Perceived social isolation and cognition

Socially isolated, but not lonely in lockdown: Exploring the role of reflective functioning as a protective factor in the early days of the COVID-19 pandemic in Germany

INTRODUCTION

Loneliness is a pressing public mental health issue. So far, there has been a paucity of investigations focused on the individual differences modulating this subjective feeling in the face of difficult circumstances, e.g., the COVID-19 pandemic. As such, the present study aimed to investigate the role of mentalization; given that the construct comprises reflection abilities that might be particularly relevant to the pandemic's interpersonal challenges.

METHODS

A survey representative of the German population was conducted from May to June 2020 (N = 2503). We examined mentalization, operationalized as reflective functioning (RF) and measured using the Mentalization Questionnaire (MZQ), both as a protective factor against loneliness on its own and as a moderator of the association of social isolation with loneliness.

RESULTS

Of the overall sample, 822 (32.8 %) individuals reported social isolation. Worse RF was moderately associated with higher levels of loneliness (r = 0.433, p < .001). A linear regression model (controlling for sociodemographic characteristics and general personality pathology) confirmed this positive association, but also indicated an interaction effect of RF and social isolation in the statistical prediction of loneliness. Stratified models showed that RF was a comparatively weaker statistical predictor of loneliness among the socially isolated.

DISCUSSION

This representative population study expanded our knowledge about the factors shaping loneliness in the population. RF emerged as a potentially modifiable protective influence. Further research needs to clarify the mechanisms through which it mitigates loneliness.

LIMITATIONS

The cross-sectional design does not give insight into the temporal association of RF and loneliness.

Chronic loneliness and chronic social isolation among older adults. A systematic review, meta-analysis and meta-regression

OBJECTIVES

We performed a systematic review and meta-analysis to examine the prevalence and antecedents/consequences of chronic loneliness and social isolation (i.e. enduring or persistent experience that extends over a certain period of time) among older adults. Moreover, we conducted a meta-regression to explore sources of heterogeneity.

METHOD

A search was conducted in four electronic databases. We included observational studies that reported prevalence and, where available, antecedents/consequences of chronic loneliness or chronic social isolation amongst older adults. Key characteristics of the studies were extracted.

RESULTS

Across 17 studies included in the meta-analysis, the estimated prevalence of chronic loneliness was 20.8% (95% CI: 16.1-25.5%), including 21.7% among women (95% CI: 16.1-27.4%) and 16.3% among men (95% CI: 10.6-21.9%). One study reported chronic social isolation (13.4%) and found that chronic social isolation predicted higher depression scores. Meta-regressions indicated that loneliness was less prevalent when assessed with single-item measures. Regarding antecedents/consequences, spousal loss can contribute to chronic loneliness which in turn may contribute to adverse health-related outcomes.

CONCLUSION

About one in five older adults experiences chronic loneliness reflecting the need to address chronic loneliness. More longitudinal research is needed on chronic loneliness and social isolation, particularly from low and middle-income countries.

[Internet-based self-help for loneliness-a systematic review]

BACKGROUND

Recently, the phenomenon of loneliness has received increasing attention. Loneliness is widespread and can have adverse consequences for mental and physical health if prolonged. Internet-based interventions (IBIs) for self-help have proven to be effective for a variety of psychological disorders. Due to several specific aspects, IBIs are also a relevant option for loneliness. This systematic review aims to present the current research on self-help IBIs for reducing loneliness.

METHODS

A systematic literature search was conducted in the databases Web of Science, PubMed, Scopus, PsycInfo, MedLine, PsycIndex, Cochrane Library and PsyArXiv between December 2023 and early January 2024. We included original German or English studies that addressed IBIs for self-help to reduce loneliness.

RESULTS

In total, eight studies published between 2017 and 2024 were included in the qualitative analysis. All studies were conducted in high-income countries, included predominantly well-educated female adults and were mostly satisfactory regarding their internal validity.

DISCUSSION

The results of this review suggest that self-help IBIs may be a promising option for alleviating loneliness. However, the work also points to the need for further research. Future studies should consider larger samples and people of different ages, genders and education levels in order to generalise the results of the present review.

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.

Default mode network dynamics: an integrated neurocircuitry perspective on social dysfunction in human brain disorders

Our intricate social brain is implicated in a range of brain disorders, where social dysfunction emerges as a common neuropsychiatric feature cutting across diagnostic boundaries. Understanding the neurocircuitry underlying social dysfunction and exploring avenues for its restoration could present a transformative and transdiagnostic approach to overcoming therapeutic challenges in these disorders. The brain's default mode network (DMN) plays a crucial role in social functioning and is implicated in various neuropsychiatric conditions. By thoroughly examining the current understanding of DMN functionality, we propose that the DMN integrates diverse social processes, and disruptions in brain communication at regional and network levels due to disease hinder the seamless integration of these social functionalities. Consequently, this leads to an altered balance between self-referential and attentional processes, alongside a compromised ability to adapt to social contexts and anticipate future social interactions. Looking ahead, we explore how adopting an integrated neurocircuitry perspective on social dysfunction could pave the way for innovative therapeutic approaches to address brain disorders.

A translational neuroscience perspective on loneliness: Narrative review focusing on social interaction, illness and oxytocin

This review addresses key findings on loneliness from the social, neurobiological and clinical fields. From a translational perspective, results from studies in humans and animals are included, with a focus on social interaction, mental and physical illness and the role of oxytocin in loneliness. In terms of social interactions, lonely individuals tend to exhibit a range of abnormal behaviors based on dysfunctional social cognitions that make it difficult for them to form meaningful relationships. Neurobiologically, a link has been established between loneliness and the hypothalamic peptide hormone oxytocin. Since social interactions and especially social touch regulate oxytocin signaling, lonely individuals may have an oxytocin imbalance, which in turn affects their health and well-being. Clinically, loneliness is a predictor of physical and mental illness and leads to increased morbidity and mortality. There is evidence that psychopathology is both a cause and a consequence of loneliness. The final section of this review summarizes the findings from social, neurobiological and clinical perspectives to present a new model of the complex construct of loneliness.

Examining bi-directional links between loneliness, social connectedness and sleep from a trait and state perspective

Greater loneliness as well as a lack of social connectedness have often been associated with poorer sleep. However, the temporal dynamics and direction of these associations remain unclear. Aim of the current study was to examine bi-directional associations between loneliness/social connectedness and sleep in 48 stress-exposed medical students during their first medical internship, considered a period of heightened stress. We obtained trait-level questionnaire data on loneliness and global sleep completed before and during the internship as well as state-level diary- and wearable-based data on daily changes in social connectedness and sleep collected twice over the period of seven consecutive days, once before and once during the internship. Bi-directional associations among greater loneliness and higher daytime dysfunction on trait-level were identified. In addition, several uni-directional associations between loneliness/social connectedness and sleep were found on trait- and state-level. In sum, findings of this study point at a bi-directional relation among loneliness/social connectedness and sleep, in which variables seem to reciprocally influence each other across longer-term periods as well as on a day-to-day basis.

Exploring the Experience of Community Participation Among Individuals With Serious Mental Illness

People with serious mental illness (SMI) encounter restrictions in the quantity of their community participation. Less is known about the quality of their participation. We aimed to explore the relationship between symptoms of SMI and the daily experience (i.e., loneliness and enjoyment) of community participation. We examined daily community participation among people with SMI using ecological momentary assessment surveys. We built multilevel models to examine the associations between symptoms of SMI and loneliness or enjoyment during community participation. Our analysis included 183 people among four participant groups: bipolar disorder (n = 44), major depressive disorder (n = 46), schizophrenia/schizoaffective disorder (n = 40), and control (n = 53). People with schizophrenia engaged in more unstructured activities (e.g., socializing) than people among other groups. Symptom association varied across diagnostic groups. To support tailored intervention development, researchers and practitioners should consider the context of participation and the clinical characteristics of the client.

