The clinical significance of loneliness: a literature review

Heinrich, Liesl M.; Gullone, Eleonora

doi:10.1016/j.cpr.2006.04.002

Cited by 1,986Health disparities and outcomesAttachment and Relationship DynamicsDeath Anxiety and Social Exclusion

The clinical significance of loneliness: a literature review

Heinrich, Liesl M., Gullone, Eleonora·2006·Clinical Psychology Review

DOI 10.1016/j.cpr.2006.04.002

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Abstract

Satisfying social relationships are vital for good mental and physical health. Accordingly, we recommend that the alleviation and prevention of social relationship deficits be a key focus of clinicians. In this review, we focus on loneliness as a crucial marker of social relationship deficits and contend that loneliness should command clinicians' attention in its own right--not just as an adjunct to the treatment of other problems such as depression. With a particular focus on the adolescent developmental period, this review is organized into five sections: Drawing on developmental and evolutionary psychology theories, the nature of social relationships and the function they serve is first discussed. In the second section, loneliness is introduced as an exemplar of social relationship deficits. Here a definition of loneliness is provided, as well as an explanation of why it may pose a situation of concern. This is followed by a review of the prototypic features of loneliness through examination of its affective, cognitive, and behavioral correlates. The fourth section includes a review of theories related to the antecedent and maintenance factors involved in loneliness. Finally, methodological and theoretical considerations are addressed, and conclusions and proposals for future research directions are put forth.

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Feeling lonely is associated with a myriad of mental health and psychosocial problems.
“The research evidence is unequivocal that feeling lonely is associated with a myriad of mental health and psychosocial problems (e.g., Cacioppo et al., 2002, 2006; Heinrich & Gullone, 2006; Houghton et al., 2016).”
From Adolescents' longitudinal trajectories of mental health and loneliness: The impact of COVID‐19 school closures (2022) · cites this paper as Heinrich & Gullone, 2006
An increasing trajectory of loneliness during adolescence predicts self-harming, suicide ideation, and more lethal suicide attempts.
“and predicts self‐harming, suicide ideation, and more lethal suicide attempts (Gvion et al., 2014; Heinrich & Gullone, 2006; Qualter et al., 2013).”
From Adolescents' longitudinal trajectories of mental health and loneliness: The impact of COVID‐19 school closures (2022) · cites this paper as Heinrich & Gullone, 2006
The strict interconnection between self-esteem and loneliness was probably due to the fact that loneliness is often related to negative self-evaluations, and feelings of being worthless, inferior, or unlovable.
“The strict interconnection between self-esteem and loneliness was probably due to the fact that loneliness is often related to negative self-evaluations, and feelings of being worthless, inferior, or unlovable (Heinrich and Gullone, 2006).”
From The Anxiety-Buffer Hypothesis in the Time of COVID-19: When Self-Esteem Protects From the Impact of Loneliness and Fear on Anxiety and Depression (2020) · cites this paper as Heinrich and Gullone, 2006
These results are in line with previous scientific literature highlighting that self-esteem can be a mediator in the relationship between loneliness, anxiety, and depression.
“These results are in line with previous scientific literature highlighting that self-esteem can be a mediator in the relationship between loneliness, anxiety, and depression (Brage and Meredith, 1994; Heinrich and Gullone, 2006; Çivitci and Çivitci, 2009).”
From The Anxiety-Buffer Hypothesis in the Time of COVID-19: When Self-Esteem Protects From the Impact of Loneliness and Fear on Anxiety and Depression (2020) · cites this paper as Heinrich and Gullone, 2006
Fear can threaten self-evaluation, and people experiencing higher feelings of loneliness also have a worse self-evaluation.
“Research show that fear can threaten self-evaluation (Greenberg et al., 1986), and that people experiencing higher feelings of loneliness also have a worse self-evaluation (Heinrich and Gullone, 2006).”
From The Anxiety-Buffer Hypothesis in the Time of COVID-19: When Self-Esteem Protects From the Impact of Loneliness and Fear on Anxiety and Depression (2020) · cites this paper as Heinrich and Gullone, 2006

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“As reviewed earlier, the literature that examines these factors separately in relation to the early family environment is consistent with such a positive profile (Heinrich & Gullone, 2007; Repetti et al., 2002; T.W. Smith & Gallo, 2001).”
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“There is now considerable evidence showing that loneliness and depression are separable and that loneliness increases the risk for depression ( J. T. Cacioppo et al., 2006; Heinrich & Gullone, 2006).”
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“The need to affiliate with others has been demonstrated across the life span (Baumeister & Leary, 1995), with loneliness being reported by people of different ages (Heinrich & Gullone, 2006).”
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“However, many of these studies have focused on selected age groups rather than the entire adult age range (e.g., Heinrich & Gullone, 2006; Victor & Yang, 2012), making it difficult to distinguish age differences from the many other differences among surveys.”
