceived burden is associated with greater social isolation. This study also uncovers that the link between physical activity and reduced social isolation is influenced by both regulatory emotional self-efficacy and the perception of self-burden. Conclusion: It is imperative for a collaborative effort involving government entities, societal groups, family units, and individuals to meticulously address and cater to the diverse requirements of senior citizens.

Role of FPR2 antagonism in alleviating social isolation-induced depression and protecting blood-brain barrier integrity

Social isolation (SI) is a prevalent issue in modern society, particularly exacerbated during the COVID-19 pandemic, and it is a significant contributor to depressive disorders. Inflammation-related markers are upregulated in patients with major depressive disorder (MDD) unresponsive to first-line selective serotonin reuptake inhibitor (SSRI) antidepressants. This study investigates the role of formyl peptide receptor 2 (FPR2), a G-protein coupled receptor expressed in central and peripheral immune cells, in SI-induced depression. We developed a mouse model of SI by housing mice individually for three weeks. SI mice exhibited increased capillary-associated microglia (CAMs) with upregulated FPR2 expression in the prefrontal cortex (PFC) and hippocampus compared to group-housed controls. Notably, subcutaneous administration of the FPR2 antagonist WRW4 alleviated depressive and anxiety-like behaviors in SI mice, reducing microglial activation and neuronal damage. WRW4 treatment decreased CAM numbers and their FPR2 expression. RNA sequencing revealed that SI primarily induced changes in genes associated with blood-brain barrier (BBB) function, followed by alterations in genes related to hormone activity, immune activation, and neuronal function. Transcriptomic changes in brain endothelial cells from SI mice resembled those observed in animal models of several neurological disorders and in MDD patients. WRW4 treatment partially reversed these transcriptomic alterations and restored compromised BBB integrity. Additionally, intracerebroventricular (ICV) injection of WRW4 also alleviated depressive and anxiety-like behaviors in SI mice. Finally, our analysis of public transcriptome databases indicates FPR2 upregulation in the orbital ventral PFC of MDD patients and peripheral blood mononuclear cells of those in severe depressive episodes. These findings suggest that the pharmacological targeting of FPR2 may rescue SI-induced pathology in mice by protecting BBB integrity.

The conceptual structure of human relationships across modern and historical cultures

A defining characteristic of social complexity in Homo sapiens is the diversity of our relationships. We build connections of various types in our families, workplaces, neighbourhoods and online communities. How do we make sense of such complex systems of human relationships? The basic organization of relationships has long been studied in the social sciences, but no consensus has been reached. Here, by using online surveys, laboratory cognitive tasks and natural language processing in diverse modern cultures across the world (n = 20,427) and ancient cultures spanning 3,000 years of history, we examined universality and cultural variability in the ways that people conceptualize relationships. We discovered a universal representational space for relationship concepts, comprising five principal dimensions (formality, activeness, valence, exchange and equality) and three core categories (hostile, public and private relationships). Our work reveals the fundamental cognitive constructs and cultural principles of human relationship knowledge and advances our understanding of human sociality.

The association between internet-use-disorder symptoms and loneliness: a systematic review and meta-analysis with a categorical approach

Loneliness may lead individuals to spend more time on the internet and increase the likelihood of experiencing internet-use disorders. Similarly, individuals with internet-use disorders may feel lonelier. In the present systematic review and meta-analysis, pre-registered in PROSPERO (CRD42023390483), we quantified associations between internet-use-disorder symptoms (e.g. internet gaming disorder and online gambling disorder) and loneliness. We searched PubMed, Web of Science, and an institutional database aggregator for references that compared degrees of loneliness in groups of individuals with and without symptoms of internet-use disorder. Means and standard deviations of loneliness, or alternatively, odds ratios, were transformed into Cohen's d for statistical pooling through a random-effects model. After screening 2,369 reports, we extracted data from 23 studies. The total number of individuals across the studies was 36,484. Participants were between 13 and 30 years of age (median 20). The pooled difference between those with and without internet-use-disorder symptoms yielded a standardized effect (Cohen's d) of 0.53 (95% CI 0.35-0.7). While heterogeneity was high, there was no indication of publication or small sample biases. Similar effect sizes were found when limiting to specific types of internet-use disorder symptoms. Moreover, meta-regressions did not show an effect of age, sex, or sample size. Individuals with symptoms of internet-use disorders scored 49.35 (43.84-54.85) points on the UCLA-Loneliness scale on average, compared to 43.78 (37.47-50.08) in individuals without symptoms of internet-use disorders (Standardized Mean Difference: 5.18, 95% CI = 2.05-8.34). Individuals with internet-use-disorder symptoms experience greater loneliness. The effect appears moderately sized.

