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This chapter concludes the book with an extended discussion of ‘Crusoe and England’, Bishop’s longest, most ambitious, and perhaps greatest poem. This final chapter outlines ‘Crusoe in England’s use of all the features of style considered in this book, and demonstrates its importance to Bishop’s allusive art. The relationship between ‘Crusoe in England’, Defoe’s Robinson Crusoe and Charles Darwin’s The Voyage of the Beagle is examined in detail. Critically negative readings of the poem are explored, and the poem is read in relation to William Wordsworth, loneliness in Bishop’s life and work, and the modernist and New Critical legacy of the evaluative term ‘self-pity’.
Among military veterans, loneliness is common and associated with poorer mental and physical health and functioning. Epidemiological studies have revealed bidirectional, longitudinal associations between loneliness and posttraumatic stress disorder (PTSD). Little is known about loneliness among treatment-seeking veterans, how loneliness impacts PTSD symptom change during treatment, and whether loneliness has differential associations with specific PTSD symptom clusters.
Method
Data were derived from the Veterans Outcome Assessment, an annual, repeated-measures (baseline and 3-month follow-up) telephone survey of patients beginning new episodes of mental health care in the Department of Veterans Affairs. Participants were 1,155 veterans (23% women) entering PTSD specialty care. We tested whether baseline loneliness predicted change in total PTSD symptom severity and according to the five-factor Dysphoric Arousal model of PTSD using hierarchical regressions in which we statistically adjusted for demographics and mental health encounters.
Results
Loneliness decreased between baseline and 3-month follow-up (d = 0.39). Baseline loneliness predicted change in PTSD for the dysphoric arousal and negative alterations in cognitions and mood symptom clusters, with lonelier veterans demonstrating more PTSD change between baseline and follow-up. However, lonelier veterans also had more severe PTSD symptoms at both timepoints. This pattern of results held even after accounting for different types of treatment encounters between timepoints.
Conclusions
While lonelier veterans have more severe PTSD symptoms, they also make greater improvements in symptoms salient to interpersonal functioning over time. Assessment of loneliness should be incorporated into PTSD treatment planning and considered as a treatment target that could be addressed to promote recovery.
Research on the link between threat-related and deprivation-related adverse childhood experiences (ACEs) and the risk of gastrointestinal (GI) and liver diseases in later life remains limited. This study aims to evaluate the independent associations of threat-related and deprivation-related ACEs with the development of GI and liver disorders in middle-aged and older Chinese adults.
Methods
This prospective cohort study used data from the China Health and Retirement Longitudinal Study, which included participants aged 45 and older who had complete ACE data, two health assessments, and no pre-existing GI or liver conditions at baseline. Participants reported on five threat-related and deprivation-related ACEs before age 17. GI and liver diseases were classified based on self-reported physician diagnoses.
Results
The outcomes of GI and liver diseases are based on self-reported physician diagnosis and broad categories. Compared with no exposures, participants with two or more threat-related ACEs exhibited a higher risk of both chronic liver disease (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.04–1.52; P = 0.016) and GI disease (HR, 1.36; 95% CI, 1.20–1.55; P < 0.001); two or more deprivation-related ACEs showed stronger associations with GI disease (HR, 1.48; 95% CI, 1.28–1.70; P < 0.001); and no significant associations with liver disease risk across all exposure levels. Additionally, depressive symptoms accounted for 10.7% (P = 0.003) of the association between threat-related ACEs and liver disease risk and accounted for 12.7% (P < 0.001) of the association between threat-related ACEs and GI disease risk. Midlife loneliness accounted for 5.3% (P = 0.001) of the association between threat-related ACEs and incident GI diseases and for 3.7% (P = 0.004) of the association between deprivation-related ACEs and incident GI diseases.
Conclusions
Threat-related ACEs are directly associated with an increased risk of liver and GI diseases. A modest proportion of this observed relationship is partially mediated through depressive symptoms and loneliness in middle age.