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Wood, A. M., & Tarrier, N. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.06.003 · Cited by 488 · see citing works
The digital revolution and its impact on mental health care
Bucci, S., Schwannauer, M., & Berry, N. (2019) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12222 · Cited by 444 · see citing works
“Humans have an innate need for belonging (Heinrich & Gullone, 2006; Beutel et al., 2017); the subjective experience of loneliness is related to the quality (not quantity) of human relationships (Lim & Gleeson, 2014).”
Background
Social capital and health: A systematic review of systematic reviews
Ehsan, A., Klaas, H. S., Bastianen, A., & Spini, D. (2019) · SSM - Population Health · doi:10.1016/j.ssmph.2019.100425 · Cited by 468 · see citing works
Loneliness over time: The crucial role of social anxiety.
Lim, M. H., Rodebaugh, T. L., Zyphur, M. J., & Gleeson, J. F. M. (2016) · Journal of Abnormal Psychology · doi:10.1037/abn0000162 · Cited by 443 · see citing works
The neurobiology of interoception in health and disease
Quadt, L., Critchley, H., & Garfinkel, S. N. (2018) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13915 · Cited by 447 · see citing works
Understanding loneliness in the twenty-first century: an update on correlates, risk factors, and potential solutions
Lim, M. H., Eres, R., & Vasan, S. (2020) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-020-01889-7 · Cited by 438 · see citing works
Instagram use, loneliness, and social comparison orientation: interact and browse on social media, but don't compare
Yang, C.-C. (2016) · Cyberpsychology, Behavior, and Social Networking · doi:10.1089/cyber.2016.0201 · Cited by 424 · see citing works
“Loneliness is an emotionally unpleasant state resulting from one’s assessment of his or her social relationships; specifically, loneliness emerges when there is a discrepancy between one’s desired and perceived levels of social connectedness.(1) Loneliness has important implications for mental health(1) and even morta…”
Background
No Employee an Island: Workplace Loneliness and Job Performance
Özçelik, H., & Barsade, S. G. (2018) · Academy of Management Journal · doi:10.5465/amj.2015.1066 · Cited by 426 · see citing works
“…loneliness at work is important given the myriad pernicious emotional, cognitive, attitudinal, and behavioral outcomes that have been found as a result of being lonely (Cacioppo & Patrick, 2008; Hawkley & Cacioppo, 2010; Heinrich & Gullone, 2006; Masi, Chen, Hawkley, & Cacioppo, 2011).”
BackgroundMethodResultInfluential
Are loneliness and social isolation associated with cognitive decline?
Lara, E., Caballero, F. F., Rico‐Uribe, L. A., Olaya, B., Haro, J. M., Ayuso‐Mateos, J. L., & Miret, M. (2019) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5174 · Cited by 423 · see citing works
“Social isolation relates to structural aspects of the social network (eg, low frequency of interactions and small size of the social network),(3) whereas loneliness refers to a distressing perceived discrepancy between one's social desires and one's actual interactions with others.(4) Over the past decade, the study o…”
Background
Gender differences in loneliness across the lifespan: a meta-analysis
Maes, M., Qualter, P., Vanhalst, J., Van den Noortgate, W., & Goossens, L. (2019) · European Journal of Personality · doi:10.1002/per.2220 · Cited by 405 · see citing works
“These detrimental effects have mainly been studied in adults, but the poor mental and physical health effects of loneliness have been found in children and adolescents as well (Doane & Thurston, 2014; Harris, Qualter, & Robinson, 2013; Heinrich & Gullone, 2006; Qualter et al., 2013).”
Background
Inflammation and social experience: An inflammatory challenge induces feelings of social disconnection in addition to depressed mood
Eisenberger, N. I., Inagaki, T. K., Mashal, N. M., & Irwin, M. R. (2010) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2009.12.009 · Cited by 413 · see citing works
“…it would be interesting to examine whether inflammatory activity also decreases the sense that one is socially supported, as a perceived lack of social support is a risk factor for both endogenous and cytokineassociated forms of depression (Capuron et al., 2004; Heinrich and Gullone, 2006).”
Influential
Loneliness, friendship, and well-being in adults with autism spectrum disorders
Mazurek, M. O. (2014) · Autism · doi:10.1177/1362361312474121 · Cited by 401 · see citing works
“In fact, solitude may be perceived positively by some individuals, while loneliness may be experienced by others even in the presence of objective social relationships (Heinrich and Gullone, 2006).”
Background
Loneliness in the Modern Age: An Evolutionary Theory of Loneliness (ETL)
Cacioppo, J. T., & Cacioppo, S. (2018) · Advances in Experimental Social Psychology · doi:10.1016/bs.aesp.2018.03.003 · Cited by 481 · see citing works
In Sickness and in Health: The Co-Regulation of Inflammation and Social Behavior
Eisenberger, N. I., Moieni, M., Inagaki, T. K., Muscatell, K. A., & Irwin, M. R. (2016) · Neuropsychopharmacology · doi:10.1038/npp.2016.141 · Cited by 396 · see citing works
“Given the important role that feelings of social disconnection (eg, loneliness) play in contributing to depression (Heinrich and Gullone, 2006), it is possible that the social consequences of inflammation may be a critical missing piece in understanding the link between inflammation and depression.”