Altered temporal awareness during Covid-19 pandemic

Social isolation during the COVID-19 pandemic had profound effects on human well-being. A handful of studies have focused on how time perception was altered during the COVID-19 pandemic, while no study has tested whether temporal metacognition is also affected by the lockdown. We examined the impact of long-term social isolation during the COVID-19 pandemic on the ability to monitor errors in timing performance. We recruited 1232 participants from 12 countries during lockdown, 211 of which were retested "post-pandemic" for within-group comparisons. We also tested a new group of 331 participants during the "post-pandemic" period and compared their data to those of 1232 participants tested during the lockdown (between-group comparison). Participants produced a 3600 ms target interval and assessed the magnitude and direction of their time production error. Both within and between-group comparisons showed reduced metric error monitoring performance during the lockdown, even after controlling for government-imposed stringency indices. A higher level of reported social isolation also predicted reduced temporal error monitoring ability. Participants produced longer duration during lockdown compared to post-lockdown (again controlling for government stringency indices). We reason that these effects may be underlain by altered biological and behavioral rhythms during social isolation experienced during the COVID-19 pandemic. Understanding these effects is crucial for a more complete characterization of the cognitive consequences of long-term social isolation.

Temporal associations of emotional and social loneliness and psychosocial functioning in emerging adulthood

Emerging adulthood is an important developmental phase often accompanied by peaks in loneliness, social anxiety, and depression. However, knowledge is lacking on how the relationships between emotional loneliness, social loneliness, social isolation, social anxiety and depression evolve over time. Gaining insight in these temporal relations is crucial for our understanding of how these problems arise and maintain each other across time. Young adults from a university sample (N = 1,357; M = 23.60 years, SD = 6.30) filled out questionnaires on emotional and social loneliness, social isolation, depressive and social anxiety symptoms at three time points within a 3-year period. Random intercept cross-lagged panel models were used to disentangle reciprocal and prospective associations of loneliness subtypes, social isolation, depressive and social anxiety symptoms across time. Results showed that on the within-person level, increases in emotional and social loneliness as well as social isolation predicted higher depression levels on later timepoints. Increases in depressive symptoms also predicted increases in subsequent social loneliness, but not in emotional loneliness. Finally, increases in depressive symptoms predicted increases in social isolation. There were no significant temporal relations between loneliness and social isolation on the one hand and social anxiety symptoms on the other hand. Social distancing imposed by COVID-19 related government restrictions may have impacted the current results. The findings suggest that emotional and social loneliness precede development of depressive symptoms, which in turn precedes development of social loneliness and social isolation, indicating a potential vicious cycle of social loneliness, social isolation and depressive symptoms in emerging adulthood. Social anxiety did not precede nor follow loneliness, depressive symptoms, or social isolation. The current study sheds more light on the temporal order of loneliness and psychopathological symptoms and hereby assists in identifying times where prevention and intervention efforts may be especially helpful to counter development of depression and loneliness.

Unraveling the complexity of human brain: Structure, function in healthy and disease states

The human brain stands as an intricate organ, embodying a nexus of structure, function, development, and diversity. This review delves into the multifaceted landscape of the brain, spanning its anatomical intricacies, diverse functional capacities, dynamic developmental trajectories, and inherent variability across individuals. The dynamic process of brain development, from early embryonic stages to adulthood, highlights the nuanced changes that occur throughout the lifespan. The brain, a remarkably complex organ, is composed of various anatomical regions, each contributing uniquely to its overall functionality. Through an exploration of neuroanatomy, neurophysiology, and electrophysiology, this review elucidates how different brain structures interact to support a wide array of cognitive processes, sensory perception, motor control, and emotional regulation. Moreover, it addresses the impact of age, sex, and ethnic background on brain structure and function, and gender differences profoundly influence the onset, progression, and manifestation of brain disorders shaped by genetic, hormonal, environmental, and social factors. Delving into the complexities of the human brain, it investigates how variations in anatomical configuration correspond to diverse functional capacities across individuals. Furthermore, it examines the impact of neurodegenerative diseases on the structural and functional integrity of the brain. Specifically, our article explores the pathological processes underlying neurodegenerative diseases, such as Alzheimer's, Parkinson's, and Huntington's diseases, shedding light on the structural alterations and functional impairments that accompany these conditions. We will also explore the current research trends in neurodegenerative diseases and identify the existing gaps in the literature. Overall, this article deepens our understanding of the fundamental principles governing brain structure and function and paves the way for a deeper understanding of individual differences and tailored approaches in neuroscience and clinical practice-additionally, a comprehensive understanding of structural and functional changes that manifest in neurodegenerative diseases.

Development and validation of the Environmental Confinement Stressors Scale (ECSS-20)

The COVID-19 pandemic has generated a global crisis with severe consequences for public health. There have been negative impacts on people's quality of life and mental health due to various stressors arising in this context, such as physical, social, economic, and psychological challenges. Noteworthy among these are the indirect effects of health measures, especially social distancing and confinement, which have significantly altered people's daily lives and social activities, producing high levels of anxiety, depression, and stress. This study proposes developing and validating a cross-sectional scale called the "Environmental Stressors Scale (ECSS-20)" to address the need to measure the impact of environmental stressors during confinement. The scale, which has been validated following ethical and methodological guidelines, consists of four dimensions: economic stressors (EE), social activities (SA), habitability (H), and exposure to virtual media (EMV). A pilot study (n = 113) and a main study (n = 314) were applied. The results showed that the instrument has a reliable and valid structure, with satisfactory internal consistency and factorial validity. Likewise, gender invariance tests supported its suitability for its applicability to women and men. Overall, the ECSS-20 is a valuable instrument for assessing the impact of confinement and improving the understanding of people's subjective experiences in this situation. Future research could further develop its applicability in different contexts and populations to better understand its usefulness and psychometric properties.

Stigma and its associations with self-confidence and sexual relations in 4 types of premature ejaculation

BACKGROUND

Although men with premature ejaculation (PE) always show more negative emotions, including embarrassment, guilt and worry, this may be related to the stigma of PE. To investigated stigma and its associations with self-confidence and sexual relations in 4 PE syndromes, a survey was conducted in our hospital from December 2018 to December 2019 among 350 men with self-reported PE and 252 men without self-reported PE. The stigma, self-confidence and sexual relations were assessed by the Social Impact Scale (SIS) and Self-Esteem and Relationship questionnaire (SEAR), respectively. Ejaculation control, sexual life satisfaction and distress caused by PE were evaluated by the Index of PE.

RESULTS

Men with self-reported PE had higher internalized shame and social isolation scores and lower SEAR scores than control subjects. The highest score of internalized shame and social isolation and the lowest score of SEAR appeared in men with lifelong PE (LPE). After age adjustment, the positive relationships were stronger between distress about PE and internalized shame. Whereas, the stronger negative associations were found between social isolation and sexual satisfaction. The strongest association was observed between social isolation and sexual relationship. Therefore, the stigma associated with PE adversely affects the self-confidence, self-esteem, and sexual relationships of men with PE.

CONCLUSION

Men with PE, especially LPE, have a high level of stigma and disharmonious sexual relations, and often lack self-confidence and self-esteem, which have a certain negative impact on their physical and mental health and life. These will be the key issues to be considered when we formulate a personalized treatment plan for PE.

Psychosocial experiences are associated with human brain mitochondrial biology

Psychosocial experiences affect brain health and aging trajectories, but the molecular pathways underlying these associations remain unclear. Normal brain function relies on energy transformation by mitochondria oxidative phosphorylation (OxPhos). Two main lines of evidence position mitochondria both as targets and drivers of psychosocial experiences. On the one hand, chronic stress exposure and mood states may alter multiple aspects of mitochondrial biology; on the other hand, functional variations in mitochondrial OxPhos capacity may alter social behavior, stress reactivity, and mood. But are psychosocial exposures and subjective experiences linked to mitochondrial biology in the human brain? By combining longitudinal antemortem assessments of psychosocial factors with postmortem brain (dorsolateral prefrontal cortex) proteomics in older adults, we find that higher well-being is linked to greater abundance of the mitochondrial OxPhos machinery, whereas higher negative mood is linked to lower OxPhos protein content. Combined, positive and negative psychosocial factors explained 18 to 25% of the variance in the abundance of OxPhos complex I, the primary biochemical entry point that energizes brain mitochondria. Moreover, interrogating mitochondrial psychobiological associations in specific neuronal and nonneuronal brain cells with single-nucleus RNA sequencing (RNA-seq) revealed strong cell-type-specific associations for positive psychosocial experiences and mitochondria in glia but opposite associations in neurons. As a result, these "mind-mitochondria" associations were masked in bulk RNA-seq, highlighting the likely underestimation of true psychobiological effect sizes in bulk brain tissues. Thus, self-reported psychosocial experiences are linked to human brain mitochondrial phenotypes.