Loneliness is a growing concern in contemporary societies, particularly in urban environments, where social dynamics are rapidly evolving. Existing measures may not fully capture the complexity of loneliness in the context of ongoing technological and social changes. This study introduces the Madrid Loneliness Questionnaire (MLQ), a new instrument designed to assess loneliness in adults within modern sociocultural contexts. A sample of 1,526 adults (77.1% women; 18–87 years) participated in the study. The sample was randomly divided for structural validation: one subsample underwent exploratory factor analysis (EFA, n = 623) and the other confirmatory factor analysis (CFA, n = 903). Measurement invariance across gender and age was examined using multigroup CFA. Convergent validity was assessed through correlations with self-esteem and perceived stress. Internal consistency was evaluated using Cronbach’s alpha and McDonald’s omega. EFA and CFA supported a three-factor structure with excellent fit indices (Comparative Fit Index = 0.998; Tucker–Lewis Index = 0.997; RMSEA = 0.019; SRMR = 0.05): Social Skills, Partner Relationships, and Emotional Isolation. Multigroup CFA confirmed scalar invariance across gender and age. Significant gender differences were found in Social Skills (higher in men) and Partner Relationships (higher in women). The oldest age group (>65 years) scored higher on Partner Relationships than younger groups. The MLQ and its subscales showed moderate to strong negative correlations with self-esteem (rho = −.36 to −.63) and positive correlations with perceived stress (rho = .25 to .49). The scale demonstrated excellent internal consistency (α = .93, ω = .92). The MLQ is a psychometrically sound instrument for assessing loneliness in adults, enabling tailored interventions by serving as a basis for public health policies.
This chapter analyses the relationship between loneliness and antagonistic political emotions. Loneliness is commonly defined as a painful experience resulting from a discrepancy between desired and actual relationships. Philosophical literature highlights its impact on self-perception, agency and possibilities for connection, yet its political dimensions remain largely overlooked. To address this gap, I examine the case of a lone-actor terrorist whose loneliness motivates a search for meaning within a radicalised community. In this context, loneliness combines with emotions such as vengeful anger and envy. This raises key philosophical questions: How should loneliness be understood? Can it count as a political emotion on its own or only when coupled with other affective states? How does loneliness interact with antagonistic emotions? I call hostile loneliness the affective state in which loneliness conditions the emergence of aggressive and oppositional emotions. These emotions enable lonely individuals to reclaim agency and pursue radical social and political change. They become fully political when taken up collectively and expressed by a community.
Can feelings of loneliness and depression be adaptive for adolescents? Yes, suggests the Evolutionary Theory of Loneliness: initially, loneliness activates depressive responses for self-preservation. In turn, these feelings prepare adolescents for reaffiliation, thereby reducing loneliness (H1a: short-term balancing feedback loop). If this fails, loneliness and depressive symptoms may become long-term traits that exacerbate each other over time (H1b: long-term reinforcing feedback loop). Therefore, the short-term balancing feedback loop between loneliness and depressive symptoms may buffer against their long-term increases (H2: across-timescale influence). We tested these hypotheses in Dutch adolescents (Mage_Wave1 = 12.9, SDage_Wave1 = 0.7, 53% female) using six-wave, half-yearly panel data (N = 774; 2017–2021) and 7-day, 1.5-hourly experience sampling data (nsubsample = 84; mid-2021). Residual dynamic structural equation modeling revealed reinforcing feedback loops at both short-term (1.5-hourly) and long-term (half-yearly), supporting H1b but not H1a. Bayesian latent change score modeling supported H2: Adolescents who felt more depressed an hour after heightened loneliness showed smaller half-yearly increases in trait loneliness. However, this buffering effect was not predicted by the hourly depressed-to-loneliness relation, nor did either hourly relations predict half-yearly changes in depressive symptoms. Our findings suggest that feeling depressed shortly after loneliness may protect adolescents from long-term loneliness.
Adolescence is characterized by heightened sensitivity to social belonging, making loneliness prevalent and consequential for youth. Maladaptive personality traits may further exacerbate loneliness. In this preregistered 14-day Ecological Momentary Assessment study, we examined loneliness across social contexts and timescales in relation to maladaptive personality traits among N = 294 adolescents aged 12–21 years (Mage = 17.5, SD = 2.64; 58.5% female; 86.73% born in Germany). Participants answered 27,503 of 32,340 momentary prompts, indicating high compliance (85.1%). Loneliness (βmomentary = 0.51; βdaily = 0.67) was higher when participants were alone, yet only the presence of close others (e.g., friends) – not weaker ties (e.g., classmates) – reduced loneliness (β = –0.39 to –0.62). Youth who were alone more frequently did not report higher overall loneliness. Maladaptive personality traits were associated with higher (βmomentary = 0.32; βend-of-day = 0.40) and more variable (βmomentary = 0.31; βend-of-day = 0.34) loneliness but amplified the effect of being alone on loneliness only on the between-person level (β = –1.13). Exploratory analyses indicated that social satisfaction partially mediated the association (β = 0.50). These findings underscore the importance of both structural and qualitative aspects of social environments, as well as personality-related vulnerabilities, to better understand loneliness dynamics in youth.
