Perceived social isolation and cognition

Psychobiological mechanisms underlying the social buffering of the hypothalamic-pituitary-adrenocortical axis: a review of animal models and human studies across development

Discovering the stress-buffering effects of social relationships has been one of the major findings in psychobiology in the last century. However, an understanding of the underlying neurobiological and psychological mechanisms of this buffering is only beginning to emerge. An important avenue of this research concerns the neurocircuitry that can regulate the activity of the hypothalamic-pituitary-adrenocortical (HPA) axis. The present review is a translational effort aimed at integrating animal models and human studies of the social regulation of the HPA axis from infancy to adulthood, specifically focusing on the process that has been named social buffering. This process has been noted across species and consists of a dampened HPA axis stress response to threat or challenge that occurs with the presence or assistance of a conspecific. We describe aspects of the relevant underlying neurobiology when enough information exists and expose major gaps in our understanding across all domains of the literatures we aimed to integrate. We provide a working conceptual model focused on the role of oxytocinergic systems and prefrontal neural networks as 2 of the putative biological mediators of this process, and propose that the role of early experiences is critical in shaping later social buffering effects. This synthesis points to both general future directions and specific experiments that need to be conducted to build a more comprehensive model of the HPA social buffering effect across the life span that incorporates multiple levels of analysis: neuroendocrine, behavioral, and social.

The effects of perceived stigma on quality of life outcomes in persons with early-stage dementia: Longitudinal findings: Part 2

This article is the second report from a study examining perceived stigma in persons with dementia with findings regarding the association between stigma and quality of life outcomes being reported here. Fifty persons with dementia and 47 family caregivers were sampled, with data being collected at baseline and six, 12, and 18 months. The modified Stigma Impact Scale measured perceived stigma. Quality of life outcomes included: depression, anxiety, behavioral symptoms, personal control, physical health, self-esteem, social support, and activity participation. Linear mixed model or generalized linear mixed model (for depression) analyses revealed that some aspect of perceived stigma was associated with each outcome. Social rejection was associated with anxiety, behavioral symptoms, health, and activity participation. Internalized shame was associated with anxiety, personal control, health, self-esteem, social support understanding and assistance, and activity participation. Finally, social isolation was associated with depression, anxiety, personal control, health, self-esteem, social support understanding, and activity participation. The complexity of relationships between perceived stigma and quality of life outcomes is evident from these findings.

Evolutionary mechanisms for loneliness

Robert Weiss (1973) conceptualised loneliness as perceived social isolation, which he described as a gnawing, chronic disease without redeeming features. On the scale of everyday life, it is understandable how something as personally aversive as loneliness could be regarded as a blight on human existence. However, evolutionary time and evolutionary forces operate at such a different scale of organisation than we experience in everyday life that personal experience is not sufficient to understand the role of loneliness in human existence. Research over the past decade suggests a very different view of loneliness than suggested by personal experience, one in which loneliness serves a variety of adaptive functions in specific habitats. We review evidence on the heritability of loneliness and outline an evolutionary theory of loneliness, with an emphasis on its potential adaptive value in an evolutionary timescale.

Does loneliness mediate the relation between social support and cognitive functioning in later life?

Research in gerontology has demonstrated mixed effects of social support on cognitive decline and dementia: Social support has been shown to be protective in some studies, but not in others. Moreover, little is known about the underlying mechanisms between social support and cognitive functioning. We investigate one of the possible mechanisms, and argue that subjective appraisals rather than received amounts of social support affect cognitive functioning. Loneliness is seen as an unpleasant experience that occurs when a person's network of relationships is felt to be deficient in some important way. As such, loneliness describes the extent to which someone's needs are not being met and thus provides a subjective assessment of support quality. We expect that receiving instrumental and emotional support reduces loneliness, which in turn preserves cognitive functioning. Data are from the Longitudinal Aging Study Amsterdam (LASA) and include 2255 Dutch participants aged 55-85 over a period of six years. Respondents were measured every three years. Cognitive functioning was assessed with the Mini-Mental State Examination (MMSE), the Coding Task, and the Raven's Coloured Progressive Matrices. The analytical approach comprised latent growth mediation models. Frequent emotional support related to reduced feelings of loneliness and better cognitive functioning. Increases in emotional support also directly enhanced cognitive performance. The protective effect of emotional support was strongest amongst adults aged 65 years and older. Increase in instrumental support did not buffer cognitive decline, instead there were indications for faster decline. After ruling out the possibility of reversed causation, we conclude that emotional support relationships are a more powerful protector of cognitive decline than instrumental support relationships.