Background
Trajectories of loneliness during childhood and adolescence: Predictors and health outcomes
Qualter, P., Brown, S. L., Rotenberg, K. J., Vanhalst, J., Harris, R. A., Goossens, L., Bangee, M., & Munn, P. (2013) · Journal of Adolescence · doi:10.1016/j.adolescence.2013.01.005 · Cited by 377 · see citing works
“Loneliness is important, not just because it affects the person’s current emotional state, but it is associated with poor social, behavioral, and health outcomes in adult, adolescent, and child samples (see Heinrich & Gullone, 2006, for review).”
BackgroundInfluential
Neurobiology and consequences of social isolation stress in animal model—A comprehensive review
Mumtaz, F., Khan, M. I., Zubair, M., & Dehpour, A. R. (2018) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2018.05.086 · Cited by 369 · see citing works
CREB regulation of nucleus accumbens excitability mediates social isolation–induced behavioral deficits
Wallace, D. L., Han, M.-H., Graham, D. L., Green, T. A., Vialou, V., Iñiguez, S. D., Cao, J.-L., Kirk, A., Chakravarty, S., Kumar, A., et al. (2009) · Nature Neuroscience · doi:10.1038/nn.2257 · Cited by 342 · see citing works
“This lack of attention is unfortunate, as social isolation would appear to be particularly relevant to certain subtypes of human depression and anxiety disorder”
Loneliness, social contacts and Internet addiction: A cross-lagged panel study
Yao, M. Z., & Zhong, Z. (2013) · Computers in Human Behavior · doi:10.1016/j.chb.2013.08.007 · Cited by 364 · see citing works
Does loneliness contribute to mild cognitive impairment and dementia? A systematic review and meta-analysis of longitudinal studies
Lara, E., Martín-María, N., De la Torre-Luque, A., Koyanagi, A., Vancampfort, D., Izquierdo, A., & Miret, M. (2019) · Ageing Research Reviews · doi:10.1016/j.arr.2019.03.002 · Cited by 351 · see citing works
Loneliness is adversely associated with physical and mental health and lifestyle factors: Results from a Swiss national survey
Richard, A., Rohrmann, S., Vandeleur, C. L., Schmid, M., Barth, J., & Eichholzer, M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0181442 · Cited by 350 · see citing works
Typologies of loneliness, living alone and social isolation, and their associations with physical and mental health
SMITH, K. J., & VICTOR, C. (2019) · Ageing and Society · doi:10.1017/s0144686x18000132 · Cited by 337 · see citing works
Loneliness, common mental disorders and suicidal behavior: Findings from a general population survey
Stickley, A., & Koyanagi, A. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.02.054 · Cited by 334 · see citing works
“mental disorders such as anxiety and depression (Cacioppo et al., 2006; Heinrich and Gullone, 2006).”
BackgroundInfluential
Feelings of loneliness among adults with mental disorder
Meltzer, H., Bebbington, P., Dennis, M. S., Jenkins, R., McManus, S., & Brugha, T. S. (2013) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-012-0515-8 · Cited by 303 · see citing works
“Some argue that loneliness should command clinicians’ attention in its own right—not just as an adjunct to the treatment of other problems such as depression [40].”
Background
Facing loneliness and anxiety during the COVID-19 isolation: the role of excessive social media use in a sample of Italian adults
Boursier, V., Gioia, F., Musetti, A., & Schimmenti, A. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.586222 · Cited by 309 · see citing works
“Moreover, clinicians might successfully orient problem-focused coping styles toward helping people facing loneliness (127).”
Background
Unpredictable chronic stress model in zebrafish (Danio rerio): Behavioral and physiological responses
Piato, Â., Capiotti, K. M., Tamborski, A. R., Oses, J. P., Barcellos, L. J. G., Bogo, M. R., Lara, D. R., Vianna, M. R. M. R., & Bonan, C. D. (2010) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2010.12.018 · Cited by 306 · see citing works
“Of note, there is a significant bidirectional relationship between loneliness and depression in humans (Heinrich and Gullone, 2006), and social separation and isolation per se can induce depressive-like behavior in rodents (Martin and Brown, 2010).”
Background
It is all in their mind: A review on information processing bias in lonely individuals.