This study examines how multiple dimensions of socio-emotional well-being relate to cognitive functioning in older adults, and whether the associations vary by cognitive status, depression, and socio-demographic factors.
Methods:
Data from the Harmonized Cognitive Assessment Protocol of the Survey of Health, Ageing and Retirement in Europe (n = 2,650; mean age = 76; 54.5% females) were used to test associations between life satisfaction, meaning in life, social connectedness, and loneliness with global, domain-specific cognitive performance, and informant-rated cognitive decline.
Results:
Linear mixed models, with individuals nested within five countries, found that higher life satisfaction, meaning in life, and social connectedness were associated with better cognitive outcomes, whereas greater loneliness was associated with worse performance and greater informant-rated decline. The largest effect sizes were observed for meaning in life (median β = .10) and loneliness (median β = −.09) across cognitive measures. The associations generally remained significant adjusting for well-known clinical (e.g., diabetes), behavioral (e.g., physical inactivity), and psychological (depressive symptomatology) risk factors for dementia. Moderation and sensitivity analyses suggested that associations with global cognition hinged on the inclusion of participants classified with cognitive impairment, while some domain-specific associations (e.g., loneliness and episodic memory) were observed only in individuals without cognitive impairment. Overall, evidence for moderation by cognitive status, depression and age was limited, and no moderation was observed for sex or education.
Conclusions:
The results underscore the importance of socio-emotional well-being in cognitive aging and highlight the need for longitudinal research to clarify mechanistic pathways and inform targeted interventions.
Loneliness is a public health concern influenced by environmental contexts. Among youth, it manifests differently at school and home, yet research in low-resource settings is limited. This study examined patterns of loneliness and how economic and sociodemographic factors correlate with it in school and home environments among Kenyan youths in the Nairobi Metropolitan Area. A cross-sectional study was conducted with 1,972 youths aged 14–25 years using a self-administered questionnaires. Analyses included paired t-tests, ANOVA and generalized estimating equations (GEEs). Among participants with complete paired data (n = 1,166), loneliness was significantly higher at school (M =23.15) than at home (M = 21.53). Females reported higher loneliness than males (school: p=.011; home: p<.001). Education level and marital status were significantly related to loneliness at home (p<.001 and p=.022) but not at school. Loneliness at home was higher among the poorest households compared to middle-class households (mean difference =2.556, p=.048). GEE models confirmed these patterns and indicated that employment status influenced differences in loneliness between home and school settings. School settings were linked with higher loneliness, while home loneliness varied by socioeconomic and demographic factors, underscoring the need for targeted interventions addressing environmental and social determinants of youth loneliness.
Despite variation in their social needs and experiences, all humans require social connections to thrive. When humans lack fulfilling connections, they experience loneliness. However, while seemingly simple, loneliness is a multidimensional construct arising from varied social deficiencies and leading to varied psychological experiences. This chapter reviews the literature on loneliness, describing what it is, why we experience it, its prevalence and consequences, and what is being done globally to address it. In doing so, we highlight the considerable impacts of loneliness on individuals and society, its complexity, and the opportunities for future work. We close acknowledging the significant advancements made in loneliness research over the past several decades and highlight how this knowledge is being mobilized to advance the prevention and treatment of loneliness. In doing so, we hope this chapter serves as a useful starting point for understanding the problem of loneliness and the challenge of addressing it.
The USA has among the highest levels of mental illness of all countries, together with the most treatment. We seek happiness through mechanisms that produce pleasure, most of which are not effective. Those lower down in the hierarchy use more destructive means to gain gratification, thereby becoming worse off. Americans may suffer more pain than people in other rich nations, especially social pain in response to chronic stressors present here. We consume 80% of the world’s opioids Smartphone use, especially among youth, may be harmful for mental health. Evolutionary pressures make us live to reproduce and nurture the progeny until they can have children. Various mental illnesses that don’t impact propagation can manifest, especially in later life, such as anxiety to cope with danger. Mental health is political, like other aspects of health
This chapter reviews the benefits of peer support for survivors of critical illness and their loved ones, which include psychological empowerment, the expression of shared experience, and fostering altruism and post traumatic growth. Peer support has also been shown to reduce social isolation and loneliness. Different modalities to deliver peer support are discussed, such as individual peer support delivered by a peer mentor. The chapter also provides an overview of structural support that should be in place to on-board, supervise, and partner with a peer volunteer. Mindfulness to power differentials and having access to a staff member that is qualified to supervise a peer volunteer are highlighted. The chapter reviews different models of peer support, including groups held in the ICU, community groups post-ICU, clinic-based groups, virtual groups, and asynchronous groups. Barriers and foundational knowledge, such as recruitment, logistics, facilitation, and sustainability, are reviewed.