Isolation associated aggression--a consequence of recovery from defeat in a territorial animal

Population density has profound influences on the physiology and behaviour of many animal species. Social isolation is generally reported to lead to increased aggressiveness, while grouping lowers it. We evaluated the effects of varying degrees of isolation and grouping on aggression in a territorial insect, the Mediterranean field cricket, Gryllusbimaculatus. Substantiating early observations, we show that dyadic contests between weight-matched, adult male crickets taken from groups rarely escalate beyond threat displays, whereas interactions between pairs of previously isolated crickets typically escalate to physical fights lasting several seconds. No significant differences were found between 1, 2 and 6-day isolates, or between individuals grouped for a few hours or lifelong. Unexpectedly, crickets grouped in immediate proximity within individual mesh cages that precluded fighting while permitting visual, olfactory and mechanical, antennal contact, were as aggressive as free isolates. This suggests that reduced aggression of grouped animals may be an acquired result of fighting. Supporting this notion, isolated crickets initially engage in vigorous fights when first grouped, but fighting intensity and duration rapidly decline to the level of life-long grouped crickets within only 10 min. Furthermore, grouped crickets become as aggressive as life-long isolates after only 3 hours of isolation, and on the same time course required for crickets to regain their aggressiveness after social defeat. We conclude that the reduced aggressiveness of grouped crickets is a manifestation of the loser effect resulting from social subjugation, while isolation allows recovery to a state of heightened aggressiveness, which in crickets can be considered as the default condition. Given the widespread occurrence of the loser effect in the Animal Kingdom, many effects generally attributed to social isolation are likely to be a consequence of recovery from social subjugation.

Social regulation of human gene expression: mechanisms and implications for public health

Recent analyses have discovered broad alterations in the expression of human genes across different social environments. The emerging field of social genomics has begun to identify the types of genes sensitive to social regulation, the biological signaling pathways mediating these effects, and the genetic polymorphisms that modify their individual impact. The human genome appears to have evolved specific "social programs" to adapt molecular physiology to the changing patterns of threat and opportunity ancestrally associated with changing social conditions. In the context of the immune system, this programming now fosters many of the diseases that dominate public health. The embedding of individual genomes within a broader metagenomic network provides a framework for integrating molecular, physiologic, and social perspectives on human health.

Early social experience is critical for the development of cognitive control and dopamine modulation of prefrontal cortex function

Social experiences during youth are thought to be critical for proper social and cognitive development. Conversely, social insults during development can cause long-lasting behavioral impairments and increase the vulnerability for psychopathology later in life. To investigate the importance of social experience during the juvenile and early adolescent stage for the development of cognitive control capacities, rats were socially isolated from postnatal day 21 to 42 followed by re-socialization until they reached adulthood. Subsequently, two behavioral dimensions of impulsivity (impulsive action in the five-choice serial reaction time task (5-CSRTT) and impulsive choice in the delayed reward task) and decision making (in the rat gambling task) were assessed. In a separate group of animals, long-lasting cellular and synaptic changes in adult medial prefrontal cortex (PFC) pyramidal neurons were determined following social isolation. Juvenile and early adolescent social isolation resulted in impairments in impulsive action and decision making under novel or challenging circumstances. Moreover, socially isolated rats had a reduced response to enhancement of dopaminergic neurotransmission (using amphetamine or GBR12909) in the 5-CSRTT under challenging conditions. Impulsive choice was not affected by social isolation. These behavioral deficits were accompanied by a loss of sensitivity to dopamine of pyramidal neurons in the medial PFC. Our data show long-lasting deleterious effects of early social isolation on cognitive control and its neural substrates. Alterations in prefrontal cognitive control mechanisms may contribute to the enhanced risk for psychiatric disorders induced by aberrations in the early social environment.

Investigating hypervigilance for social threat of lonely children

The hypothesis that lonely children show hypervigilance for social threat was examined in a series of three studies that employed different methods including advanced eye-tracking technology. Hypervigilance for social threat was operationalized as hostility to ambiguously motivated social exclusion in a variation of the hostile attribution paradigm (Study 1), scores on the Children's Rejection-Sensitivity Questionnaire (Study 2), and visual attention to socially rejecting stimuli (Study 3). The participants were 185 children (11 years-7 months to 12 years-6 months), 248 children (9 years-4 months to 11 years-8 months) and 140 children (8 years-10 months to 12 years-10 months) in the three studies, respectively. Regression analyses showed that, with depressive symptoms covaried, there were quadratic relations between loneliness and these different measures of hypervigilance to social threat. As hypothesized, only children in the upper range of loneliness demonstrated elevated hostility to ambiguously motivated social exclusion, higher scores on the rejection sensitivity questionnaire, and disengagement difficulties when viewing socially rejecting stimuli. We found that very lonely children are hypersensitive to social threat.

Selected findings from the Religious Orders Study and Rush Memory and Aging Project

The Religious Orders Study and the Rush Memory and Aging Project are both cohort studies of aging and dementia that include organ donation at death. Together, more than 2,700 persons have agreed to annual clinical evaluation and brain donation at death. A subset of participants also participated in a substudy that included ante-mortem imaging. We highlight recent findings that have been highly cited over the past five years. The findings fall into three general categories. The first relates to the neuropathology of probable Alzheimer's disease, mild cognitive impairment, and those without dementia or mild cognitive impairment. The second relates to risk factors for Alzheimer's disease and neuropathology. The third are clinical and imaging studies of mild cognitive impairment. The findings illustrate the range of insights that can be gained into cognitive aging by incorporating neuropathologic indices into well designed, prospective cohort studies.