Analysis of changes in social isolation, loneliness, or both, and subsequent cognitive function among older adults: Findings from a nationwide cohort study

INTRODUCTION

The study aimed to investigate the associations of changes in social isolation, loneliness, or both, with cognitive function.

METHODS

Data were from 7299 older adults in the Chinese Longitudinal Healthy Longevity Survey. We defined four change patterns (no, incident, transient, and persistent) for social isolation and loneliness, and created nine-category variable to represent the joint changes. Tobit regression models and Cox models were performed.

RESULTS

Incident, transient, and persistent social isolation or loneliness may accelerate cognitive decline (p < 0.05). Incident, transient, and persistent social isolation were associated with higher cognitive impairment risk, while only persistent loneliness was associated with higher cognitive impairment risk (p < 0.001). Notably, short-term or persistent social isolation was associated with accelerated cognitive decline and incident cognitive impairment, regardless of different loneliness change status (p < 0.05).

DISCUSSION

Short-term or persistent social isolation and persistent loneliness may be a salient risk factor for cognitive decline and cognitive impairment.

HIGHLIGHTS

Incident, transient, and persistent social isolation were associated with accelerated cognitive decline and higher cognitive impairment risk. Persistent loneliness was associated with accelerated cognitive decline and higher cognitive impairment risk. Short-term or persistent social isolation with concurrent different loneliness change status accelerated cognitive decline and higher cognitive impairment risk.

The Social and Cognitive Online Training (SCOT) project: A digital randomized controlled trial to promote socio-cognitive well-being in older adults

OBJECTIVES

Effective prevention programs targeting risk factors for cognitive decline in the elderly are recommended given the progressive increase in the aging of the general population. The Social and Cognitive Online Training (SCOT) project is a randomized, controlled, parallel clinical trial designed to prevent the age-related decline in executive and social functions.

METHODS

The study included 60 cognitively healthy older adults (age = 71.8±5.3, education = 12.3±3.7, MoCA = 25.1±2.4). Participants underwent a baseline clinical and neuropsychological assessment and were then assigned to either an experimental group (SCOT) or a non-specific cognitive training group (CON). Both 8-week digital interventions included two individual cognitive training sessions and one group meeting per week. Post-intervention assessment evaluated the efficacy of the training on specific outcome measures: the Tower of London for executive functioning, the Ekman-60 Faces test, and the Mini-Social cognition & Emotional Assessment battery for social cognition. A measure of loneliness was included as an exploratory outcome.

RESULTS

Baseline demographic and neuropsychological characteristics were balanced between SCOT (n = 29) and CON (n = 28) groups. Pre-post-intervention analyses showed improvements in executive functioning and social cognition in both groups, without significant interaction effects. Exploratory post-hoc analyses stratifying the SCOT group by training performance showed significant post-training improvements in executive functioning, emotion recognition, and cognitive theory of mind for high-performing participants.

DISCUSSION

Results provide preliminary evidence for the beneficial effects of SCOT training, particularly for those who performed best during the training. The SCOT training could represent a new intervention to promote socio-cognitive well-being in the context of active ageing and dementia prevention.

Loneliness and socioemotional memory

Do chronically high-lonely individuals exhibit specific memory biases when recalling past social episodes? We explored negative memory biases, focusing on the recall of unfavourable social experiences and social memory biases, emphasizing the recall of social experiences irrespective of emotional valence. We conducted a dictionary-based semantic analysis of autobiographical episodes obtained from 4095 participants via four datasets. Participants recalled a positive, negative or emotionally neutral episode from their recent past. High-lonely individuals predominantly exhibited a decline in recalling positive social episodes, providing partial support for negative memory biases. However, both high- and low-lonely individuals were similarly inclined to recall negative social episodes. These results suggest that the primary issue among high-lonely individuals is the limited recall of positive social experiences rather than the general negativity in memory biases or the hypersensitivity to general social memories.

Loneliness and psychotic-like experiences in middle-aged and older adults: the mediating role of selective attention to threat and external attribution biases

OBJECTIVES

Loneliness has been associated with psychotic-like experiences (PLEs) in the general population, but the mechanisms underlying this association are poorly understood. Theoretical models, corroborated by empirical findings, signify the key role of biased cognition in both loneliness and psychosis. This study tested whether two cognitive biases - Selective Attention to Threat (ATB) and External Attribution Bias (EAB) - account for the association between loneliness and PLEs.

METHOD

A convenience sample (n = 357) of middle-aged and older adults (aged 40+) was recruited online from the UK population. The parallel mediation model with two the aforementioned cognitive biases as mediators was tested.

RESULTS

A mediation effect between loneliness and PLEs via ATB (ab1 = 0.441, 95% CI = [0.264, 0.646]) and EAB (ab2 = 0.354, 95% CI [0.124, 0.627] was established. This model remained significant after controlling for the current symptoms of anxiety and depression.

CONCLUSION

Greater loneliness was associated with a higher rate of PLEs in the sample of middle-aged and older adults. This association was fully explained by ATB and EAB, independent of the current symptoms of anxiety and depression.

Associations of state and chronic loneliness with interpretation bias: The role of internalizing symptoms

Loneliness is common and, while generally transient, persists in up to 22% of the population. The rising prevalence and adverse impacts of chronic loneliness highlight the need to understand its underlying mechanisms. Evolutionary models of loneliness suggest that chronically lonely individuals demonstrate negative interpretation biases towards social information. It may also be that such biases are exacerbated by momentary increases in state loneliness, or elevated anxiety or depression. Yet, little research has tested these possibilities. The current study aimed to advance understandings of loneliness by examining associations of chronic loneliness with individual differences in negative interpretation bias for social (relative to non-social) stimuli, and testing whether these associations change in the context of increased state loneliness and current levels of anxiety and depressive symptoms. These aims were explored in 591 participants who completed an interpretation bias task before and after undergoing a state loneliness induction. Participants also self-reported chronic loneliness, anxiety, and depression. Linear mixed models indicated that only state (but not chronic) loneliness was associated with more positive interpretations of non-social stimuli, with greater anxiety and depressive symptoms predicting more negative interpretations. Implications of these findings for present theoretical models of loneliness are discussed.

Momentary loneliness and intrusive thoughts among older adults: the interactive roles of mild cognitive impairment and marital status

OBJECTIVES

Loneliness is associated with maladaptive cognitions, yet little is known about the association between loneliness and intrusive thinking during older adulthood. Links between loneliness and intrusive thoughts may be particularly strong among individuals with mild cognitive impairment (MCI), who may have greater difficulty regulating emotion and intrusive thoughts. In contrast, having close relationships (e.g. being married) may serve as a protective factor as marital status is associated with better overall well-being.

METHOD

Participants were 316 older adults (recruited from the Bronx, NY, as part of a larger study) without dementia at study intake (40% Black; 13% Hispanic, Mage = 77.45 years, 67% women) who completed ecological momentary assessments five times daily for 14 consecutive days (13,957 EMAs total). Multilevel modeling was used to examine the association between momentary loneliness and intrusive thoughts and whether MCI and marital status interacted to moderate this association.

RESULTS

There was a significant three-way interaction (β = -0.17, p < 0.05), such that lagged momentary loneliness was positively associated with intrusive thoughts (3-4 h later) for those with MCI who were not married.

CONCLUSION

Findings suggest that among older adults with MCI, being married may be a protective factor and being unmarried may be a risk factor for experiencing loneliness and subsequent intrusive thoughts.

Childhood adversities and memory function in later life: the mediating role of activity participation

BACKGROUND

Childhood adversities may lead to decreased activity participation in later life, impacting memory health in ageing adults. Childhood adversities related to deprivation and threat, as conceptualized by the Dimensional Model of Adversity, can exhibit distinct impacts on cognitive and emotional outcomes in children and younger adults. This study examined the potential influence of childhood deprivation and threat on memory function in later life and the mediating role of activity participation in these relationships.

METHODS

This study used data from the first wave of Panel Study of Active Ageing and Society (PAAS), a representative survey of Hong Kong residents aged 50 or above (N = 1,005). Key variables included late-life memory function measured by delayed recall test, deprivation- and threat-related childhood adversities, and the frequency of participation in informal and formal types of activities. Mediation tests were used for analysis.