Spithoven, A., Bijttebier, P., & Goossens, L. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.10.003 · Cited by 275 · see citing works
“As pointed out in other reviews as well (e.g., Heinrich & Gullone, 2006; Qualter et al., 2015), the cross-sectional design adopted in the majority of studies (also see Appendix 1) makes it impossible to draw any conclusion on the temporal ordering of cognitive correlates and loneliness (Heinrich &…”
Influential
Social Isolation Stress Induces Anxious-Depressive-Like Behavior and Alterations of Neuroplasticity-Related Genes in Adult Male Mice
Ieraci, A., Mallei, A., & Popoli, M. (2016) · Neural Plasticity · doi:10.1155/2016/6212983 · Cited by 294 · see citing works
“Social Isolation Stress Induces Anxious-Depressive-Like”
Review: Alleviating loneliness in young people – a meta‐analysis of interventions
Eccles, A. M., & Qualter, P. (2021) · Child and Adolescent Mental Health · doi:10.1111/camh.12389 · Cited by 285 · see citing works
“Where are all the lonely people?” A population-based study of high-risk groups across the life span
Lasgaard, M., Friis, K., & Shevlin, M. (2016) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-016-1279-3 · Cited by 282 · see citing works
“The second model echoes both theoretical approaches to loneliness that assign special importance to adolescence [22] and the findings of a study from New Zealand which suggests that loneliness rates may be elevated in both adolescence and old age [23].”
Background
Perceived social isolation in a community sample: its prevalence and correlates with aspects of peoples’ lives
Hawthorne, G. (2008) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-007-0279-8 · Cited by 279 · see citing works
“participating in a society and feeling a valued and supported member of a friendship group or community [41, 53, 62, 99].”
BackgroundInfluential
Loneliness in Psychosis: A Meta-analytical Review
da Rocha, B. M., Rhodes, S., Vasilopoulou, E., & Hutton, P. (2017) · Schizophrenia Bulletin · doi:10.1093/schbul/sbx036 · Cited by 286 · see citing works
Nature-Based Social Prescribing in Urban Settings to Improve Social Connectedness and Mental Well-being: a Review
Leavell, M. A., Leiferman, J. A., Gascón, M., Braddick, F., González, J. C., & Litt, J. (2019) · Current Environmental Health Reports · doi:10.1007/s40572-019-00251-7 · Cited by 283 · see citing works
Sex Differences in Depressive and Socioemotional Responses to an Inflammatory Challenge: Implications for Sex Differences in Depression
Moieni, M., Irwin, M. R., Jevtic, I., Olmstead, R., Breen, E. C., & Eisenberger, N. I. (2015) · Neuropsychopharmacology · doi:10.1038/npp.2015.17 · Cited by 273 · see citing works
“Importantly, feelings of social disconnection contribute to the onset and perpetuation of depression (Heinrich and Gullone, 2006), and it has been argued that females’ greater dependence on social relationships may contribute to the sex differences in depression (Cyranowski et al, 2000).”
Loneliness, depressive symptomatology, and suicide ideation in adolescence: cross-sectional and longitudinal analyses
Lasgaard, M., Goossens, L., & Elklit, A. (2011) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-010-9442-x · Cited by 258 · see citing works
“Indeed loneliness in adolescence has been associated with poor adjustment (Heinrich and Gullone 2006).”
BackgroundInfluential
Mental Health, Academic Self-Efficacy and Study Progress Among College Students – The SHoT Study, Norway
Grøtan, K., Sund, E. R., & Bjerkeset, O. A. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00045 · Cited by 256 · see citing works
“In a review article based on studies among students in Australia, the authors reported that loneliness, also commonly linked to depression, was an independent risk factor for low study progress (Heinrich and Gullone, 2006).”
Background
Positive activities as protective factors against mental health conditions
Layous, K., Chancellor, J., & Lyubomirsky, S. (2014) · Journal of Abnormal Psychology · doi:10.1037/a0034709 · Cited by 253 · see citing works
Increased risk of mortality associated with social isolation in older men: only when feeling lonely? Results from the Amsterdam Study of the Elderly (AMSTEL)
Holwerda, T. J., Beekman, A. T. F., Deeg, D. J. H., Stek, M. L., van Tilburg, T. G., Visser, P. J., Schmand, B., Jonker, C., & Schoevers, R. A. (2012) · Psychological Medicine · doi:10.1017/s0033291711001772 · Cited by 240 · see citing works
PERCEIVED SOCIAL SUPPORT MEDIATES ANXIETY AND DEPRESSIVE SYMPTOM CHANGES FOLLOWING PRIMARY CARE INTERVENTION: Research Article: Social Support Mediates Symptom Change
Dour, H. J., Wiley, J. F., Roy-Byrne, P., Stein, M. B., Sullivan, G., Sherbourne, C. D., Bystritsky, A., Rose, R. D., & Craske, M. G. (2014) · Depression and Anxiety · doi:10.1002/da.22216 · Cited by 243 · see citing works
Toward an Integrated and Differential Approach to the Relationships Between Loneliness, Different Types of Facebook Use, and Adolescents’ Depressed Mood
Frison, E., & Eggermont, S. (2020) · Communication Research · doi:10.1177/0093650215617506 · Cited by 239 · see citing works
“Avoidant coping (i.e., cognitive or behavioral attempts to deny and minimize the problem) in particular has frequently been examined as an outcome of loneliness (e.g., Heinrich & Gullone, 2006) and a predictor of depressive symptoms (e.g., Calvete, Camara, Estevez, & Villardón, 2011).”