Social isolation in older Malaysians: prevalence and risk factors

BACKGROUND

Social isolation is one of the most important emerging issues among ageing populations, as it reduces well-being, health and quality of life. The purpose of this study was to identify prevalence and risk factors of social isolation in older Malaysians.

METHODS

The sample for this study was drawn from a national survey entitled 'Patterns of Social Relationships and Psychological Well-Being among Older Persons in Peninsular Malaysia'. Social isolation was measured with the Lubben Social Network Scale.

RESULTS

The findings from the present study showed that 49.8% of older Malaysians are at risk for social isolation. The results of logistic regression analysis revealed that the number of sons, number of brothers, number of sisters, household size, self-rated health, place of residence, home ownership, sex and ethnicity were significantly associated with social isolation.

CONCLUSION

These findings may have some implications for social and health-care policymakers in planning and developing new and effective interventions such as educational programmes to reduce social isolation among this vulnerable population.

The role of social isolation in social anxiety disorder: a systematic review and meta-analysis

INTRODUCTION

Social isolation in the context of social anxiety disorder has not been closely examined. This study aimed to describe the role and measurement of social isolation in those with social anxiety disorder.

METHOD

A systematic review and meta-analyses were conducted using a prospectively prepared protocol for search strategy, selection criteria, and data extraction. DerSimonian-Laird random effects models were used to calculate pooled estimates of effect.

RESULTS

Thirty-four studies, containing 20 formal instruments and four other measures of social isolation, were included. Most formal instruments were utilized in single studies, whereas simple structural measures (e.g., living alone) were used most frequently. The pooled score was 38.1 on the Loneliness and Social Dissatisfaction Questionnaire, 33.1 on the Liebowitz Social Anxiety Scale (avoidance subscale), and 21.1 on the Social Avoidance and Distress Scale.

CONCLUSIONS

Social isolation is common in social anxiety disorder but assessed by a heterogeneous mix of measures.

Psychobiological mechanisms underlying the social buffering of the hypothalamic-pituitary-adrenocortical axis: a review of animal models and human studies across development

Discovering the stress-buffering effects of social relationships has been one of the major findings in psychobiology in the last century. However, an understanding of the underlying neurobiological and psychological mechanisms of this buffering is only beginning to emerge. An important avenue of this research concerns the neurocircuitry that can regulate the activity of the hypothalamic-pituitary-adrenocortical (HPA) axis. The present review is a translational effort aimed at integrating animal models and human studies of the social regulation of the HPA axis from infancy to adulthood, specifically focusing on the process that has been named social buffering. This process has been noted across species and consists of a dampened HPA axis stress response to threat or challenge that occurs with the presence or assistance of a conspecific. We describe aspects of the relevant underlying neurobiology when enough information exists and expose major gaps in our understanding across all domains of the literatures we aimed to integrate. We provide a working conceptual model focused on the role of oxytocinergic systems and prefrontal neural networks as 2 of the putative biological mediators of this process, and propose that the role of early experiences is critical in shaping later social buffering effects. This synthesis points to both general future directions and specific experiments that need to be conducted to build a more comprehensive model of the HPA social buffering effect across the life span that incorporates multiple levels of analysis: neuroendocrine, behavioral, and social.

Trajectories of loneliness during childhood and adolescence: predictors and health outcomes

The present study employed latent growth mixture modeling to discern distinct trajectories of loneliness using data collected at 2-year intervals from age 7-17 years (N = 586) and examine whether measures taken at age 5 years were good predictors of group membership. Four loneliness trajectory classes were identified: (1) low stable (37% of the sample), (2) moderate decliners (23%), (3) moderate increasers (18%), and (4) relatively high stable (22%). Predictors at age 5 years for the high stable trajectory were low trust beliefs, low trusting, low peer acceptance, parent reported negative reactivity, an internalizing attribution style, low self-worth, and passivity during observed play. The model also included outcome variables. We found that both the high stable and moderate increasing trajectories were associated with depressive symptoms, a higher frequency of visits to the doctor, and lower perceived general health at age 17. We discuss implications of findings for future empirical work.

The Emerging Field of Human Social Genomics

Although we generally experience our bodies as being biologically stable across time and situations, an emerging field of research is demonstrating that external social conditions, especially our subjective perceptions of those conditions, can influence our most basic internal biological processes-namely, the expression of our genes. This research on human social genomics has begun to identify the types of genes that are subject to social-environmental regulation, the neural and molecular mechanisms that mediate the effects of social processes on gene expression, and the genetic polymorphisms that moderate individual differences in genomic sensitivity to social context. The molecular models resulting from this research provide new opportunities for understanding how social and genetic factors interact to shape complex behavioral phenotypes and susceptibility to disease. This research also sheds new light on the evolution of the human genome and challenges the fundamental belief that our molecular makeup is relatively stable and impermeable to social-environmental influence.

