Lecture 11 - Loneliness

The Social Brain: Critical Perspectives on Science, Society and Neurodiversity

Richard Ramsey

Today


Part 1

  • Loneliness


Part 2

  • Read articles and discuss



Overview

  • Background
  • The reaffiliation model
  • Neuroscience
  • Brain injury
  • Lifespan
  • Interventions

Background

What is loneliness?


Loneliness and social isolation are often used interchangeably, which is confusing.


Social isolation is objectively quantifiable: the quantity and frequency of social contact, plus proximity to others.


Loneliness is a subjective interpretation: an evaluation that social needs are not being met satisfactorily.

(Cacioppo & Patrick, 2008; Perissinotto & Covinsky, 2014; Valtorta et al., 2016)

Isolation versus loneliness

Types of loneliness


Social loneliness: the absence of a desired social network (family, friends and acquaintances).


Emotional loneliness: the lack of attachment figure/s that one could form an intimate connection with.

(Dahlberg & McKee, 2014; Weiss, 1973)

Physical versus social pain

  • Physical pain is an aversive signal that evolved to minimise damage to one’s body.
  • Loneliness is a social pain that may serve a similar function.

(Cacioppo & Hawkley, 2009)

Health imapct


  • Loneliness is associated with increased morbidity and mortality.

  • It is clearly bad for your health and well-being.

  • But is loneliness worse than smoking 15 cigarettes a day?

(Cacioppo & Patrick, 2008; Holt-Lunstad et al., 2015)

Physiological impact


Loneliness predicts physiological responses associated with stress (e.g., elevated blood pressure, rise in cortisol), above and beyond objective measures of social isolation.

(Bruine de Bruin et al., 2020; Cacioppo et al., 2015)

Psychological impact


Loneliness predicts maladaptive cognition and behavior (e.g., perception of social interactions as unpleasant, reduced physical activity, and lifetime satisfaction), above and beyond objective measures of social isolation.

(Cacioppo & Hawkley, 2009)

Basic research impact

  • Loneliness offers a way to study individual differences in social neuroscience.

  • Somewhat surprisingly, social neuroscience rarely studies variation in “socialness” across individuals.

  • But things are changing…

(Kanai et al., 2012)

The reaffiliation model (RAM)

RAM

(Qualter et al., 2015)

Neuroscience

Structural changes

(Spreng et al., 2020)

Functional changes

(Spreng et al., 2020)

Brain injury

Clinical observation


  • Following a brain injury, such as a stroke, cognitive and social functions are impacted.

  • Brain injury assessments routinely include an assessment of cognitive function.

  • But what about social function and loneliness?

Assessing loneliness following stroke


  • The national survey for Wales dataset
  • Two cohorts (2016/17 and 2017/18)
  • De Jong Gierveld Loneliness Scale (Gierveld & Tilburg, 2006)
  • N~8000 per cohort.

(Byrne et al., 2021)

Loneliness ratings and stroke

(Byrne et al., 2021)

What about other illnesses?

(Byrne et al., 2021)

Lifespan

social vs emotional

(Manoli et al., 2022)

Interventions

Are interventions effective?


  • Sometimes, but not always.
  • Effect sizes are modest.
  • Not a one-size-fits-all solution.
  • We lack a clear mechanistic understanding to guide interventions.

(Lasgaard et al., 2025; Masi et al., 2011; Morrish et al., 2023)

Take a break

Part 2 - Read and discuss

Discussion material

  • break into small groups (~ 5 per group)
  • discuss aspects of the lecture
  • discuss aspects of these articles:

Is loneliness worse than smoking 15 cigarettes a day?:

BBC’s ‘More or less’ radio programme

There is NOT an epidemic of loneliness:

Psychology Today

The Conversation

References

Bruine de Bruin, W., Parker, A. M., & Strough, J. (2020). Age differences in reported social networks and well-being. Psychology and Aging, 35(2), 159–168. https://doi.org/10.1037/pag0000415
Byrne, C., Saville, C. W. N., Coetzer, R., & Ramsey, R. (2021). Stroke Survivors Experience Elevated Levels of Loneliness: A Multi-Year Analysis of the National Survey for Wales. Archives of Clinical Neuropsychology, 47(2), 390–407. https://doi.org/10.1093/arclin/acab046
Cacioppo, J. T., Cacioppo, S., Capitanio, J. P., & Cole, S. W. (2015). The Neuroendocrinology of Social Isolation. Annual Review of Psychology, 66(1), 733–767. https://doi.org/10.1146/annurev-psych-010814-015240
Cacioppo, J. T., & Hawkley, L. C. (2009). Perceived social isolation and cognition. Trends in Cognitive Sciences, 13(10), 447–454. https://doi.org/10.1016/j.tics.2009.06.005
Cacioppo, J. T., & Patrick, W. (2008). Loneliness: Human Nature and the Need for Social Connection. W. W. Norton & Company. https://books.google.com?id=w8pWZ2AGI4MC
Dahlberg, L., & McKee, K. J. (2014). Correlates of social and emotional loneliness in older people: Evidence from an English community study. Aging & Mental Health, 18(4), 504–514. https://doi.org/10.1080/13607863.2013.856863
Gierveld, J. D. J., & Tilburg, T. V. (2006). A 6-Item Scale for Overall, Emotional, and Social Loneliness:Confirmatory Tests on Survey Data. Research on Aging, 28(5), 582–598. https://doi.org/10.1177/0164027506289723
Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and Social Isolation as Risk Factors for Mortality:A Meta-Analytic Review. Perspectives on Psychological Science, 10(2), 227–237. https://doi.org/10.1177/1745691614568352
Kanai, R., Bahrami, B., Duchaine, B., Janik, A., Banissy, M., & Rees, G. (2012). Brain Structure Links Loneliness to Social Perception. Current Biology, 22(20), 1975–1979. https://doi.org/10.1016/j.cub.2012.08.045
Lasgaard, M., Qualter, P., Løvschall, C., Laustsen, L. M., Lim, M. H., Sjøl, S. E., Burke, L., Blæhr, E. E., Maindal, H. T., Hargaard, A.-S., Christensen, R., & Christiansen, J. (2025). Are loneliness interventions effective for reducing loneliness? A meta-analytic review of 280 studies. American Psychologist. https://doi.org/10.1037/amp0001578
Manoli, A., McCarthy, J., & Ramsey, R. (2022). Estimating the prevalence of social and emotional loneliness across the adult lifespan. Scientific Reports, 12(1, 1), 21045. https://doi.org/10.1038/s41598-022-24084-x
Masi, C. M., Chen, H.-Y., Hawkley, L. C., & Cacioppo, J. T. (2011). A Meta-Analysis of Interventions to Reduce Loneliness. Personality and Social Psychology Review, 15(3), 219–266. https://doi.org/10.1177/1088868310377394
Morrish, N., Choudhury, S., & Medina-Lara, A. (2023). What works in interventions targeting loneliness: A systematic review of intervention characteristics. BMC Public Health, 23(1), 2214. https://doi.org/10.1186/s12889-023-17097-2
Perissinotto, C. M., & Covinsky, K. E. (2014). Living Alone, Socially Isolated or Lonely—What are We Measuring? Journal of General Internal Medicine, 29(11), 1429–1431. https://doi.org/10.1007/s11606-014-2977-8
Qualter, P., Vanhalst, J., Harris, R., Van Roekel, E., Lodder, G., Bangee, M., Maes, M., & Verhagen, M. (2015). Loneliness Across the Life Span. Perspectives on Psychological Science, 10(2), 250–264. https://doi.org/10.1177/1745691615568999
Spreng, R. N., Dimas, E., Mwilambwe-Tshilobo, L., Dagher, A., Koellinger, P., Nave, G., Ong, A., Kernbach, J. M., Wiecki, T. V., Ge, T., Li, Y., Holmes, A. J., Yeo, B. T. T., Turner, G. R., Dunbar, R. I. M., & Bzdok, D. (2020). The default network of the human brain is associated with perceived social isolation. Nature Communications, 11(1), 6393. https://doi.org/10.1038/s41467-020-20039-w
Valtorta, N. K., Kanaan, M., Gilbody, S., & Hanratty, B. (2016). Loneliness, social isolation and social relationships: What are we measuring? A novel framework for classifying and comparing tools. BMJ Open, 6(4). https://doi.org/10.1136/bmjopen-2015-010799
Weiss, R. S. (1973). Loneliness: The experience of emotional and social isolation. The MIT Press.

Acknowledgements