BackgroundInfluential
Surviving remotely: How job control and loneliness during a forced shift to remote work impacted employee work behaviors and well‐being
Becker, W. J., Belkin, L. Y., Tuskey, S., & Conroy, S. A. (2022) · Human Resource Management · doi:10.1002/hrm.22102 · Cited by 263 · see citing works
Loneliness and Social Support in Adolescent Boys with Autism Spectrum Disorders
Lasgaard, M., Nielsen, A., Eriksen, M. E., & Goossens, L. (2010) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-009-0851-z · Cited by 242 · see citing works
“It is particularly relevant to focus on loneliness and mental health in adolescence, because the available evidence suggests that loneliness increases and is most prevalent during this developmental period (Heinrich and Gullone 2006; Mahon et al. 2006).”
Background
Psychometric analysis of the short-form UCLA Loneliness Scale (ULS-6) in older adults
Neto, F. F. M. (2014) · European Journal of Ageing · doi:10.1007/s10433-014-0312-1 · Cited by 247 · see citing works
“On the basis of previous studies (Pinquart and Sörensen 2001; Heinrich and Gullone 2006) we predicted that loneliness would be negatively correlated with self-esteem, satisfaction with life and positive affect and positively correlated with negative affect (DiTommaso et al.”
Integrating Etiological Models of Social Anxiety and Depression in Youth: Evidence for a Cumulative Interpersonal Risk Model
Epkins, C. C., & Heckler, D. R. (2011) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-011-0101-8 · Cited by 233 · see citing works
Sex differences in antidepressant efficacy
LeGates, T. A., Kvarta, M. D., & Thompson, S. M. (2018) · Neuropsychopharmacology · doi:10.1038/s41386-018-0156-z · Cited by 225 · see citing works
Personality change following unemployment.
Boyce, C. J., Wood, A. M., Daly, M., & Sedikides, C. (2015) · Journal of Applied Psychology · doi:10.1037/a0038647 · Cited by 231 · see citing works
“Lack of social support may result in loneliness (Heinrich & Gullone, 2006) and low self-esteem (Waters & Moore, 2002).”
Background
Suicide ideation as a symptom of adolescent depression. a network analysis
Gijzen, M., Rasing, S. P. A., Creemers, D. H. M., Smit, F., Engels, R. C. M. E., & Beurs, D. P. D. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.09.029 · Cited by 240 · see citing works
Adolescent non-suicidal self-injury: A cross-national study of community samples from Italy, the Netherlands and the United States
Giletta, M., Scholte, R. H. J., Engels, R. C. M. E., Ciairano, S., & Prinstein, M. J. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.02.009 · Cited by 228 · see citing works
Rumination and anxiety mediate the effect of loneliness on depressed mood and sleep quality in college students.
Zawadzki, M. J., Graham, J. E., & Gerin, W. (2013) · Health Psychology · doi:10.1037/a0029007 · Cited by 224 · see citing works
“Loneliness correlates with anxiety (Heinrich & Gullone, 2006).”
Background
Feeling lonely at work: investigating the consequences of unsatisfactory workplace relationships
Lam, L. W., & Lau, D. C.-S. (2012) · The International Journal of Human Resource Management · doi:10.1080/09585192.2012.665070 · Cited by 225 · see citing works
“Lonely individuals experience emotional distress due to unsatisfactory social relationships (Heinrich and Gullone 2006; Cacioppo and Hawkley 2009).”
BackgroundMethodInfluential
The relationships between social support and loneliness: a meta-analysis and review
Zhang, X., & Dong, S. (2022) · Acta Psychologica · doi:10.1016/j.actpsy.2022.103616 · Cited by 222 · see citing works
‘The invisible enemy’: disability, loneliness and isolation
Macdonald, S. J., Deacon, L., Nixon, J., Akintola, A. R., Gillingham, A., Kent, J., Ellis, G., Mathews, D., Ismail, A., Sullivan, S., et al. (2018) · Disability & Society · doi:10.1080/09687599.2018.1476224 · Cited by 222 · see citing works
“by Heinrich and Gullone (2006) in Australia explored the effect that loneliness”
BackgroundMethodInfluential
Loneliness and Facebook motives in adolescence: A longitudinal inquiry into directionality of effect
Teppers, E., Luyckx, K., A. Klimstra, T., & Goossens, L. (2014) · Journal of Adolescence · doi:10.1016/j.adolescence.2013.11.003 · Cited by 217 · see citing works
“Loneliness is particularly relevant to investigate in adolescence (Heinrich & Gullone, 2006).”
Background
Prevalence of loneliness amongst older people in high-income countries: A systematic review and meta-analysis
Chawla, K., Kunonga, P., Stow, D., Barker, R., Craig, D., & Hanratty, B. (2021) · PLoS ONE · doi:10.1371/journal.pone.0255088 · Cited by 214 · see citing works
“In addition, published prevalence rates have been most consistent for very frequent or severe loneliness amongst the older population, at between 5 and 13% [77].”