Social ties and health: a social neuroscience perspective

Research over the last several decades has shown that the health of the body is intimately tied to the strength of our social connections, but why? This article reviews evidence from affective and social neuroscience suggesting that, because of the importance of social ties for mammalian survival, threats to social connection are processed by some of the same neural regions that process basic threats to survival and consequently trigger physiological threat responses that have negative health implications. Likewise, social support is processed by some of the same neural regions that process safety or protection from basic threats and inhibit these same health-relevant physiological threat responses.

Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English Longitudinal Study of Ageing

OBJECTIVE

This study aims to evaluate the impact of social isolation and loneliness, individually and simultaneously, on cognitive function in older adults during a 4-year period, using data from the English Longitudinal Study of Ageing, and to evaluate if these associations are moderated by educational level.

METHODS

Data on social isolation, loneliness, and cognitive function (verbal fluency, immediate recall, and delayed recall) were obtained at baseline. Follow-up measures on cognitive function were obtained 4 years later for 6034 participants (mean age at baseline=65.6 years). Regression analyses were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Interactions between social isolation, loneliness, and educational level were also evaluated.

RESULTS

Baseline isolation was significantly associated with decreases in all cognitive function measures at follow-up (β=-.05 to -.03, p<.001), independently of baseline scores, whereas loneliness was associated with poorer immediate recall (β=-.05, p<.001) and delayed recall (β=-.03, p=.02). There was a significant interaction between educational level and both isolation (p=.02) and loneliness (p=.01) for delayed recall, such that isolation and loneliness were associated with poorer recall only among those with low levels of education.

CONCLUSIONS

Loneliness and isolation are associated with poorer cognitive function among older adults. Interventions to foster social connections may be particularly beneficial for individuals with low levels of education.

Social Isolation and Cognitive Function in Appalachian Older Adults

Objective:

Investigating the relation between social isolation and cognitive function will allow us to identify components to incorporate into cognitive interventions.

Method:

Data were collected from 267 Appalachian older adults ( M = 78.5, range 70–94 years). Overall cognitive functioning and specific cognitive domains were assessed from data of a self-assembled neuropsychological battery of frequently used tasks. Social isolation, social disconnectedness, and perceived isolation were measured from the Lubben Social Network scale-6.

Results:

Results indicated a significant positive association between all predictor variables (e.g., social isolation, social disconnectedness, and perceived isolation) and outcome variables (e.g., overall cognitive function, memory, executive functioning, attention, and language abilities). Perceived isolation accounted for nearly double the amount of variance in overall cognitive functioning than social disconnectedness (10.2% vs. 5.7%).

Discussion:

Findings suggest that social isolation is associated with poorer overall cognitive functioning and this remains true across varied cognitive domains.

Feelings of loneliness among adults with mental disorder

Loneliness can affect people at any time and for some it can be an overwhelming feeling leading to negative thoughts and feelings. The current study, based on the Adult Psychiatric Morbidity Survey in England, 2007, quantified the association of loneliness with a range of specific mental disorders and tested whether the relationship was influenced by formal and informal social participation and perceived social support.Methods Using a random probability sample design,7,461 adults were interviewed in a cross-sectional national survey in England in 2007. Common Mental Disorders were assessed using the revised Clinical Interview Schedule;the diagnosis of psychosis was based on the administration of the Schedules of the Clinical Assessment of Neuropsychiatry, while loneliness was derived from an item in the Social Functioning Questionnaire.Results Feelings of loneliness were more prevalent in women (OR = 1.34, 95 % CI 1.20–1.50, P\0.001) as well as in those who were single (OR = 2.24, 95 % C I1.96–2.55, P<0.001), widowed, divorced or separated(OR = 2.78, 95 % CI 2.38–3.23, P<0.001), economically inactive (OR = 1.24, 95 % CI 1.11–1.44,P = 0.007), living in rented accommodation (OR = 1.73,95 % CI 1.53–1.95, P<0.001) or in debt (OR = 2.47,95 % CI 2.07–1.50, P<0.001). Loneliness was associated with all mental disorders, especially depression [corrected].

Loneliness in old age in Eastern and Western European societies: theoretical perspectives

Data from European countries participating in the Generations and Gender Surveys showed that mean loneliness scores of older adults are higher in Eastern than in Western European countries. Although co-residence is considered as one of the fundamental types of social integration, and although co-residence is more common in Eastern Europe, the mean loneliness scores of older co-resident adults in Eastern Europe are still very high. This article investigates mechanisms behind the puzzling between-country differences in social integration and loneliness. Firstly, the theoretical framework of loneliness is discussed starting from the individual's perspective using the deficit and the cognitive discrepancy approach and taking into account older adults' deprived living conditions. Secondly, mechanisms at the societal level are investigated: cultural norms, the demographical composition and differences in societal wealth and welfare. It is argued that an integrated theoretical model, as developed in this article, combining individual and societal level elements, is most relevant for understanding the puzzling reality around social integration and loneliness in country-comparative research. An illustration of the interplay of individual and societal factors in the emergence of loneliness is presented.