Good sleep quality shields older adults from depressive symptoms linked to isolation: Comparing online and in-person social connections

OBJECTIVE

This study investigated the role of sleep quality in the link between social connections and depressive symptoms among older adults.

METHODS

A total of 1,230 older adults participated in this study following the lifting of the lockdown. Network analysis and random intercept cross-lagged panel model (RI-CLPM) were conducted to examine the relationship between social connections and depressive symptoms. A multi-group RI-CLPM analysis identified potential differences in this relationship between good and poor sleepers in the context of online and in-person social connections.

RESULTS

The results showed a stable interrelationship between social connections and depressive symptoms in older adults. Sleep quality moderated this association across temporal responses in online but not in-person social connections.

CONCLUSIONS

These findings underscore the urgency of addressing the adverse influence of lockdown by facilitating in-person social connections and improving the sleep quality among individuals with limited online social interactions to protect against depression.

Social isolation, loneliness, and their joint effects on cognitive decline and incident Alzheimer's disease: Findings from the Chicago health and aging project

BACKGROUND

There has been contradictory evidence on the prospective associations between social isolation/loneliness (SI/L) and cognitive decline (CD). There is also a scarcity of large and diverse population-based cohort studies examining SI/L that have confirmed clinical diagnoses of Alzheimer's Disease (AD). Notably, beyond individual associations, whether the effects of SI/L compound and accelerate CD and incident AD are not known.

OBJECTIVES

We hypothesized that SI and L, independently, would be associated with CD and incident AD to a similar extent, and the association of SI with CD and incident AD would be higher in lonely older adults.

DESIGN

Prospective cohort study.

SETTING

Urban Chicago areas.

PARTICIPANTS

We analyzed data in the Chicago Health and Aging Project (CHAP), which comprised 7,760 biracial community-dwelling older adults [mean age (standard deviation (SD))=72.3 (6.3); 64 % Black & 63 % women; mean (SD) of follow-up=7.9 (4.3) years].

INTERVENTION (IF ANY)

NA MEASUREMENTS: Linear mixed and logistic regression models were used to regress CD and incident AD separately on the SI index/L.

RESULTS

SI index and L were significantly associated with CD, with one-point increase of beta estimate (SE, p-value) = -0.002 (0.001,0.022) and -0.012 (0.003,<0.001), respectively. Given that the SI index ranges from 0 to 5 and the L from 0 to 1, they had similar effect sizes. Similarly, there were significant associations between SI index and incident AD, odds ratio (95 % CI, p-value) = 1.183 (1.016-1.379,0.029), and between L and incident AD, 2.117 (1.227-3.655,0.006). When stratified by loneliness status, compared to older adults who were not isolated and not lonely, older adults who reported being socially isolated and not lonely experienced accelerated CD, -0.003 (0.001,0.004), despite no significantly increased odds of incident AD.

CONCLUSIONS

SI/L had significant associations with CD and incident AD. Notably, socially isolated older adults who reported not being lonely appeared to be most socially vulnerable to CD. These findings suggest a specific at-risk subgroup of socially vulnerable older adults for future targeted interventions to improve cognitive health.

Technology for sustainable living: The impact of digital inclusion on the health of China's elderly living alone

Enhancing elderly health has become an important measure for coping with population ageing and building a healthy China. Among them, older adults living alone seem to suffer from greater loneliness and psychological stress. We analyzed data from the China Health and Retirement Longitudinal Study in 2015, 2018, and 2020, and carried out an empirical investigation into the impact of digital inclusion on the health of elderly individuals living alone, using two-way fixed effects models and two-stage least squares. The findings suggest that digital inclusion could positively impact the health of older people living alone. Specifically, for a one-standard-deviation increase in digital inclusion, the depression scale score decreases by 0.48 (α = -0.21, p < 0.01); the cognitive function score increases by 0.27(α = 0.12, p < 0.01); the instrumental activities of daily living score would decrease by 0.11 (α = -0.05, p < 0.01). An increase of 1 in the digital inclusion score decreases the self-rated health score by 0.02 (α = -0.02, p < 0.01). It can significantly enhance the health status of elderly people who live alone through mechanisms of improving life satisfaction, increasing the utilization of preventive health care services, and promoting social participation. Subsequent analyses identified varying effects of digital inclusion on older adults living alone, influenced by their income and education levels. In particular, digital inclusion substantially enhanced instrument activities of daily living among the aged who lived alone and with higher income and educational backgrounds. However it had no significant effect on older people living alone with lower incomes and educational backgrounds. The insights from this study could be invaluable for policymakers in promoting broader adoption of digital technologies among older adults living alone.