RESULTS

Childhood deprivation was associated with a lower late-life memory function, whereas threat was not. The negative effects of childhood deprivation and its subdomain, economic hardship, on memory function were mediated by activity participation. Total participation scores presented the strongest mediating effect (17.3-20.6%), with formal activities playing a more substantial mediating role than informal activities in mitigating the effect of childhood deprivation.

CONCLUSIONS

These findings expand the applicability of the Dimensional Model of Adversity to ageing populations, highlighting the influence of deprivation on life-long cognitive development. Furthermore, this study revealed an indirect mechanism by which childhood deprivation affects memory health in old age through diverse activity participation.

Investigating the relationship between early cardiovascular disease markers and loneliness in young adults

Loneliness is recognised as a risk factor for cardiovascular disease development. However, it is unclear whether loneliness itself or other closely related mental health symptoms, such as depression and social anxiety, are associated with the development of cardiovascular disease. In the present study, we examined the relationship between loneliness and several early cardiovascular disease markers in young adults, after controlling for depression and social anxiety. Sixty-six young adults (18-35 years old, Mage = 22.70; 75.8% females) completed psychological questionnaires and took part in several physiological tests assessing cardiovascular health (e.g., vascular function). Results revealed higher loneliness was significantly associated with shorter pulse transit time (β = - 0.70, p = 0.002; shorter pulse transit time is a subclinical marker for arterial stiffness). Additionally, results show that while loneliness and depression were both related to vascular dysfunction in young adults, the underlining physiological mechanisms through which they affect vascular function may be different. Specifically, higher loneliness was associated with increased arterial stiffness, whereas depression was associated with increased endothelial dysfunction (β = - 0.43, p = 0.04). Our findings indicate that presence of loneliness and depression in young adults may be accompanied by early indicators of poor cardiovascular health, such as arterial stiffness and endothelial dysfunction. Results from the study further support the link between loneliness and cardiovascular disease development.

Physical exercise and mental health among older adults: the mediating role of social competence

Background

Healthy aging is crucial to the quality of life of older adults, of which mental health is an essential part. Physical exercise strongly affects their mental health and can alleviate psychological problems to a certain extent. Nevertheless, the correlation between physical exercise and the mental health of older adults individuals, as well as the underlying mechanism by which physical exercise impacts mental health, remains rather ambiguous.

Methods

We utilized multiple linear regression models to investigate the relationship between physical activity and mental health in 3,240 persons aged 60 and up. The propensity score matching (PSM) method was used to assess the robustness of the regression results. In addition, sequential recursive models were employed to investigate the mediating role of social competence in the link between physical activity and mental health.

Results and discussion

We discovered a strong favorable association between physical exercise and mental health, which was mediated by social competence. Furthermore, the effect of physical exercise on mental health differed across older persons from various socioeconomic backgrounds.

Conclusion

Older adults should strengthen their understanding of the role of physical exercise. Sports organizations that serve older adults by providing resources and services to help them maintain physical fitness and by hosting sports activities and competitions according to their needs should be established.

Bidirectional Associations of Depressive Symptoms and Cognitive Function Over Time

Importance

Cognitive decline and depressive symptoms often co-occur among older adults, and they share several mechanisms. Despite the fact that cognitive dysfunction has been linked to increased depressive symptoms, the directionality of this association remains unclear.

Objective

To examine whether there is a bidirectional association between depressive symptoms and cognitive function in English adults aged 50 years or older throughout a 16-year follow-up period.

Design, Setting, and Participants

This cohort study included a nationally representative sample of community-dwelling English adults aged 50 years or older. The current analysis included 8268 eligible participants with relevant data. These participants were examined every other year from 2002 and 2003 until 2018 and 2019, resulting in a follow-up period of up to 16 years. Data were analyzed from July to November 2023.

Main Outcomes and Measures

The bivariate dual change score models were used to estimate the multivariable associations between depressive symptoms and cognitive function, which were interchangeably used as exposures and outcomes. Cognitive measures include memory and verbal fluency tests, while the Center for Epidemiologic Studies Depression Scale evaluated depressive symptoms.

Results

The study population of 8268 participants had a mean (SD) age of 64 (10) years at the study baseline, and 4517 participants (55%) were female. Higher depressive symptoms were cross-sectionally associated with poorer memory (β intercept, -0.018; standard error [SE], 0.004; P < .001) and verbal fluency (β intercept, -0.009; SE, 0.004; P = .02) at study baseline. A steeper linear change in depressive symptoms was associated with an accelerated memory change (β intercept, -0.253; SE, 0.079; P = .001), and a linear change in memory was associated with an acceleration in depressive symptoms over time (β intercept, 0.016; SE, 0.006; P = .005). This bidirectional change was not observed with verbal fluency.

Conclusions and Relevance

In this study, greater depressive symptoms were associated with poorer memory at the study baseline and steeper memory change over time. A gradual linear change in depressive symptoms contributed to accelerated memory loss and vice versa, suggesting that psychological mood and memory performance are intrinsically associated.

Characterizing Life Stress Exposure Among Sexual Minority Adolescents: Temporality, Content, And Mediating Role in Mental Health Disparities

Though sexual minority adolescents face a wide array of deleterious stressors, few studies have examined the role of specific types of stress exposure (i.e., chronic vs. episodic, interpersonal vs. non-interpersonal) on mental health disparities. This study utilizes a contextual threat-based assessment to (a) compare levels of stress exposure types between sexual minority and non-sexual minority adolescents, and (b) examine stress type as a mediator between sexual orientation and two outcomes: depressive symptoms and emotion dysregulation. Data comes from a longitudinal sample (14-17 years-old, N = 241; 17.6% sexual minority; 54% assigned female at birth; 73.9% White), with two time-points (T1 and T2) utilized. Sexual minority adolescents reported higher chronic interpersonal stress, but no differences in non-interpersonal chronic or episodic stress, relative to non-sexual minority adolescents. Chronic interpersonal stress exposure mediated the link between membership in an oppressed group (i.e., sexual minority teens) and the primary outcomes (emotion dysregulation and depressive symptoms) at both T1 and T2. Findings demonstrate the utility of contextual threat-based assessments within sexual minority research.

Dyadic loneliness, age, and cognitive functioning among midlife and older Black couples

Objectives: Within marriages, loneliness has been linked with individuals' own and their partners' cognitive health. Yet little research has situated Black older adults within a relational, dyadic context.

Method: This study analyzed longitudinal dyadic data from the Health and Retirement Study (2010-2016; n = 1270 participants from 635 couples) from both partners in opposite-sex midlife and older couples where at least one partner reported being Black or African American.

Results: Results indicated (1) husbands' loneliness was associated with worse cognitive functioning 4 years later for wives who had high baseline cognitive functioning themselves; (2) wives' loneliness was associated with worse cognitive functioning 4 years later only for oldest-old husbands; and (3) wives' cognitive functioning was associated with slower increases to husbands' loneliness 4 years later.

Conclusion: Findings indicate that loneliness has dyadic consequences for cognitive functioning among older Black couples, but that context is crucial for determining who is at greatest risk of harmful repercussions from a partner's loneliness.

Loneliness and Its Predictors in Rare Versus Common Chronic Illnesses

BACKGROUND

Loneliness is a growing public health concern associated with substantial negative mental and physical health outcomes. Loneliness is especially relevant for individuals with a chronic illness, perhaps more so if their illness is rare. Little is known about the psychosocial experience of individuals with a rare chronic illness, and whether and how it may differ from the experience of individuals with common chronic illnesses. We compared the magnitude of loneliness in persons with a rare or common chronic illness and examined theoretically guided predictors of loneliness as follows: stigma, illness intrusiveness, social comparison, social support, support from healthcare providers, and self-efficacy.

METHOD

Individuals with a chronic illness (common or rare) completed an anonymous online survey (N = 952).

RESULTS

Individuals with common chronic illnesses were as lonely as those with a rare chronic illness. Loneliness in both groups was higher than that in population norms. Regression analyses reveal that independent of other predictors, loneliness was especially high among people who feel stigmatized by others, those who have less social support available, and people whose functioning is more disrupted by their illness (all p values < 0.01).

CONCLUSION

The similarity of loneliness in these groups reinforces the value of further systematic research to identify the needs of individuals with any type of chronic illness. Study findings highlight the importance of examining internalized stigma and social support as possible targets of intervention to reduce loneliness among individuals with a chronic illness, recognizing some of the unique features and challenges of their disorders, whether common or rare.