On the reciprocal association between loneliness and subjective well-being

Loneliness has been shown to longitudinally predict subjective well-being. The authors used data from a longitudinal population-based study (2002-2006) of non-Hispanic white, African-American, and nonblack Latino-American persons born between 1935 and 1952 and living in Cook County, Illinois. They applied marginal structural models for time-varying exposures to examine the magnitude and persistence of the effects of loneliness on subjective well-being and of subjective well-being on loneliness. Their results indicate that, if interventions on loneliness were made 1 and 2 years prior to assessing final subjective well-being, then only the intervention 1 year prior would have an effect (standardized effect = -0.29). In contrast, increases in subjective well-being 1 year prior (standardized effect = -0.26) and 2 years prior (standardized effect = -0.13) to assessing final loneliness would both have an effect on an individual's final loneliness. These effects persist even after control is made for depressive symptoms, social support, and psychiatric conditions and medications as time-varying confounders. Results from this study indicate an asymmetrical and persistent feedback of fairly substantial magnitude between loneliness and subjective well-being. Mechanisms responsible for the asymmetry are discussed. Developing interventions for loneliness and subjective well-being could have substantial psychological and health benefits.

Brain structure links loneliness to social perception

Loneliness is the distressing feeling associated with the perceived absence of satisfying social relationships [1]. Loneliness is increasingly prevalent in modern societies [2, 3] and has detrimental effects on health and happiness [4, 5]. Although situational threats to social relationships can transiently induce the emotion of loneliness, susceptibility to loneliness is a stable trait that varies across individuals [6–8] and is to some extent heritable [9–11]. However, little is known about the neural processes associated with loneliness (but see [12–14]). Here, we hypothesized that individual differences in loneliness might be reflected in the structure of the brain regions associated with social processes [15]. To test this hypothesis, we used voxel-based morphometry and showed that lonely individuals have less gray matter in the left posterior superior temporal sulcus (pSTS)—an area implicated in basic social perception. As this finding predicted, we further confirmed that loneliness was associated with difficulty in processing social cues. Although other sociopsychological factors such as social network size, anxiety, and empathy independently contributed to loneliness, only basic social perception skills mediated the association between the pSTS volume and loneliness. Taken together, our results suggest that basic social perceptual abilities play an important role in shaping an individual’s loneliness.

Mindfulness-Based Stress Reduction training reduces loneliness and pro-inflammatory gene expression in older adults: a small randomized controlled trial

Lonely older adults have increased expression of pro-inflammatory genes as well as increased risk for morbidity and mortality. Previous behavioral treatments have attempted to reduce loneliness and its concomitant health risks, but have had limited success. The present study tested whether the 8-week Mindfulness-Based Stress Reduction (MBSR) program (compared to a Wait-List control group) reduces loneliness and downregulates loneliness-related pro-inflammatory gene expression in older adults (N = 40). Consistent with study predictions, mixed effect linear models indicated that the MBSR program reduced loneliness, compared to small increases in loneliness in the control group (treatment condition × time interaction: F(1,35) = 7.86, p = .008). Moreover, at baseline, there was an association between reported loneliness and upregulated pro-inflammatory NF-κB-related gene expression in circulating leukocytes, and MBSR downregulated this NF-κB-associated gene expression profile at post-treatment. Finally, there was a trend for MBSR to reduce C Reactive Protein (treatment condition × time interaction: (F(1,33) = 3.39, p = .075). This work provides an initial indication that MBSR may be a novel treatment approach for reducing loneliness and related pro-inflammatory gene expression in older adults.

Supportive social relationships attenuate the appeal of choice

People like having options when choosing, but having too many options can lead to negative decision-related consequences. The present study focused on how social-relational factors--common aspects of daily life--can maintain or attenuate the appeal of choice. Study 1 examined the effect of a supportive- or nonsupportive-relationship prime on the decision to pay for having more options in choosing a consumer product. People who thought of supportive relationships, compared with those who thought of nonsupportive ones (and control participants), were less willing to pay for a larger choice set. Study 2 showed that the activation of thoughts of security and calmness in participants recalling supportive relationships (compared with participants recalling nonsupportive relationships) mediated the appeal of choice. This finding offers one possible explanation for the reduced desire for options when people are reminded of supportive relationships.

Parents as a resource: communication quality affects the relationship between adolescents' internet use and loneliness

The authors examined the influence of parent-adolescent communication quality, as perceived by the adolescents, on the link between adolescents' Internet use and loneliness, controlling for perceived family support in general terms. Adolescents (N = 216, M(age) = 15.80 years) provided data on Internet use, loneliness, Internet-related parent-adolescent communication, and perceived family support. Moderated regression analyses showed that Internet-related communication quality determined whether more extensive Internet use was associated with more loneliness. This moderation effect remained significant when perceived family support in general terms was controlled for. Gender and age of the participants did not influence the findings. Implications for successful Internet-related parenting strategies are discussed.