The long-term impact of childhood peer relationships on disability in later life: Causal mediation evidence from older Chinese adults

Despite the recognized importance of social connections in Chinese culture, research on how childhood peer relationship deficits impact health later in life has been limited. This study aimed to investigate the association between childhood peer relationship deficits and the odds of disability among older Chinese adults and to explore the potential mediating roles of social isolation, loneliness, and cognitive function. Using the longitudinal sample of respondents aged 60 years and older in the China Health and Retirement Longitudinal Study 2013-2018 (N = 7133), the link between peer relationship deficits in childhood and disability in late life was assessed using marginal structural models, and the potential mediating effects of social isolation, loneliness, and cognitive function were examined by the inverse odds ratio weighting technique. Participants who experienced greater childhood peer relationship deficits were more prone to disability (odds ratio: 1.19, 95% CI: 1.09, 1.29) than those with more positive childhood peer interactions. The inverse odds ratio weighting analysis indicated that social isolation, loneliness, and cognitive function individually played partial mediating roles in the association between childhood peer relationships and disability by 11.36% (95% CI: 4.04%-18.99%), 11.95 % (95% CI: 4.65%-19.23%), and 24.58% (95% CI: 17.01%-32.43%), respectively. The combined mediation effect of the three mediators was 30.57% (95% CI: 23.52%-39.91%). These findings suggest that interventions to enhance social connections and cognitive health in older adults may help mitigate the long-term impacts of childhood peer relationship deficits on disability among older Chinese adults.

Loneliness mediates the association between trait social anxiety and cardiovascular reactivity to acute psychological stress

The primary aims of the current study are (1) to examine the association between trait social anxiety and cardiovascular reactivity to acute psychological stress, and (2) to identify if loneliness significantly mediates the association between trait social anxiety and cardiovascular reactivity. A sample of 658 participants completed a cardiovascular reactivity protocol consisting of a resting baseline and stressor phase (mental arithmetic and Stroop), with systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) monitored throughout. Participants also completed self-reported measures assessing social anxiety and loneliness. Social anxiety was associated with increased self-reported stress. However, no significant associations between social anxiety and measures of cardiovascular reactivity were observed in regression analyses. Loneliness was significantly associated with lower SBP and DBP reactivity. Additionally, loneliness significantly mediated the association between trait social anxiety and both SBP reactivity and DBP reactivity. Here, trait social anxiety predicted greater levels of loneliness, which in turn was associated with diminished cardiovascular reactivity. No significant associations emerged for HR reactivity. These blunted blood pressure responses to acute stress may indicate a potential mechanism leading to adverse prospective health outcomes.

Echoes of Home: The Impact of Acculturative Stress on Nigerian Students in Northern Cyprus, Investigating the Role of Loneliness and Social Support

International students navigate a complex ecosystem influenced by various interrelated factors such as academic settings, family influences, social supports, and the process of cultural adjustment. While universities provide institutional support, the direct or indirect effect of family and social support network in the adaptation process and mental wellbeing is paramount. The interplay of acculturative stress, loneliness, perceived social support, and depression among international students warrants extensive study due to its profound impact on mental health and academic outcomes. This research aims to investigate the mediating role of loneliness and the moderating influence of perceived social support in the relationship between acculturative stress and depression among Nigerian university students in Northern Cyprus. Utilizing a cross-sectional quantitative research design, data were collected via a Google Survey from 392 Nigerian international students residing in Northern Cyprus. Participants completed self-report questionnaires assessing acculturative stress, loneliness, perceived social support, depression, and demographic details. Results indicate that acculturative stress directly influences depression, with loneliness partially mediating this relationship. Additionally, the impact of acculturative stress on loneliness and depression is significantly moderated by participants' perceived social support. These findings underscore the importance of addressing acculturative stress and fostering social support networks to mitigate depressive symptoms among Nigerian students studying abroad. Further research and interventions aimed at enhancing social support mechanisms are imperative to promote the mental well-being of this population.