Loneliness is a major psychological challenge in older adulthood, contributing to increased risks of depression, anxiety, and mortality. Conversational agents – technologies that interact with users via natural language – have emerged as potential tools to support psychological well-being in later life. This systematic review and meta-analysis evaluated the effects of autonomous conversational agents, including robotic and nonrobotic systems, on loneliness, as well as social isolation, depression, and anxiety in older people without cognitive impairment. Seventeen studies with pre–post intervention data were included. Nine used physically embodied robots and eight employed nonrobotic agents, such as personal voice assistants, chatbots, or screen-based embodied agents. Due to the limited number of high-quality comparison studies, all meta-analyses were based on within-group pre–post comparisons. Meta-analytic results showed mild to moderate improvements in loneliness (standardized mean changes using change score [SMCC] = 0.350, 95% confidence interval [CI]: 0.180–0.520) and depression (SMCC = 0.464, 95% CI: 0.327–0.602), with no study reporting symptom worsening. No study included validated measures of social isolation, and only one assessed anxiety. These findings indicate that conversational agents may offer scalable support for older adults’ mental health, with potential especially for reducing loneliness and depression. Nonetheless, methodological limitations, including lack of blinded outcome assessment, inconsistent reporting, and heterogeneous intervention designs, underscore the need for more rigorous research. Advances in large language models may further enhance the responsiveness and relevance of these technologies for supporting psychological well-being in aging populations.
This article analyzes the relationship between subjective well-being (SWB) and participation in neighborhood associations (NHA) in Japan. While the theoretical and empirical literature suggests a strong positive correlation between participation in NHAs and SWB, recent research on Japan could not validate this result. This study shows how those diverging results can be explained by including two factors in the analysis: the voluntariness of the action as well as loneliness as a mediating variable. Using linear regression models on data from two different studies, we find that—even in the case of Japan—voluntary participation in NHAs is positively associated with SWB in two ways: directly and indirectly mediated by loneliness. This result is robust to differently sampled data and different measures of our key variables.
Persistent concerns about loneliness and social isolation in later life have prompted increasing attention to the social and environmental factors that enable or constrain connection. Yet, while previous research has identified community and societal determinants of social connection, little is known about how these factors interact dynamically with individual and interpersonal circumstances to shape older adults’ lived connection experiences. This study addresses this knowledge gap by examining how older Australians perceive and experience environmental influences on their social connectedness, and how factors across multiple ecological levels work together to create or hinder opportunities for connection. Four focus groups were conducted with 15 participants, aged 60 years and over, from metropolitan and regional areas in New South Wales, Australia, to explore how participants described the role of different factors in their connection experiences. Participants identified a range of influences across individual, interpersonal, community and societal levels, including meaningful roles, community spaces, local businesses and transport accessibility. Three patterns of cross-level interaction were revealed: the interplay between personality and community infrastructure; the multi-level role of digital technology; and the cascading influence of policy frameworks shaping community participation opportunities. By uncovering how factors interact dynamically across social-ecological levels, this study advances understanding of the contexts that foster or constrain social connection in later life. The findings contribute to ongoing debates in social gerontology by demonstrating that loneliness and social isolation are best addressed through coordinated, multi-level interventions that align individual, community and policy environments to promote healthy ageing in place.
Although previous research has demonstrated that social media use (SMU) can influence loneliness, the underlying mechanisms of this relationship among older adults remain insufficiently understood. Specifically, limited research has examined how different purposes of SMU (communication, posting and browsing) may contribute to loneliness through variations in social resources, and for whom these pathways differ as a function of attachment styles. To address these gaps, the present study constructed a moderated mediation model to examine whether perceived social support mediated the relationships between different purposes of SMU and loneliness among older adults, and whether attachment styles moderated the mediation of perceived social support. A total of 538 older adults aged 55 and above participated in this survey. The results revealed that all purposes of SMU (communication, posting and browsing) were significantly and negatively associated with loneliness among older adults. Moreover, perceived social support fully mediated the association between social media communication and loneliness. In addition, attachment anxiety and avoidance moderated this indirect association, such that the protective effect of communication was stronger among older adults with higher attachment anxiety or avoidance, likely due to enhanced perceived social support. These findings emphasize the importance of social media communication in promoting mental wellbeing among older adults and highlight its potential to facilitate their social adaptation in the digital era.
Rates of loneliness have increased over the past several decades worldwide, particularly among people with serious mental illnesses. A better understanding of the neurocognitive mechanisms underlying loneliness could provide useful information for the efforts to address this public health problem.