Cochlear implantation in older adults

Cochlear implants allow individuals with severe to profound hearing loss access to sound and spoken language. The number of older adults in the United States who are potential candidates for cochlear implantation (CI) is approximately 150,000 and will continue to increase with the aging of the population. Should CI be routinely recommended for these older adults, and do these individuals benefit from CI? We reviewed our 12-year experience with CI in adults aged ≥60 years (n = 445) at Johns Hopkins Medical Institutions to investigate the impact of CI on speech understanding and to identify factors associated with speech performance. Complete data on speech outcomes at baseline and 1 year post-CI were available for 83 individuals. Our results demonstrate that CI in adults aged ≥60 years consistently improved speech understanding scores, with a mean increase of 60.0% (SD 24.1) on HINT (Hearing in Noise Test) sentences in quiet. The magnitude of the gain in speech scores was negatively associated with age at implantation, such that for every increasing year of age at CI the gain in speech scores was 1.3 percentage points less (95% confidence interval [95% CI], 0.6-1.9) after adjusting for age at hearing loss onset. Conversely, individuals with higher pre-CI speech scores (HINT scores between 40% and 60%) had significantly greater post-CI speech scores by a mean of 10.0 percentage points (95% CI, 0.4-19.6) than those with lower pre-CI speech scores (HINT <40%) after adjusting for age at CI and age at hearing loss onset. These results suggest that older adult CI candidates who are younger at implantation and with higher preoperative speech scores obtain the highest speech understanding scores after CI, with possible implications for current United States Medicare policy. Finally, we provide an extended discussion of the epidemiology and impact of hearing loss in older adults. Future research of CI in older adults should expand beyond simple speech outcomes to take into account the broad cognitive, social, and physical functioning outcomes that are likely detrimentally affected by hearing loss and may be mitigated by CI.

Cognitive Readiness: The Need for a Multi-Modal Measurement Approach

Cognitive readiness is the fit of cognitive state to a task or mission. High cognitive readiness enables successful execution of tasks and missions and supports good decision-making under the complex and dynamic conditions common to military operations. In these environments, where the consequences of poor performance can be catastrophic, cognitive readiness assessment could enable leaders to ensure that individuals and teams are ready to maintain safety and attain mission success. The current paper summarizes Aptima Inc.’s work with individual cognitive readiness, including the development of a revised definition and model of individual cognitive readiness, and the proposal of a multi-modal measurement approach for its assessment.

Social strain and executive function across the lifespan: the dark (and light) sides of social engagement

We investigated how the association between social strain and cognitive efficiency varies with task demands across adulthood, from latencies on simpler speeded tasks to tests involving executive function. Participants (N = 3280) were drawn from the MIDUS survey, a large, diverse national sample of adults who completed cognitive tests including speeded task-switching (Tun & Lachman, 2008, Developmental Psychology, 44, 1421). After controlling for demographic and health variables, we found that higher levels of reported social strain were associated with slower processing speed, particularly for the complex task-switching test relative to simpler speeded tests. Effects of strain were greatest for those with the lowest general cognitive ability. Moreover, those with very high levels of social strain but low levels of social support gave the poorest task-switching performance. These findings provide further evidence for the complex relationship between the social environment and cognition across adulthood, particularly the association between efficiency of executive functions and negative social interactions.

Theta signal as the neural signature of social exclusion

The feeling of being excluded from a social interaction triggers social pain, a sensation as intense as actual physical pain. Little is known about the neurophysiological underpinnings of social pain. We addressed this issue using intracranial electroencephalography in 15 patients performing a ball game where inclusion and exclusion blocks were alternated. Time-frequency analyses showed an increase in power of theta-band oscillations during exclusion in the anterior insula (AI) and posterior insula, the subgenual anterior cingulate cortex (sACC), and the fusiform "face area" (FFA). Interestingly, the AI showed an initial fast response to exclusion but the signal rapidly faded out. Activity in the sACC gradually increased and remained significant thereafter. This suggests that the AI may signal social pain by detecting emotional distress caused by the exclusion, whereas the sACC may be linked to the learning aspects of social pain. Theta activity in the FFA was time-locked to the observation of a player poised to exclude the participant, suggesting that the FFA encodes the social value of faces. Taken together, our findings suggest that theta activity represents the neural signature of social pain. The time course of this signal varies across regions important for processing emotional features linked to social information.