Background
The Interplay of Loneliness and Depressive Symptoms Across Adolescence: Exploring the Role of Personality Traits
Vanhalst, J., Klimstra, T. A., Luyckx, K., Scholte, R. H. J., Engels, R. C. M. E., & Goossens, L. (2012) · Journal of Youth and Adolescence · doi:10.1007/s10964-011-9726-7 · Cited by 208 · see citing works
Experiences of Loneliness Associated with Being an Informal Caregiver: A Qualitative Investigation
Vasileiou, K., Barnett, J. C., Barreto, M., Vines, J., Atkinson, M., Lawson, S. W., & Wilson, M. L. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00585 · Cited by 208 · see citing works
“Loneliness is also related to poor mental health outcomes (for a review see Heinrich and Gullone, 2006), such as depression (Cacioppo et al., 2010; Teo et al., 2013), deliberate self-harm (Rönkä et al., 2013), increased risk of dementia (Holwerda et al., 2014), and Alzheimer’s disease (Wilson et…”
Loneliness among people with substance use problems: A narrative systematic review
Ingram, I., Kelly, P. J., Deane, F. P., Baker, A. L., Goh, M. C. W., Raftery, D. K., & Dingle, G. A. (2020) · Drug and Alcohol Review · doi:10.1111/dar.13064 · Cited by 206 · see citing works
Loneliness and social anxiety across childhood and adolescence: Multilevel meta-analyses of cross-sectional and longitudinal associations.
Maes, M., Nelemans, S. A., Danneel, S., Fernández-Castilla, B., Van den Noortgate, W., Goossens, L., & Vanhalst, J. (2019) · Developmental Psychology · doi:10.1037/dev0000719 · Cited by 207 · see citing works
Vulnerability to Loneliness in People with Intellectual Disability: An Explanatory Model
Gilmore, L., & Cuskelly, M. (2014) · Journal of Policy and Practice in Intellectual Disabilities · doi:10.1111/jppi.12089 · Cited by 209 · see citing works
“Compared with around 15–30% of people in the general population (Heinrich & Gullone, 2006), it is estimated that up to half of those with intellectual disability are chronically lonely (Stancliffe et al., 2010).”
Background
Psychosocial predictors and outcomes of loneliness trajectories from childhood to early adolescence <sup>☆</sup>
Schinka, K. C., van Dulmen, M. H. M., Mata, A. D., Bossarte, R., & Swahn, M. (2013) · Journal of Adolescence · doi:10.1016/j.adolescence.2013.08.002 · Cited by 199 · see citing works
Adolescent Loneliness and Health in Early Adulthood
Goosby, B. J., Bellatorre, A., Walsemann, K., & Cheadle, J. E. (2013) · Sociological inquiry · doi:10.1111/soin.12018 · Cited by 171 · see citing works
Chatbots and mental health: Insights into the safety of generative <scp>AI</scp>
De Freitas, J., Uğuralp, A. K., Oğuz‐Uğuralp, Z., & Puntoni, S. (2024) · Journal of Consumer Psychology · doi:10.1002/jcpy.1393 · Cited by 211 · see citing works
Gender differences in the behavioral associates of loneliness and social dissatisfaction in kindergarten
Coplan, R. J., Closson, L. M., & Arbeau, K. A. (2007) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2007.01804.x · Cited by 198 · see citing works
The burden of loneliness: Implications of the social determinants of health during COVID-19
McQuaid, R. J., Cox, S. M. L., Ogunlana, A., & Jaworska, N. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113648 · Cited by 201 · see citing works
Loneliness across time and space
Luhmann, M., Buecker, S., & Rüsberg, M. (2022) · Nature Reviews Psychology · doi:10.1038/s44159-022-00124-1 · Cited by 197 · see citing works
Characterization of depression in children with autism spectrum disorders
Magnuson, K. M., & Constantino, J. N. (2011) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e318213f56c · Cited by 193 · see citing works
The importance of belonging and the avoidance of social risk taking in adolescence
Tomova, L., Andrews, J. L., & Blakemore, S.-J. (2021) · Developmental Review · doi:10.1016/j.dr.2021.100981 · Cited by 196 · see citing works
“It has been suggested that increased substance use might serve as a form of self-medication to cope with loneliness (Heinrich & Gullone, 2006), or as a way to affiliate with others if substance use is known to be endorsed by the peer group (DeWall & Pond, 2011).”
Background
A prospective study of social isolation, loneliness, and mortality in Finland
Tanskanen, J., & Anttila, T. (2016) · American Journal of Public Health · doi:10.2105/ajph.2016.303431 · Cited by 189 · see citing works
Problem-focused and emotion-focused coping options and loneliness: how are they related?
Schoenmakers, E., van Tilburg, T. G., & Fokkema, T. (2015) · European Journal of Ageing · doi:10.1007/s10433-015-0336-1 · Cited by 192 · see citing works
“…1998; Peplau and Perlman 1982) observed to be related to negative effects on well-being (De Jong Gierveld 1998) and physical and mental health (Hawkley and Cacioppo 2010; Heinrich and Gullone 2006; Holwerda et al. 2012; Ó Luanaigh and Lawlor 2008; Routasalo and Pitkala 2003; Shankar et al. 2013).”