Contributions of loneliness to cognitive impairment and dementia in older adults are independent of other risk factors and Alzheimer's pathology: a narrative review

Loneliness significantly contributes to cognitive impairment and dementia in older adults. Loneliness is a distressing feeling resulting from a perceived lack of social connection (i.e., a discrepancy between desired and actual social relationships), while social isolation is a related term that can be defined by number and type of social relationships. Importantly, loneliness is distinct from social isolation in that it is associated with a distressing self-perception. The primary focus of this narrative review is the impact of chronic loneliness on cognitive impairment and dementia among older adults. Loneliness has a significant association with many factors that are related to worse cognition, and therefore we include discussion on health, mental health, as well as the physiological effects of loneliness, neuropathology, and potential treatments. Loneliness has been shown to be related to development of dementia with a hazard ratio (HR) risk comparable to having a single APOE4 gene. The relationship of dementia to loneliness appears to be at least partially independent of other known dementia risk factors that are possibly associated with loneliness, such as depression, educational status, social isolation, and physical activity. Episodic memory is not consistently impacted by loneliness, which would be more typically impaired if the mild cognitive impairment (MCI) or dementia was due to Alzheimer's disease (AD) pathology. In addition, the several longitudinal studies that included neuropathology showed no evidence for a relationship between loneliness and AD neuropathology. Loneliness may decrease resilience, or produce greater cognitive change associated with the same level of AD neuropathology. Intervention strategies to decrease loneliness in older adults have been developed but need to consider key treatment targets beyond social isolation. Loneliness needs to be assessed in all studies of cognitive decline in elders, since it significantly contributes to the variance of cognitive function. It will be useful to better define the underlying mechanism of loneliness effects on cognition to determine if it is similar to other psychological factors related to excessive stress reactivity, such as neuroticism or even depression, which are also associated with cognitive decline. It is important from a health perspective to develop better strategies to decrease loneliness in older adults.

Loneliness is associated with more trust but worse trustworthiness expectations

Subjective feelings of loneliness emerge due to unsatisfactory social relationships, representing a major risk for mental and physical well-being. Despite its social nature, evidence on how loneliness affects social behaviours and expectations is lacking. Using Bayesian analyses and economic games, we show in three different studies that lonelier individuals trusted their partners to a greater extent despite less favourable trustworthiness expectations, showing a greater discrepancy between their trusting behaviours and their expectations of others' trustworthiness. Such discrepancy was reversed in extravert individuals who also reported to be less lonely. These results provide evidence on two opposing effects of loneliness as a motivator for social connections and promoter of social withdrawal, and demonstrate the moderating role of personality traits. This work contributes to a better understanding of how loneliness impacts social behaviour and social expectations, with important downstream clinical implications for varying health conditions associated with heightened feelings of loneliness.

Leisure activities as reserve mediators of the relationship between loneliness and cognition in aging

Previous studies have found that loneliness affects cognitive functions in older persons. However, the influence of loneliness on different cognitive fields and the internal mechanism of the relationship are unclear. A total of 4772 older persons aged above 50 years (Mean = 65.31, SD = 6.96, 57.7% female) were included in this study. All the participants completed the characteristics scale, as well as the loneliness scale, leisure activity scale, and cognitive function tests in six domains. The results showed that 17.6% of participants had high loneliness, while 16.7% of participants had low loneliness. Associations were observed between higher levels of loneliness and lower scores in general cognitive ability, memory, and executive functions. Mediation analysis suggested that leisure activities, encompassing mental, physical, and social activities, were associated with cognitive functions in the context of loneliness. These results indicate that leisure activities may play a significant role in the relationship between loneliness and cognitive functions in older adults. The study highlights the importance of considering leisure activities in this demographic to potentially mitigate the adverse cognitive effects associated with loneliness.

The association between perceived social functioning and heart rate variability is mediated by subclinical depressive symptomatology and moderated by gender

Chronic loneliness and low perceived social support have been recognized as risk factors for both mental and cardiovascular disorders. It has been proposed that their link to psychophysiological problems may involve changes in parasympathetic activity. However, the exact underlying psychopathological mechanisms and the moderating effects of gender are still not thoroughly examined. Thus, the present study investigated associations between perceived social functioning and resting vagal tone in the context of potential cognitive and subclinical mediators and gender differences. Three hundred twenty-five young adults (aged 18-35, 180 women) underwent an electrocardiogram measurement of 6-minute resting heart rate variability (HRV). They also completed questionnaires assessing loneliness, perceived social support, social cognitive biases, depressive and social anxiety symptoms, and general mental health. In men, HRV was significantly and negatively associated with poorer perceived social functioning, depressive symptoms, and self-reported social cognitive biases, while in women, there was a quadratic link between HRV and depressive symptoms and HRV and general mental health. Moderated mediation analysis revealed that depressive symptoms fully mediated the relationship between perceived social functioning and HRV in men. The results suggest that decreased resting vagal tone in lonely individuals is linked to depressive symptomatology rather than to specific social cognitive biases and that this association is significant only in men.

Oxytocin-Augmented Modular-Based Group Intervention for Loneliness: A Proof-Of-Concept Randomized Controlled Trial

INTRODUCTION

Loneliness poses a significant health problem and existing psychological interventions have shown only limited positive effects on loneliness. Based on preliminary evidence for impaired oxytocin signaling in trait-like loneliness, the current proof-of-concept study used a randomized, double-blind, placebo-controlled design to probe intranasal oxytocin (OT) as an adjunct to a short-term modular-based group intervention for individuals suffering from high trait-like loneliness (HL, UCLA Loneliness Scale ≥55).

METHODS

Seventy-eight healthy HL adults (56 women) received five weekly group psychotherapy sessions. HL participants received OT or placebo before the intervention sessions. Primary outcomes were trait-like loneliness measured at baseline, after the intervention, and again at two follow-up time points (3 weeks and 3 months), and, assessed at each session, state loneliness (visual analog scale), perceived stress (Perceived Stress Scale, PSS-10), quality of life (World Health Organization Five Well-Being Index, WHO-5), and the therapeutic relationship (Group Questionnaire, GQ-D).

RESULTS

The psychological intervention was associated with significantly reduced perceived stress and improved trait-like loneliness across treatment groups, which was still evident at the 3-month follow-up. OT had no significant effect on trait-like loneliness, quality of life, or perceived stress. However, compared to placebo, OT significantly facilitated the decrease in state loneliness within sessions and significantly improved positive bonding between the group members.

CONCLUSION

Despite significantly improved trait-like loneliness after the intervention, OT did not significantly augment this effect. Further studies are needed to determine optimal intervention designs to translate the observed acute effects of OT into long-term benefits.

The study of female college students' consumer psychology mechanism toward male celebrity endorsed products: Tempted or coerced?

The trend of male celebrities endorsing female products is increasing. However, research is lacking on whether this influence is due to the positive emotions generated by the male celebrity's attractiveness or the peer pressure due to mass purchases by the celebrity's fans, and how these effects differ across products with different attributes. This study aims to fill the gap in the existing literature by investigating the influence of male endorsers on female consumers purchase intention, and to deepen the understanding of the mechanisms by which attractiveness and conformity jointly influence purchase decisions. This study used a mixed-design text experiment to investigate the impact of male endorsers' attractiveness and conformity on female college students' positive product attitude and purchase intention for gender-neutral product, female skincare product, and female intimate product, based on the Theory of Planned Behaviour (TPB). The data collected from 456 female college students were analyzed using bootstrap analysis. The study found that both male endorsers' attractiveness and conformity can enhance female college students' positive product attitude and promote their purchase intention for gender-neutral product. However, for female skincare product, male endorsers' attractiveness affects their positive product attitude and purchase intention. Nevertheless, when conformity was present, attractiveness no longer had an effect. Furthermore, for individuals with high levels of loneliness, attractiveness had a detrimental effect on their positive product attitude. On the other hand, conformity had a positive effect by promoting positive product attitude and increasing purchase intention. For female's intimate product, attractiveness did not affect positive product attitude and purchase intention, but the positive effect of conformity remained significant, and both relationships were not moderated by loneliness. It enhances our comprehension of the intricate dynamics underlying the influence of male celebrity endorsements on consumer purchasing decisions, and also offers theoretical justification for the selection of male endorsers for diverse female product.