Effects of social isolation on glucocorticoid regulation in social mammals

The regulation and function of the hypothalamic-pituitary-adrenocortical (HPA) axis and glucocorticoids have been well conserved across vertebrate species. Glucocorticoids influence a wide range of physiological functions that include glucose regulation, metabolism, inflammatory control, as well as cardiovascular, reproductive, and neuronal effects. Some of these are relatively quick-acting non-genomic effects, but most are slower-acting genomic effects. Thus, any stimulus that affects HPA function has the potential to exert wide-ranging short-term and long-term effects on much of vertebrate physiology. Here, we review the effects of social isolation on the functioning of the HPA axis in social species, and on glucocorticoid physiology in social mammals in particular. Evidence indicates that objective and perceived social isolation alter HPA regulation, although the nature and direction of the HPA response differs among species and across age. The inconsistencies in the direction and nature of HPA effects have implications for drawing cross-species conclusions about the effects of social isolation, and are particularly problematic for understanding HPA-related physiological processes in humans. The animal and human data are incommensurate because, for example, animal studies of objective isolation have typically not been modeled on, or for comparability with, the subjective experience of isolation in humans. An animal model of human isolation must be taken more seriously if we want to advance our understanding of the mechanisms for the effects of objective and perceived isolation in humans.

Decoding the invisible forces of social connections

By its 20th anniversary, social neuroscience has witnessed an incredible rise in the number of studies demonstrating the effects of perceived social isolation (e.g., loneliness, ostracism), and inversely, the beneficial effects of social bonding (e.g., love, desire, attachment) on social perception, cognition, and behavior and on mental and physical health. The current review underscores the importance of two factors in this literature: (1) where an individual falls along the continuum of isolation/bonding from feelings of rejection and neglect to feelings of strong, stable, trusted social bonds, and (2) whether gauging an individual's general feeling of social isolation/bonding or the specific feeling of isolation/bonding toward the person with whom the individual is interacting. Evidence shows that these factors are related to brain and cognition, including embodied social cognition-a system integrating past self-related actions from which simulation mechanisms can be used to access other people's minds and anticipate their actions. The neurophysiological mechanisms underlying sensorimotor mapping between interacting individuals offers an empirical opportunity to investigate the interpersonal forces that operate on individuals at a distance. This multilevel integrative approach provides a valuable tool for investigating the brain networks responsible for understanding acute and chronic social disorders.

Loneliness in older adults: an embodied experience

Loneliness is of significant concern in the older adult population. Loneliness has been associated with old age because of multiple losses that may occur. These include loss of health, social status, friends, and/or spouse. There is a gap in the literature with regard to understanding the meaning of loneliness in older adults. Interpretive phenomenology was used for this study, involving multiple interviews with older adults to explore the meaning of loneliness. Findings revealed that many participants experienced loneliness as a result of disrupted meaningful engagement with others due to different age-related changes. Loneliness was embodied as it was expressed through the participants' bodies in several ways, including fatigue, tension, withdrawal, and emptiness. Conclusions from this study reveal the need for nurses to become more aware of loneliness in older adults as a significant health issue.

Close relationships and health in daily life: a review and empirical data on intimacy and somatic symptoms

OBJECTIVE

To review research on close relationships and health in daily life, with a focus on physiological functioning and somatic symptoms, and to present data on the within-person effects of physical intimacy on somatic symptoms in committed couples' daily life. The empirical study tested whether prior change in physical intimacy predicted subsequent change in symptoms, over and above their concurrent association. In addition, the study tested if increasing and decreasing intimacy had asymmetric effects on symptom change.

METHODS

In this study, 164 participants in 82 committed couples reported physical intimacy and somatic symptoms once a day for 33 days.

RESULTS

Prior within-person change in intimacy predicted a subsequent reduction in symptoms; when a person's intimacy increased from one day to the next day, then symptoms decreased over the following days (B = -0.098, standard error [SE] = 0.038, p = .013). This lagged effect of intimacy held over and above the association of concurrent change in intimacy and symptoms (B = -0.122, SE = 0.041, p = .004). The study found asymmetric effects of prior increase and decrease in intimacy; prior intimacy increase predicted reduced subsequent symptoms (B = -0.189, SE = 0.068, p = .047), whereas prior intimacy decrease was unrelated to subsequent symptoms (B = -0.003, SE = 0.063, not significant). There was no evidence for asymmetric effects of intimacy increase and decrease on concurrent symptom change.

CONCLUSIONS

Close relationships exert influences on health in daily life, and part of this influence is due to intimacy.

The social motivation theory of autism

The idea that social motivation deficits play a central role in Autism Spectrum Disorders (ASD) has recently gained increased interest. This constitutes a shift in autism research, which has traditionally focused more intensely on cognitive impairments, such as theory-of-mind deficits or executive dysfunction, and has granted comparatively less attention to motivational factors. This review delineates the concept of social motivation and capitalizes on recent findings in several research areas to provide an integrated account of social motivation at the behavioral, biological and evolutionary levels. We conclude that ASD can be construed as an extreme case of diminished social motivation and, as such, provides a powerful model to understand humans' intrinsic drive to seek acceptance and avoid rejection.