Assessing the Recognition of Social Interactions Through Body Motion in the Routine Care of Patients with Post-Lingual Sensorineural Hearing Loss

Background: Body motion significantly contributes to understanding communicative and social interactions, especially when auditory information is impaired. The visual skills of people with hearing loss are often enhanced and compensate for some of the missing auditory information. In the present study, we investigated the recognition of social interactions by observing body motion in people with post-lingual sensorineural hearing loss (SNHL). Methods: In total, 38 participants with post-lingual SNHL and 38 matched normally hearing individuals (NHIs) were presented with point-light stimuli of two agents who were either engaged in a communicative interaction or acting independently. They were asked to classify the actions as communicative vs. independent and to select the correct action description. Results: No significant differences were found between the participants with SNHL and the NHIs when classifying the actions. However, the participants with SNHL showed significantly lower performance compared with the NHIs in the description task due to a higher tendency to misinterpret communicative stimuli. In addition, acquired SNHL was associated with a significantly higher number of errors, with a tendency to over-interpret independent stimuli as communicative and to misinterpret communicative actions. Conclusions: The findings of this study suggest a misinterpretation of visual understanding of social interactions in individuals with SNHL and over-interpretation of communicative intentions in SNHL acquired later in life.

Loneliness and cognition in older adults: A meta-analysis of harmonized studies from the United States, England, India, China, South Africa, Mexico, and Chile

BACKGROUND

Loneliness is a risk factor for late-life dementia. There is less consistent evidence of its association with cognitive performance. This study examined the replicability of the association between loneliness and overall and domain-specific cognitive function and informant-rated cognitive decline in cohorts from seven countries: the United States, England, India, China, South Africa, Mexico, and Chile.

METHODS

Data were from the Harmonized Cognitive Assessment Protocol administered in seven population-based studies (total N > 20,000). Participants reported their loneliness, completed a battery of cognitive tests, and nominated a knowledgeable informant to rate their cognitive decline. Random-effect meta-analyses were used to summarize the associations from each cohort.

RESULTS

Loneliness was associated with poor overall cognitive performance and informant-rated cognitive decline controlling for sociodemographic factors (meta-analytic correlation for overall cognition = -.10 [95% CI = -.13, -.06] and informant-rated decline = .16 [95% CI = .14, .17]). Despite some heterogeneity, the associations were significant across samples from Africa, Asia, Europe, North, Central, and South America. The meta-analysis also indicated an association with specific cognitive domains: episodic memory, speed-attention, visuospatial abilities, numeric reasoning, and verbal fluency. The associations were attenuated but persisted when depressive symptoms were added as a covariate. Depression, cognitive impairment, and sociodemographic factors did not consistently moderate the associations across samples.

CONCLUSIONS

Loneliness is associated with poor performance across multiple domains of cognition and observer-rated cognitive decline, associations that replicated across diverse world regions and cultures.

How does loneliness affect satisfaction with life? What is the role of the perception of God in this interaction?

Introduction

This study examined the role of loneliness and the perception of God in affecting the satisfaction with life of Muslim individuals living alone in Turkey during the COVID-19 pandemic. Additionally, the study explored the regulatory role of the perception of God in the relationship between individuals' loneliness and satisfaction with life.

Methods

The research is a cross-sectional study that evaluates individuals' loneliness, satisfaction with life, and perception of God. The study group consists of 378 individuals living alone in Turkey. Among the participants, 196 are women (51.9%) and 182 are men (48.1%). The UCLA loneliness scale, the satisfaction with life scale, the perception of God scale, and a personal information form were used as data collection tools in the study.

Results

The examination of research findings indicated that the variables of loneliness, perception of God, and the interaction between loneliness and the perception of God explained 28% of the variance in individuals' satisfaction with life. We determined that satisfaction with life was affected significantly and positively by the perception of God (β = 0.28, p < 0.001) and significantly and negatively by loneliness (β = -0.38, p < 0.001). The interactional effect of the variables of loneliness and perception of God on satisfaction with life was also found to be significant (β = -0.10, p = 0.023). When we examined the details of the regulatory effect, we found that the effect of loneliness on satisfaction with life decreased even more in cases where the perception of God was high.

Discussion

The research findings suggest that loneliness decreases life satisfaction, while positive self-image mitigates this effect. It can be stated that using belief-sensitive therapeutic approaches in the therapeutic process could contribute to alleviating the negative effects of loneliness.