(R)-ketamine restores anterior insular cortex activity and cognitive deficits in social isolation-reared mice

Chronic social isolation increases the risk of mental health problems, including cognitive impairments and depression. While subanesthetic ketamine is considered effective for cognitive impairments in patients with depression, the neural mechanisms underlying its effects are not well understood. Here we identified unique activation of the anterior insular cortex (aIC) as a characteristic feature in brain-wide regions of mice reared in social isolation and treated with (R)-ketamine, a ketamine enantiomer. Using fiber photometry recording on freely moving mice, we found that social isolation attenuates aIC neuronal activation upon social contact and that (R)-ketamine, but not (S)-ketamine, is able to counteracts this reduction. (R)-ketamine facilitated social cognition in social isolation-reared mice during the social memory test. aIC inactivation offset the effect of (R)-ketamine on social memory. Our results suggest that (R)-ketamine has promising potential as an effective intervention for social cognitive deficits by restoring aIC function.

Dyadic contagion in cognitive function: A nationally-representative longitudinal study of older U.S. couples

Later-life cognitive function is strongly influenced by one's environment. At this life stage, a partner's behaviors and attributes-including their own cognitive status-are a key environmental determinant. A recent "social allostasis" theory also yields specific predictions on patterns of mutual influence-or "contagion"-in cognitive function. Yet, no population representative studies have examined these coupled dynamics. Using recently developed fixed-effects cross-lagged panel modeling (FE-CLPM) methods and ten-year data from the Health and Retirement Study-nationally-representative of U.S. adults over 50-the current study filled this gap. Results supported dyadic cognitive contagion over the long- but not short-run. Short-term associations suggested intriguing "cognitive cycling" possibilities among both men and women that need further investigation. Overall, results supported a theoretical model of coupled "cognitive careers," and relational inducement of allostatic load. Especially among men, recurrent impulses also cumulatively induced substantial path-dependent cognitive improvements, supporting the added value of repeated over one-time interventions. Theoretical and substantive implications are discussed.

Workplace ostracism in healthcare: Association with job satisfaction, stress, and perceived health

AIMS

To examine (1) the association between healthcare workers' workplace ostracism and job satisfaction, stress and perceived health, and (2) whether this relationship is mediated by loneliness and self-esteem.

DESIGN

A cross-sectional study.

METHODS

Healthcare (N = 569) managers and employees (nurses, practical nurses, doctors and social workers) in Finland responded to a semi-structured survey in January 2021 and evaluated their experiences of workplace ostracism, job satisfaction, stress, perceived health, loneliness and self-esteem during the last year. To examine the association of these variables, linear regression and mediator model tests were performed.

RESULTS

Workplace ostracism had a clear direct association with job satisfaction, stress and perceived health. Loneliness fully mediated the relationship between workplace ostracism, stress and perceived health, and partly mediated the association between workplace ostracism and job satisfaction. Self-esteem partly mediated the association between workplace ostracism, stress, job satisfaction and perceived health.

CONCLUSION

The experience of workplace ostracism in organizations is a significant factor in job satisfaction, stress and perceived health. Healthcare organizations could strengthen job satisfaction and increase workers' well-being by strengthening social relationships in the organization and, via that, reducing turnover intention.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

This study gives understanding and information to the healthcare profession on how workplace ostracism affects work well-being and workplace relationships. Workplace ostracism decreases interaction, which can also endanger patient care if information is not openly exchanged.

IMPACT

This study indicated that workplace ostracism weakened job satisfaction more than loneliness. More commonality and consideration for others at work are needed because these factors may help increase work well-being and decrease exits from working life. Further research is needed on why workplace ostracism occurs in healthcare workplaces.

REPORTING METHOD

STROBE.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

A randomized clinical trial to assess feasibility, acceptability and preliminary effects of telehealth-delivered cognitive-behavioral therapy for perceived social isolation among individuals with opioid use disorders

BACKGROUND

The purpose of this study was to report on feasibility, acceptability, and initial efficacy data cognitive-behavioral therapy for perceived isolation (CBT-PSI) compared to health education among individuals with opioid use disorders (OUD) reporting elevated loneliness.

METHODS

Participants (n = 125) with OUD reporting elevated loneliness were recruited using online advertising to participate in a telehealth-delivered randomized clinical trial. Participants received either a 6-session CBT-PSI (n = 63) or health education (n = 62). Measures assessing loneliness, quantity of social interactions, perceived social support, substance use, substance use consequences, and treatment engagement among others, were completed at baseline, post-intervention, and 1- and 2-months post-intervention. Participants also reported on treatment acceptability for both conditions.

RESULTS

Target enrollment was met with loneliness, social disconnectedness measures, and substance use reflecting a clinically severe sample. Retention was high (> 80%) for both conditions. Participants rated both Health Education and CBT-PSI as acceptable, helpful, and useful interventions to address loneliness and opioid use. Loneliness was reduced and quantity of social interactions and perceived social support were increased to the same extent for both conditions and across the follow-up assessments. Opioid use and overall substance use were reduced in both conditions; however, the reductions among participants received CBT-PSI were significantly greater compared to Health Education.

CONCLUSIONS

This study supports the feasibility and acceptability of CBT-PSI. CBT-PSI findings related to loneliness, substance use, and other social connectedness outcomes are encouraging. Additional testing of CBT-PSI in a fully-powered trial is warranted.

Sexual conflict and social networks in bed bugs: effects of social experience

Living in groups can provide essential experience that improves sexual performance and reproductive success. While the effects of social experience have drawn considerable scientific interest, commonly used behavioral assays often do not capture the dynamic nature of interactions within a social group. Here, we conducted 3 experiments using a social network framework to test whether social experience during early adulthood improves the sexual competence of bed bugs (Cimex lectularius) when placed in a complex and competitive group environment. In each experiment, we observed replicate groups of bed bugs comprising previously socialized and previously isolated individuals of the same sex, along with an equal number of standardized individuals of the opposite sex. Regardless of whether we controlled for their insemination history, previously isolated males mounted and inseminated females at significantly higher rates than previously socialized males. However, we found no evidence of social experience influencing our other measures of sexual competence: proportion of mounts directed at females, ability to overcome female resistance, and strength of opposite-sex social associations. We similarly did not detect effects of social experience on our female sexual competence metrics: propensity to avoid mounts, rate of successfully avoiding mounts, opposite-sex social association strength, and rate of receiving inseminations. Our findings indicate that early social experience does not improve sexual competence in male and female bed bugs.

Behavioral Development of Pediatric Exotic Pets and Practical Applications

The discovery of epigenetics and the interaction between genes and the environment have moved our understanding of how animal behavior develops from gestation to adulthood, and even throughout generations, to a new level. Studying the natural biology of exotic pets is key to providing them with a rich social and physical environment that will encourage species-specific behaviors. Combining parent-raising with appropriately timed human handling is likely to result in individuals with more resilience to stress. Using operant conditioning techniques early in life to train the animals' basic behaviors gives them control over their environment, empowering them through their social interactions.

Loneliness as neurobehavioral issue in amyotrophic lateral sclerosis

OBJECTIVE

In elderly people loneliness represents a risk factor for dementia and may negatively impact on mental and physical health. The specific contribute of loneliness to cognitive and behavioral functioning have not yet been determined in amyotrophic lateral sclerosis (ALS). Our hypothesis was that loneliness may be related to motor dysfunction with a negative impact on cognitive and behavioral decline, possibly related to specific cortical involvement.

METHODS

In 200 ALS patients (ALSpts) and 50 healthy controls (HCs) we measured loneliness, mood, and quality of life (QoL). ALSpts underwent comprehensive clinical, genetic, and neuropsychological assessment to define phenotypes. Seventy-seven ALSpts performed 3T MRI scans to measure cortical thickness. Between-group, partial correlation and regression analyses were used to examined clinical, neuropsychological, and cortical signatures of loneliness.

RESULTS

Feelings of loneliness were documented in 38% of ALSpts (ALS/L+pts) and in 47% of HCs. In both groups loneliness was associated with anxiety (P < 0.001), depression (P ≤ 0.005), and poor QoL (P < 0.001). ALS/L+pts had similar motor dysfunctions and cognitive abilities than non-lonely ALSpts, but distinct behavioral profiles (P ≤ 0.005) and frontoparietal involvement (P < 0.05). Loneliness in ALS is related to behavioral changes, apathy, and emotional dysregulation (P < 0.001).