The relationship between companion animals and loneliness among rural adolescents

The relationship between loneliness and companion animal bonding was explored among 293 rural adolescents. Participants from two ethnically diverse southwestern high schools completed self-report measures of loneliness, pet ownership, companion animal attachment, and social support. Pet owners reported significantly lower loneliness scores than non-pet owners. Furthermore, companion animal bonding scores were inversely related to loneliness scores. Companion animal attachment was positively related to the number of humans in the social support network. The results of this study indicate that interventions promoting a pet relationship may be valuable in reducing loneliness among adolescents.

Social snails: the effect of social isolation on cognition is dependent on environmental context

Social isolation is often considered to have negative effects on cognitive function in a wide range of species. Here we assess how environmental context alters the effect of isolation on long-term memory formation (24 h) in the pond snail Lymnaea stagnalis. We operantly trained snails to reduce aerial respiration in hypoxia following exposure to one of three social conditions: (1) maintained and trained in groups; (2) maintained in groups, trained in isolation; or (3) maintained and trained in isolation. In addition, snails also experienced four stress exposure levels: control, exposure to low calcium availability, predator kairomone exposure during training or a combination of low calcium and predator kairomones. Snails isolated during training alone demonstrated no difference in memory formation compared with the snails trained in groups. Maintaining snails in social isolation for 8 days prior to training had a neutral effect on memory in control conditions or in the presence of predator kairomones alone. However, social isolation enhanced long-term memory formation in snails exposed to low calcium conditions, a stress that blocks memory formation in snails maintained in groups. Conversely, when exposed to low calcium and predator kairomones combined, grouped snails normally demonstrate long-term memory, but following maintenance in isolation long-term memory was blocked. Therefore, the effect of social isolation on cognitive function is highly dependent on the environmental context in which it is experienced.

Social support and invalidation by others contribute uniquely to the understanding of physical and mental health of patients with rheumatic diseases

This study examined whether social support and invalidation (lack of understanding and discounting by others) are differently associated with physical and mental health. Participants were 1455 patients with fibromyalgia, rheumatoid arthritis, ankylosing spondylitis, osteorarthritis, or another rheumatic disease. Participants completed online questionnaires. Social support correlated negatively with discounting responses of others (moderately) and lack of understanding (strongly). Both invalidation and social support were additively associated with patients’ mental health, but only discounting was significantly associated with patients’ physical health. This suggests that improving health of patients with rheumatic diseases requires the consideration of both social support and invalidation.

Life Regrets and the Need to Belong

The present research documents a link between regret and the need to belong. Across five studies, using diverse methods and samples, the authors established that regrets involving primarily social relationships (e.g., romance and family) are felt more intensely than less socially based regrets (e.g., work and education). The authors ruled out alternative explanations for this pattern and found that it is best explained by the extent to which regrets are judged to constitute threats to belonging. Threats to belonging at the regret level and the need to belong at the individual level were strong predictors of regret intensity across multiple regret domains. These findings highlight the central role social connectedness plays in what people regret most.

Loneliness, health, and mortality in old age: a national longitudinal study

This study examined the relationship between loneliness, health, and mortality using a U.S. nationally representative sample of 2101 adults aged 50 years and over from the 2002 to 2008 waves of the Health and Retirement Study. We estimated the effect of loneliness at one point on mortality over the subsequent six years, and investigated social relationships, health behaviors, and health outcomes as potential mechanisms through which loneliness affects mortality risk among older Americans. We operationalized health outcomes as depressive symptoms, self-rated health, and functional limitations, and we conceptualized the relationships between loneliness and each health outcome as reciprocal and dynamic. We found that feelings of loneliness were associated with increased mortality risk over a 6-year period, and that this effect was not explained by social relationships or health behaviors but was modestly explained by health outcomes. In cross-lagged panel models that tested the reciprocal prospective effects of loneliness and health, loneliness both affected and was affected by depressive symptoms and functional limitations over time, and had marginal effects on later self-rated health. These population-based data contribute to a growing literature indicating that loneliness is a risk factor for morbidity and mortality and point to potential mechanisms through which this process works.

What's hot: the enhancing effects of thermal stress on long-term memory formation in Lymnaea stagnalis

The pond snail, Lymnaea stagnalis, naturally inhabits slow flowing, shallow and stagnant environments in the northern temperate zone. Consequently, it will experience wide temperature fluctuations dependent on prevailing weather conditions. We hypothesize that periods of warming act as a thermal stressor to alter memory formation. Snails were exposed to an acute 1h period of 30°C pond water and we determined how memory formation following operant conditioning of aerial respiration was affected. In snails used here (the Dutch strain), a single 0.5h training session (TS) results in intermediate-term (3h) but not long-term memory (LTM). Applying the thermal stressor during training caused memory enhancement (i.e. LTM lasting 24 h). However, the breathing rate also increased in warm water, which might explain the enhanced memory. Therefore, we applied the thermal stressor (1h at 30°C) up to 4h before or 1h after training. This did not alter baseline breathing rate during the period when snails would experience training. However, the thermal stressor weather experienced prior to or following the single TS, resulted in an enhanced memory that persisted up to 48h (i.e. LTM). We conclude that memory enhancement is due to the stress associated with the thermal stimulus.