Background
The Psychological Impact of ‘Mild Lockdown’ in Japan during the COVID-19 Pandemic: A Nationwide Survey under a Declared State of Emergency
Yamamoto, T., Uchiumi, C., Suzuki, N., Yoshimoto, J., & Murillo‐Rodríguez, E. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17249382 · Cited by 201 · see citing works
Loneliness, social relations and health and well-being in deprived communities
Kearns, A., Whitley, E., Tannahill, C., & Ellaway, A. (2014) · Psychology Health & Medicine · doi:10.1080/13548506.2014.940354 · Cited by 187 · see citing works
“The associations between social contact, social support and loneliness throw light on what have been termed the “situational determinants of loneliness” (Heinrich & Gullone, 2006) for people in deprived areas.”
Sociodemographic and Health-Related Risks for Loneliness and Outcome Differences by Loneliness Status in a Sample of U.S. Older Adults
Theeke, L. A. (2010) · Research in Gerontological Nursing · doi:10.3928/19404921-20091103-99 · Cited by 186 · see citing works
“One most recent literature review regarding the clinical significance of loneliness concluded that self-report may be the most "tenable method of data collection" (Heinrich & Gullone, 2006).”
Method
Low Self-Esteem as a Risk Factor for Loneliness in Adolescence: Perceived - but not Actual - Social Acceptance as an Underlying Mechanism
Vanhalst, J., Luyckx, K., Scholte, R. H. J., Engels, R. C. M. E., & Goossens, L. (2013) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-013-9751-y · Cited by 196 · see citing works
“Similarly, literature reviews have indicated that loneliness is not only related to psychopathology in adolescence (e.g., depression and anxiety; Heinrich and Gullone 2006), but also marks an increased risk for morbidity and mortality”
Background
Would the Real Loneliness Please Stand Up? The Validity of Loneliness Scores and the Reliability of Single-Item Scores
Mund, M., Maes, M., Drewke, P. M., Gutzeit, A., Jaki, I., & Qualter, P. (2023) · Assessment · doi:10.1177/10731911221077227 · Cited by 192 · see citing works
“…on health-related outcomes (for reviews, see Cacioppo et al., 2015; Ernst & Cacioppo, 1999; Hawkley & Cacioppo, 2010; Hawkley & Capitanio, 2015; Heinrich & Gullone, 2006; Holt-Lunstad et al., 2015) and interpersonal outcomes (Cacioppo et al., 2017; Lodder et al., 2017; Mund et al., 2022; Mund…”
Loneliness, social isolation, their synergistic interaction, and mortality.
Beller, J., & Wagner, A. (2018) · Health Psychology · doi:10.1037/hea0000605 · Cited by 217 · see citing works
“Not surprisingly, loneliness and social isolation are thus also associated with mortality (e.g., Coyle & Dugan, 2012; Elovainio et al., 2017; Hawkley & Cacioppo, 2010; Heinrich & Gullone, 2006; Pantell et al., 2013).”
Background
Loneliness and health risk behaviours among Russian and U.S. adolescents: a cross-sectional study
Stickley, A., Koyanagi, A., Koposov, R. A., Schwab‐Stone, M., & Ruchkin, V. V. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-366 · Cited by 185 · see citing works
Grief literacy: A call to action for compassionate communities
Breen, L. J., 川島, 大., Joy, K., Cadell, S., Roth, D., Chow, A. Y. M., & Macdonald, M. E. (2020) · Death Studies · doi:10.1080/07481187.2020.1739780 · Cited by 184 · see citing works
The development of loneliness from mid‐ to late adolescence: Trajectory classes, personality traits, and psychosocial functioning
Vanhalst, J., Goossens, L., Luyckx, K., Scholte, R. H. J., & Engels, R. C. M. E. (2013) · Journal of Adolescence · doi:10.1016/j.adolescence.2012.04.002 · Cited by 177 · see citing works
“Finally, the experience of loneliness has been shown to relate to more depressive symptoms, lower self-esteem, higher anxiety, and greater perceived stress (Ernst & Cacioppo,1999; Heinrich & Gullone, 2006).”
Background
Internet-Based Cognitive Behavior Therapy for Loneliness: A Pilot Randomized Controlled Trial
Käll, A., Jägholm, S., Hesser, H., Andersson, F., Mathaldi, A., Norkvist, B. T., Shafran, R., & Andersson, G. (2019) · Behavior Therapy · doi:10.1016/j.beth.2019.05.001 · Cited by 176 · see citing works
Social networks and support in first-episode psychosis: exploring the role of loneliness and anxiety
Sündermann, O., Onwumere, J., Kane, F., Morgan, C., & Kuipers, E. (2013) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-013-0754-3 · Cited by 175 · see citing works
“This is also in line with research showing that loneliness is more influenced by subjective appraisals of the social relationships than by its objective features [12].”
BackgroundResult
Mental Health of Elders in Retirement Communities: Is Loneliness a Key Factor?