INTERPRETATION

Our cross-sectional study indicates that, in ALS, the satisfaction of social environment is associated with a sense of life well-being that is not limited to the motor status, proving instead that loneliness can impact on disease-related neurobehavioral changes with a possible flashback on brain architecture. This suggests that sociality could promote personal resilience against behavioral and affective decline in ALS.

Exploring the impact of socially assistive robots on health and wellbeing across the lifespan: An umbrella review and meta-analysis

BACKGROUND

Socially assistive robots offer an alternate source of connection for interventions within health and social care amidst a landscape of technological advancement and reduced staff capacity. There is a need to summarise the available systematic reviews on the health and wellbeing impacts to evaluate effectiveness, explore potential moderators and mediators, and identify recommendations for future research and practice.

OBJECTIVE

To explore the effect of socially assistive robots within health and social care on psychosocial, behavioural, and physiological health and wellbeing outcomes across the lifespan (PROSPERO registration number: CRD42023423862).

DESIGN

An umbrella review utilising meta-analysis, narrative synthesis, and vote counting by direction of effect.

METHODS

14 databases were searched (ProQuest Health Research Premium collection, Scopus, PubMed, Web of Science, ASM Digital Library, IEEE Xplore, Cochrane Reviews, and EPISTEMONIKOS) from 2005 to May 4, 2023. Systematic reviews including the effects of socially assistive robots on health outcomes were included and a pooled meta-analysis, vote counting by direction of effect, and narrative synthesis were applied. The second version of A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) was applied to assess quality of included reviews.

RESULTS

35 reviews were identified, most focusing on older adults with or without dementia (n = 24). Pooled meta-analysis indicated no effect of socially assistive robots on quality of life (standard mean difference (SMD) = 0.43), anxiety (SMD = -0.02), or depression (SMD = 0.21), although vote counting identified significant improvements in social interaction, mood, positive affect, loneliness, stress, and pain across the lifespan, and narrative synthesis identified an improvement in anxiety in children. However, some reviews reported no significant difference between the effects of socially assistive robots and a plush toy, and there was no effect of socially assistive robots on psychiatric outcomes including agitation, neuropsychiatric symptoms, and medication use.

DISCUSSION

Socially assistive robots show promise for improving non-psychiatric outcomes such as loneliness, positive affect, stress, and pain, but exert no effect on psychiatric outcomes such as depression and agitation. The main mechanism of effect within group settings appeared to be the stimulation of social interaction with other humans. Limitations include the low quality and high amount of overlap between included reviews.

CONCLUSION

Socially assistive robots may help to improve loneliness, social interaction, and positive affect in older adults, decrease anxiety and distress in children, and improve mood, stress, and reduce pain across the lifespan. However, before recommendations for socially assistive robots can be made, a cost-effectiveness analysis of socially assistive robots to improve mood across the lifespan, and a quantitative analysis of the effects on pain, anxiety, and distress in children are required.

Loneliness in the Daily Lives of People With Mood and Psychotic Disorders

BACKGROUND AND HYPOTHESIS

Loneliness, the subjective experience of feeling alone, is associated with physical and psychological impairments. While there is an extensive literature linking loneliness to psychopathology, limited work has examined loneliness in daily life in those with serious mental illness. We hypothesized that trait and momentary loneliness would be transdiagnostic and relate to symptoms and measures of daily functioning.

STUDY DESIGN

The current study utilized ecological momentary assessment and passive sensing to examine loneliness in those with schizophrenia (N = 59), bipolar disorder (N = 61), unipolar depression (N = 60), remitted unipolar depression (N = 51), and nonclinical comparisons (N = 82) to examine relationships of both trait and momentary loneliness to symptoms and social functioning in daily life.

STUDY RESULTS

Findings suggest that both trait and momentary loneliness are higher in those with psychopathology (F(4,284) = 28.00, P < .001, ηp2 = 0.27), and that loneliness significantly relates to social functioning beyond negative symptoms and depression (β = -0.44, t = 6.40, P < .001). Furthermore, passive sensing measures showed that greater movement (β = -0.56, t = -3.29, P = .02) and phone calls (β = -0.22, t = 12.79, P = .04), but not text messaging, were specifically related to decreased loneliness in daily life. Individuals higher in trait loneliness show stronger relationships between momentary loneliness and social context and emotions in everyday life.

CONCLUSIONS

These findings provide further evidence pointing to the importance of loneliness transdiagnostically and its strong relation to social functioning. Furthermore, we show that passive sensing technology can be used to measure behaviors related to loneliness in daily life that may point to potential treatment implications or early detection markers of loneliness.

Relationships between trace elements and cognitive and depressive behaviors in sprague dawley and wistar albino rats

Introduction: This study investigates the effects of social isolation on mental health and cognitive functions in Sprague Dawley (SD) and Wistar Albino (WIS) rat strains, prompted by the heightened awareness of such impacts amid the COVID-19 pandemic. This study aims to explore the impact of social isolation on memory, learning, and behavioral changes in middle-aged SD and WIS rat strains and to investigate cortical trace element levels, seeking potential correlations between these levels and the observed behavioral responses to social isolation. Methods: Four groups of 14-month-old male rats were established: control and isolated SDs and WIS rats (CONT-SD, ISO-SD, CONT-WIS, ISO-WIS). Morris Water Maze and Porsolt Forced Swimming tests were conducted for behavioral assessment. Following behavioral tests, rats were sacrificed under general anesthesia, and cortices were isolated for analysis of macro and trace element levels (ICP/MS). Results: In behavioral tests, CONT-SD rats exhibited superior performance in the Morris Water Maze test compared to CONT-WIS rats, but displayed increased depressive behaviors following social isolation, as evident in the Porsolt Forced Swimming test (p < 0.05). ISO-SD rats showed elevated levels of Co and Cu, along with reduced levels of Cs and As, compared to ISO-WIS rats. Moreover, isolation resulted in decreased Cu and Mo levels but increased Rb levels in WIS rats. Comparison of trace element levels in naïve groups from different strains revealed lower Zn levels in the WIS group compared to SD rats. Discussion: The findings suggest that the SD strain learns faster, but is more susceptible to depression after isolation compared to the WIS strain. Increased Co and Cu levels in ISO-SD align with previous findings, indicating potential trace element involvement in stress responses. Understanding these mechanisms could pave the way for preventive treatment strategies or therapeutic targets against the consequences of stressors, contributing to research and measures promoting a balanced diet to mitigate neurobehavioral abnormalities associated with social isolation in the future.

The relationship between loneliness and the experiences of everyday stress and stressor-related emotion

Loneliness influences how people experience and respond to stressors, which may account for its role as a risk factor for morbidity and mortality. The present study was motivated by emerging evidence that affective responses to minor daily events have long-term implications for health and well-being. Specifically, we evaluated how individual differences in loneliness relate to the frequency of everyday stressors and stressor-related negative emotions. A diverse community sample of 255 adults (age 25-65 years) completed ecological momentary assessments (EMA), during which they reported recent stressors and current negative affect (NA) five times a day for 14 days. Multilevel logistic analyses indicated that there was a quadratic association between loneliness and likelihood of reporting stressors, controlling for demographics, social isolation, depressive symptoms, and context (current activities, current location). Multilevel regression indicated that loneliness was unrelated to the concurrent effect of stressors on NA but significantly larger lagged stressor effects were observed among individuals in the low and high ranges of loneliness. These findings suggest that individuals with high levels of loneliness are more likely to experience everyday stressors and have prolonged emotional responses following stressors.

Social Isolation, Brain Food Cue Processing, Eating Behaviors, and Mental Health Symptoms

Importance

Perceived social isolation is associated with negative health outcomes, including increased risk for altered eating behaviors, obesity, and psychological symptoms. However, the underlying neural mechanisms of these pathways are unknown.

Objective

To investigate the association of perceived social isolation with brain reactivity to food cues, altered eating behaviors, obesity, and mental health symptoms.

Design, Setting, and Participants

This cross-sectional, single-center study recruited healthy, premenopausal female participants from the Los Angeles, California, community from September 7, 2021, through February 27, 2023.

Exposure

Participants underwent functional magnetic resonance imaging while performing a food cue viewing task.

Main Outcomes and Measures

The main outcomes included brain reactivity to food cues, body composition, self-reported eating behaviors (food cravings, reward-based eating, food addiction, and maladaptive eating behaviors), and mental health symptoms (anxiety, depression, positive and negative affect, and psychological resilience).

