Cited by 448Health disparities and outcomesStress Responses and CortisolDeath Anxiety and Social Exclusion

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Loneliness and pathways to disease

Hawkley, Louise C, Cacioppo, John T·2003·Brain, Behavior, and Immunity

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Abstract

Social isolation predicts morbidity and mortality from cancer, cardiovascular disease, and a host of other causes. The mechanisms by which the social world impacts on health are poorly understood, in part because of lack of specificity in the conceptualization and operationalization of relevant aspects of social relationships and physiological processes. Perceived social isolation, commonly termed loneliness, may represent a link between the epidemiological and biological levels of analysis. Research is presented that investigates loneliness as a social factor of importance in three predisease pathways: health behaviors, excessive stress reactivity, and inadequate or inefficient physiological repair and maintenance processes. Empirical evidence of autonomic, endocrine, and immune functioning suggests that the physiological effects of loneliness unfold over a relatively long time period. For cancer patients, interventions should be aimed at providing instrumental support for the immediate demands of the disease.

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Cohen, S., & Wills, T. A. (1985) · Psychological Bulletin · doi:10.1037/0033-2909.98.2.310 · Cited by 18,093
Social Relationships and Health
House, J. S., Landis, K. R., & Umberson, D. (1988) · Science · doi:10.1126/science.3399889 · Cited by 7,073
Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents
BERKMAN, L. F., & SYME, S. L. (1979) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a112674 · Cited by 5,341
The Revised UCLA Loneliness Scale: concurrent and discriminant validity evidence
Russell, D., Peplau, L. A., & Cutrona, C. E. (1980) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.39.3.472 · Cited by 5,173
Impact of sleep debt on metabolic and endocrine function
Spiegel, K., Leproult, R., & Van Cauter, E. (1999) · The Lancet · doi:10.1016/s0140-6736(99)01376-8 · Cited by 3,668
Healthy People 2000: National Health Promotion and Disease Prevention Objectives.
Heidel, R. E. (1991) · Population and Development Review · doi:10.2307/1971966 · Cited by 3,162
The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health.
Uchino, B. N., Cacioppo, J. T., & Kiecolt-Glaser, J. K. (1996) · Psychological Bulletin · doi:10.1037/0033-2909.119.3.488 · Cited by 2,727
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Spiegel, D., Kraemer, H., Bloom, J., & Gottheil, E. (1989) · The Lancet · doi:10.1016/s0140-6736(89)91551-1 · Cited by 2,353
Loneliness: A Sourcebook of Current Theory, Research and Therapy.
Peplau, L. A., & Perlman, D. (1984) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2068915 · Cited by 1,937
Emotional experience in everyday life across the adult life span.
Carstensen, L. L., Pasupathi, M., Mayr, U., & Nesselroade, J. R. (2000) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.79.4.644 · Cited by 1,558

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Authors: Hawkley, L. C., & Cacioppo, J. T.
Affiliations: University of Chicago (US)
Corresponding author: Hawkley, Louise C
ORCID: Hawkley, Louise C
Cacioppo, John T
Venue: Brain, Behavior, and Immunity
Publisher: Elsevier BV
Published: 2003-02
Volume: 17
Issue: 1
Pages: 98-105
ISSN: 0889-1591 (ISSN-L)
DOI: 10.1016/s0889-1591(02)00073-9
OpenAlex: W2037345996
Cited by: 446
References: 48
Citations by year: 2026: 21 · 2025: 27 · 2024: 35 · 2023: 39 · 2022: 38 · 2021: 43 · 2020: 26 · 2019: 10 · 2018: 11 · 2017: 19 · 2016: 19 · 2015: 16 · 2014: 22 · 2013: 13 · 2012: 21
FWCI: 1.16
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: Brain Behavior and Immunity (publishedVersion)
PubMed (publishedVersion)
Funders: John D. and Catherine T. MacArthur Foundation
National Institutes of Health
National Institute on Aging (P01AG18911, P01AG018911)
Topics: Social Sciences › Health › Health disparities and outcomes
Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
Keywords: loneliness, social isolation, interpersonal relationships, health behavior, stress reactivity, autonomic nervous system, endocrine function, immune function, cancer, cardiovascular disease, morbidity and mortality, social support interventions
MeSH terms: Cardiovascular Diseases, Humans, Loneliness, Neoplasms, Sleep, Neuroimmunomodulation

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Loneliness and pathways to disease

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