Bekhet, A. K., & Zauszniewski, J. A. (2011) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2011.09.007 · Cited by 175 · see citing works
“The causes of loneliness are multidimensional and may include poor coping strategies, insecure attachments, failure expectations, and relationships that lack intimacy (Heinrich & Gullone, 2006; Seapersad, 2010).”
Background
Do the socially rich get richer? A nuanced perspective on social network site use and online social capital accrual.
Cheng, C., Wang, H.-Y., Sigerson, L., & Chau, C.-L. (2019) · Psychological bulletin · doi:10.1037/bul0000198 · Cited by 156 · see citing works
“Loneliness is characterized by negative thoughts and feelings of inadequacy in social relations (e.g., de Jong Gierveld, van Tilburg, & Dykstra, 2006; Heinrich & Gullone, 2006).”
Background
Does loneliness mediate the relation between social support and cognitive functioning in later life
Ellwardt, L., Aartsen, M., Deeg, D., & Steverink, N. (2013) · Social Science & Medicine · doi:10.1016/j.socscimed.2013.09.002 · Cited by 167 · see citing works
“A crucial marker of unfavorably evaluated support and deficits in social relationships is loneliness (Heinrich & Gullone, 2006; O’Donovan & Hughes, 2007; Pinquart & Sörensen, 2001), defined as a “distressing feeling that accompanies the perception that one’s social needs are not being met by the…”
Background
Adolescents' longitudinal trajectories of mental health and loneliness: The impact of COVID‐19 school closures
Houghton, S., Kyron, M., Hunter, S. C., Lawrence, D., Hattie, J., Carroll, A., & Zadow, C. (2022) · Journal of Adolescence · doi:10.1002/jad.12017 · Cited by 173 · see citing works
Loneliness and social isolation causal association with health-related lifestyle risk in older adults: a systematic review and meta-analysis protocol
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The Anxiety-Buffer Hypothesis in the Time of COVID-19: When Self-Esteem Protects From the Impact of Loneliness and Fear on Anxiety and Depression
Rossi, A., Panzeri, A., Pietrabissa, G., Manzoni, G. M., Castelnuovo, G., & Mannarini, S. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.02177 · Cited by 166 · see citing works
Does Mode of Contact with Different Types of Social Relationships Predict Depression in Older Adults? Evidence from a Nationally Representative Survey
Teo, A. R., Choi, H., Andrea, S. B., Valenstein, M. M., Newsom, J. T., Dobscha, S. K., & Zivin, K. (2015) · Journal of the American Geriatrics Society · doi:10.1111/jgs.13667 · Cited by 170 · see citing works
Feeling Lonely Versus Being Alone: Loneliness and Social Support Among Recently Bereaved Persons
Utz, R., Swenson, K. L., Caserta, M. S., Lund, D., & deVries, B. (2013) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbt075 · Cited by 169 · see citing works
“Greater social support was associated with lower levels of loneliness overall, but the receipt of social support did not modify one’s expression of loneliness over time.”
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“…ourna l homepage: www.e lsev ie r .com/ locate /schres Australia indicate that around 7–11% of adults describe themselves currently as often or very lonely (Griffin, 2010; Hawthorne, 2008), with roughly 30% indicating that loneliness is an enduring part of life (Heinrich and Gullone, 2006).”
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DETERMINING QUALITY REQUIREMENTS AT THE UNIVERSITIES TO IMPROVE THE QUALITY OF EDUCATION
Mustafa, N. H., Kelesbayev, D., & Alibekova, Z. D. (2018) · The Journal of Economic Research & Business Administration · doi:10.26577/be-2018-2-2141
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The Acceptance of Lonely Others: Effects of Loneliness and Gender of the Target Person and Loneliness of the Perceiver
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Authors: Heinrich, L. M., & Gullone, E.
Affiliations: Monash University (AU)
Corresponding author: Heinrich, Liesl M.
ORCID: Heinrich, Liesl M.
Venue: Clinical Psychology Review
Publisher: Elsevier BV
Published: 2006-10
Volume: 26
Issue: 6
Pages: 695-718
ISSN: 0272-7358 (ISSN-L)
DOI: 10.1016/j.cpr.2006.04.002
OpenAlex: W1974322420
Cited by: 1,986
References: 221
Citations by year: 2026: 135 · 2025: 158 · 2024: 183 · 2023: 201 · 2022: 198 · 2021: 170 · 2020: 132 · 2019: 113 · 2018: 106 · 2017: 100 · 2016: 83 · 2015: 91 · 2014: 75 · 2013: 69 · 2012: 54
FWCI: 2.96
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinical Psychology Review (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Health › Health disparities and outcomes
Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
Keywords: loneliness, interpersonal relationships, adolescents, evolutionary psychology, developmental psychology, mental health, physical health
MeSH terms: Adolescent, Affect, Anxiety Disorders, Depressive Disorder, Biological Evolution, Health Services, Health Services Needs and Demand, Health Status, Humans, Interpersonal Relations, Loneliness, Motivation, Psychophysiologic Disorders, Self Concept, Social Behavior, Prevalence

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