Results

The study included 93 participants (mean [SD] age, 25.38 [7.07] years). Participants with higher perceived social isolation reported higher fat mass percentage, lower diet quality, increased maladaptive eating behaviors (cravings, reward-based eating, uncontrolled eating, and food addiction), and poor mental health (anxiety, depression, and psychological resilience). In whole-brain comparisons, the higher social isolation group showed altered brain reactivity to food cues in regions of the default mode, executive control, and visual attention networks. Isolation-related neural changes in response to sweet foods correlated with various altered eating behaviors and psychological symptoms. These altered brain responses mediated the connection between social isolation and maladaptive eating behaviors (β for indirect effect, 0.111; 95% CI, 0.013-0.210; P = .03), increased body fat composition (β, -0.141; 95% CI, -0.260 to -0.021; P = .02), and diminished positive affect (β, -0.089; 95% CI, -0.188 to 0.011; P = .09).

Conclusions and Relevance

These findings suggest that social isolation is associated with altered neural reactivity to food cues within specific brain regions responsible for processing internal appetite-related states and compromised executive control and attentional bias and motivation toward external food cues. These neural responses toward specific foods were associated with an increased risk for higher body fat composition, worsened maladaptive eating behaviors, and compromised mental health. These findings underscore the need for holistic mind-body-directed interventions that may mitigate the adverse health consequences of social isolation.

Causal relationship between feelings and cognitive decline: An univariable and multivariable Mendelian randomization study

BACKGROUND

While the impact of depression on cognition is well-documented, the relationship between feelings and cognition has received limited attention.

AIM

To explore the potential association between feelings and cognition with a two-sample Mendelian randomization (MR) analysis.

METHODS

Our analysis utilized genome-wide association data on various feelings (fed-up feelings, n = 453071; worrier/anxious feelings, n = 450765; guilty feelings, n = 450704; nervous feelings, n = 450700; sensitivity/hurt feelings, n = 449419; miserableness, n = 454982; loneliness/isolation, n = 455364; happiness, n = 152348) in the European population and their impact on cognitive functions (intelligence, n = 269867). Conducting a univariable MR (UVMR) analysis to assess the relationship between feelings and cognition. In this analysis, we applied the inverse variance weighting (IVW), weighted median, and MR Egger methods. Additionally, we performed sensitivity analysis (leave-one-out analysis), assessed heterogeneity (using MR-PRESSO and Cochran's Q test), and conducted multiple validity test (employing MR-Egger regression). Subsequently, a multivariable MR (MVMR) analysis was employed to examine the impact of feelings on cognition. IVW served as the primary method in the multivariable analysis, complemented by median-based and MR-Egger methods.

RESULTS

In this study, UVMR indicated that sensitivity/hurt feelings may have a negative causal effect on cognition (OR = 0.63, 95%CI: 0.43-0.92, P = 0.017). After adjustment of other feelings using MVMR, a direct adverse causal effect on cognition was observed (ORMVMR = 0.39, 95%CI: 0.17-0.90, PMVMR = 0.027). While a potential increased risk of cognitive decline was observed for fed-up feelings in the UVMR analysis (ORUVMR = 0.64, 95%CI: 0.42-0.97, PUVMR = 0.037), this effect disappeared after adjusting for other feelings (ORMVMR = 1.42, 95%CI: 0.43-4.74, PMVMR = 0.569). These findings were generally consistent across MV-IVW, median-based, and MR-Egger analyses. MR-Egger regression revealed pleiotropy in the impact of worrier/anxious feelings on cognition, presenting a challenge in identifying the effect. Notably, this study did not demonstrate any significant impact of guilty feelings, nervous feelings, miserableness, or loneliness/isolation on cognition. Due to a limited number of instrumental variables for happiness, this study was unable to analyze the relationship between happiness and cognition.

CONCLUSION

This MR study finds that sensitivity/hurt feelings are associated with cognitive decline, while the link between worrier/anxious feelings and cognition remains inconclusive. Insufficient evidence supports direct associations between happiness, guilty feelings, nervous feelings, miserableness, loneliness/isolation, and cognition.

Efficacy of an Internet-based self-help intervention with human guidance or automated messages to alleviate loneliness: a three-armed randomized controlled trial

Loneliness is a prevalent and stigmatized phenomenon associated with adverse (mental) health outcomes. However, evidence-based interventions to alleviate loneliness are scarce. This randomized controlled trial (ClinicalTrials.gov-ID: NCT04655196) evaluated the efficacy of an internet-based cognitive behavioral self-help intervention (ICBT) to reduce loneliness by comparing two intervention groups with guidance or automated messages against a waitlist control group. Adults (N = 243) suffering from loneliness were recruited from the general public and then randomly assigned (2:2:1) to a 10-week ICBT with human guidance (GU) or automated messages (AM) or to a waitlist control group (WL). Loneliness, assessed with the UCLA-9, was the primary outcome. Outcomes were assessed at baseline and 10 weeks (post) and analyzed using mixed-effects models. The pooled intervention conditions resulted in lower loneliness scores at post-assessment than the WL (Cohen's d = 0.57, 95% CI [0.25; 0.89]) and reduced depressive symptoms, social anxiety, social avoidance behavior, and rejection sensitivity (d = 0.32-0.52). The GU group had lower loneliness scores at post-assessment than the AM group (d = 0.42, 95% CI [0.13; 0.70]). ICBT effectively alleviated loneliness, and guidance increased the reduction in loneliness compared to automated messages. Alleviating loneliness with ICBT further seems to reduce the overall burden of psychopathological symptoms.

Intergenerational continuity of loneliness and potential mechanisms: Young Finns Multigenerational Study

Evidence on the intergenerational continuity of loneliness and on potential mechanisms that connect loneliness across successive generations is limited. We examined the association between loneliness of (G0) parents (859 mothers and 570 fathers, mean age 74 years) and their children (G1) (433 sons and 558 daughters, mean age 47 years) producing 991 parent-offspring pairs and tested whether these associations were mediated through subjective socioeconomic position, temperament characteristics, cognitive performance, and depressive symptoms. Mean loneliness across parents had an independent effect on their adult children's experienced loneliness (OR = 1.72, 95% CI 1.23-2.42). We also found a robust effect of mothers' (OR = 1.64, 95% CI 1.17-2.29), but not of fathers' loneliness (OR = 1.47, 95% CI 0.96-2.25) on offspring's experienced loneliness in adulthood. The associations were partly mediated by offspring depressive (41-54%) and anxiety (29-31%) symptoms. The current findings emphasize the high interdependence of loneliness within families mediated partly by offspring's mental health problems.

Predictors and moderators of outcome of ICBT for loneliness with guidance or automated messages - A secondary analysis of a randomized controlled trial

Internet-based cognitive behavioral therapy (ICBT) is promising in alleviating loneliness in adults. Identifying individuals who benefit from ICBT for loneliness is pivotal to offering this intervention in a more targeted way and improving the intervention for those who do not benefit. This secondary analysis of a randomized controlled trial (RCT) aimed to identify predictors and moderators of outcome of an ICBT with guidance or automated messages for loneliness. In the RCT, 243 participants suffering from loneliness were randomly assigned to an ICBT with guidance (n = 98), automated messages (n = 97), or a waitlist-control condition (n = 48). In total, 180 participants completed the post-assessment (i.e., 10 weeks post-randomization). Outcomes were treatment outcome assessed with the UCLA-9 Loneliness Scale at post-assessment and treatment response, i.e., reliable improvement on the UCLA-9 from pre- to post. The relationship between a wide range of patient characteristics (grouped into socio-demographic, clinical, loneliness-specific, and treatment-related variables) and outcome was analyzed using multiple linear and logistic regressions. Feeling less burdened by loneliness resulted in higher odds of reliable improvement in guided ICBT compared to the waitlist-control condition. No treatment outcome or response moderators were identified for ICBT with automated messages compared to the waitlist-control group. Across active intervention groups, loneliness at baseline, age and fit between the tasks and goals of the intervention and participants' need predicted treatment outcome. Predictors of treatment response for ICBT with guidance and automated messages were not identified, and no variables differentially predicted the effects of ICBT with guidance or automated messages on the outcomes. In conclusion, individuals less burdened by their feelings of loneliness benefited more from guided ICBT. Lower baseline loneliness scores, younger age, and a better match between tasks and goals of the intervention and participants' needs also predicted a more favorable treatment outcome for both ICBT with guidance and automated messages.