Methods
To investigate these mechanisms, a functional magnetic resonance imaging (fMRI) study was conducted which accounted for known cognitive biases associated with loneliness. Participants with (n = 40) and without (n = 60) psychotic disorders (PD) viewed images of faces that appeared to approach or withdraw from the participants while fMRI data were collected. Following the scanning, participants rated the trustworthiness of the faces, and these ratings were included as weights in the fMRI analyses. Neural responses to approaching versus withdrawing faces were measured, and whole-brain regression analyses, with loneliness as the regressor, were performed.
Results
In the PD and full samples, a higher level of loneliness was significantly associated with greater responses of the hippocampus and areas of the basal ganglia to withdrawing (versus approaching) face stimuli. Moreover, the effects in the hippocampus, but not the basal ganglia, remained significant after controlling for potential confounds such as social activity levels, depression and social anhedonia. Finally, in a subset of the full sample (n = 66), greater hippocampal responses to withdrawing faces predicted greater loneliness 1 year later.
Conclusions
Heightened responses of the hippocampus to withdrawing faces may represent a candidate neurobiological marker of loneliness that could be modified by interventions targeting loneliness.
Loneliness and social isolation represent persisent global public health concerns, particurarly for people in later life, with extensive mental, social, and biological consequences. Both have been associated with increased risk of depression, anxiety, dementia, cardiovascular disease, premature mortality, and greater demand for health and social care services. A growing body of evidence indicates that nature-based interventions are effective in reducing loneliness, enhancing mood, and promoting overall well being, yet they still remain underutilised within health and social care strategies; particularly for older adults and those with limited mobility. One such initiative, Cycling Without Age, a grassroots programme, demonstrates the potential of nature-based interventions. Evidence across multiple contexts indicates improvements in mood, life satisfaction, and social connectedness, alongside benefits for families and care staff. Cycling Without Age illustrates a type of scalable, person-centred intervention that could be integrated into healthy ageing strategies. However, rigourous large-scale research remains scarce, which highlights the need for further evaluation to guide policy adoption and sustainable implementation. Effective responses to loneliness and social isolation require integrated support programmes that foster social connectedness and healthy ageing, delivered through coordinated efforts spanning public health, urban design, and community services.
Although the short-term preventive effects of mHealth consultation intervention on postpartum depressive symptoms have been demonstrated, the long-term effects and role of alleviating loneliness on depressive symptoms remain unclear.
Methods
This follow-up study extended our previous trial, which ended at three months postpartum, by continuing observation to 12 months. Participants in the original trial were randomized to the mHealth group (n = 365) or the usual care group (n = 369). Women in the mHealth group had access to free, unlimited mHealth consultation services with healthcare professionals from enrollment through four months postpartum. The primary outcome of this study was the risk of elevated postpartum depressive symptoms at 12 months post-delivery (Edinburgh Postnatal Depression Scale score of ≥9). The mediation effect of alleviating loneliness on the primary outcome was also evaluated, using the UCLA loneliness scale at three months postpartum.
Results
A total of 515 women completed the follow-up questionnaires (mHealth group, 253/365; usual care group, 262/369; 70.2% of the original participants). Compared to the usual care group, the mHealth group had a lower risk of elevated postpartum depressive symptoms at 12 months post-delivery (36/253 [14.2%] vs. 55/262 [21.0%], risk ratio: 0.68 [95% confidence interval: 0.46–0.99]). Mediation analysis showed that reducing loneliness at three months post-delivery mediated approximately 20% of the total effect of the intervention on depressive symptoms 12 months post-delivery.
Conclusions
mHealth consultation services provided during the early perinatal period may help alleviate depressive symptoms at 12 months postpartum.
Social isolation and loneliness are concerns in gerontology. The impact of the human–animal interaction (HAI) on loneliness for older adults living alone is understudied. This scoping review explored the extent to which HAI is included in studies investigating social connectedness, specifically social isolation and loneliness, and if HAI bolsters healthy aging through increased perceived support. Following the PRISMA-ScR protocol, data from 58 articles were thematically categorized, identifying (a) existing inclusion of HAI; (b) definitions and descriptions of HAI; and (c) the relationships between HAI and loneliness outcomes, in social connectedness research. Studies including HAI (animal companions and animal-assisted interventions) have increased over time; many noting protection against loneliness and few noting health detriments. Older adults overwhelmingly consider interactions with companion animals as meaningful relationships, whether living at home or in care. Substantial knowledge gaps exist concerning the influence of HAI on perceived social connectedness for older adults living alone.