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A Meta-Analysis of Interventions to Reduce Loneliness
Open accessAbstract
Social and demographic trends are placing an increasing number of adults at risk for loneliness, an established risk factor for physical and mental illness. The growing costs of loneliness have led to a number of loneliness reduction interventions. Qualitative reviews have identified four primary intervention strategies: (a) improving social skills, (b) enhancing social support, (c) increasing opportunities for social contact, and (d) addressing maladaptive social cognition. An integrative meta-analysis of loneliness reduction interventions was conducted to quantify the effects of each strategy and to examine the potential role of moderator variables. Results revealed that single-group pre-post and nonrandomized comparison studies yielded larger mean effect sizes relative to randomized comparison studies. Among studies that used the latter design, the most successful interventions addressed maladaptive social cognition. This is consistent with current theories regarding loneliness and its etiology. Theoretical and methodological issues associated with designing new loneliness reduction interventions are discussed.
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“in contrast, some technological interventions for reducing loneliness, as well as animal therapy or robot pets, were not found to significantly reduce loneliness (Masi et al. 2011; Veronese et al. 2021), although other studies find more promising results of such interventions with older adults (Banks, Willoughby, and Banks 2008; Chen et al. 2020; Gasteiger et al. 2021).”
From AI Companions Reduce Loneliness (2024) · cites this paper as Masi et al. 2011
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In the citing paper
“As a potential stressor, chronic loneliness is closely associated with depressive symptoms, maladaptive social cognition, and poor recovery following a mental health crisis.82–84”
From A Longitudinal Study of Loneliness Before the End of the COVID-19 Pandemic: Trajectories, Predictors, and Impact on Chinese Adolescent Mental Health (2024) · cites this paper as [83]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Interventions that focus on improving social skills and social support are one of the successful strategies that have been used to alleviate loneliness among adult population, as discussed in a previous meta-analysis [163].”
From Association between friendship quality and subjective wellbeing among adolescents: a systematic review (2022) · cites this paper as [163]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Most current interventions assume loneliness results from lack of opportunities or competencies to form close relationships (Masi et al., 2011).”
From Young Adult Adaptability to the Social Challenges of the COVID-19 Pandemic: The Protective Role of Friendships (2022) · cites this paper as Masi et al., 2011
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“a meta-analysis by Masi et al. (2011) revealed that cognitive approaches (i.e., addressing maladaptive social cognition) were most effective in reducing loneliness compared to other strategies, such as social support.”
From Feasibility, acceptability, and preliminary efficacy of an internet-based CBT intervention for loneliness in older adults: A pilot RCT (2024) · cites this paper as Masi et al. (2011)
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“as generally effects of loneliness interventions seem to be rather small in randomized group designs (Masi et al., 2011)”
From Feasibility, acceptability, and preliminary efficacy of an internet-based CBT intervention for loneliness in older adults: A pilot RCT (2024) · cites this paper as Masi et al., 2011
In the citing paper
“Nine out of 10 reviews of these trials report significant reductions in depressive symptoms, 428-436 generally with small effect sizes.”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [436]
In the citing paper
“Bullying at school (and in other settings) is an important target for interventions to avert a strong lifetime risk for depression. 436”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [436]
In the citing paper
“Cacioppo and Cacioppo [30] reviewed data suggesting that experiences of physical warmth/coldness and feelings of social warmth/coldness share similar sensorimotor representations.”
From Loneliness and health in older adults: a mini-review and synthesis (2016) · cites this paper as [30]
In the citing paper
“loneliness or perceived social isolation may play a role in modulating the way in which individuals perceive and mirror the expressions and actions of others, particularly nonverbal cues that may indicate social rejection.”
From Loneliness and health in older adults: a mini-review and synthesis (2016) · cites this paper as [30]
In the citing paper
“Psychological approaches, such as Cognitive Behavioural Therapy and Mindfulness, have also been used to help people change their thinking about social relationships: some promising results have been reported, especially with older adult populations [77].”
From Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review (2018) · cites this paper as [77]
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“Various approaches have been developed to specifically target loneliness (Peplau & Perlman, 1982); cognitive– behavioral therapy with a focus on maladaptive social cognitions have been found to be especially effective in randomized controlled trials (Masi et al., 2011).”
Hoang, P., King, J. A., Moore, S., Moore, K., Reich, K., Sidhu, H., Tan, C. V., Whaley, C., & McMillan, J. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.36676 · Cited by 315
It is all in their mind: A review on information processing bias in lonely individuals
Spithoven, A. W. M., Bijttebier, P., & Goossens, L. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.10.003 · Cited by 339
“A meta-analysis on intervention programs designed to reduce loneliness reached a similar conclusion (Masi et al., 2010).”
Loneliness and physical activity: A systematic review
Pels, F., & Kleinert, J. (2016) · International Review of Sport and Exercise Psychology · doi:10.1080/1750984x.2016.1177849 · Cited by 303
“Accordingly, studies have found different dimensions of loneliness to be highly correlated and their antecedents and consequences to have a high degree of overlap (for an overview, see Masi et al., 2011).”
BackgroundPoscia, A., Stojanovic, J., La Milia, D. I., Duplaga, M., Grysztar, M., Moscato, U., Onder, G., Collamati, A., Ricciardi, W., & Magnavita, N. (2018) · Experimental Gerontology · doi:10.1016/j.exger.2017.11.017 · Cited by 369
“For example, group interventions might provide beneficial effects and create a sense of security and belonging, but the true effect of the intervention might be masked by the nature of gathering in a group (Masi et al., 2011).”
BackgroundA Systematic Review of Loneliness and Common Chronic Physical Conditions in Adults
Petitte, T. M., Mallow, J. A., Barnes, E. R., Petrone, A. B., Barr, T. L., & Theeke, L. A. (2015) · The Open Psychology Journal · doi:10.2174/1874350101508010113 · Cited by 311
“One meta-analysis of interventions, that included studies across populations and age groups, reported that the most effective interventions may be those that address the ineffective or maladaptive thinking processes that occur when one is experiencing loneliness [64].”
BackgroundReview: 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
“Other potential moderators focused on the delivery of the intervention and included (1) groups or individual delivery (Cattan et al., 2005; Findlay, 2003; Masi et al., 2011; McWhirter, 1990; Rook, 1984), the use of technology (Findlay, 2003; Hagan et al.”
BackgroundMethodResultInfluentialLoneliness, Resilience, Mental Health, and Quality of Life in Old Age: A Structural Equation Model
Gerino, E., Rollè, L., Sechi, C., & Brustia, P. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.02003 · Cited by 343
“The fact that loneliness could be reduced (Findlay, 2003; Cattan et al., 2005; Fokkema and Van Tilburg, 2007; Dickens et al., 2011; Forsman et al., 2011; Masi et al., 2011; Hagan et al., 2014), self-efficacy beliefs modified (Bandura, 1993), and resilience strengthened (Hartling, 2008) makes these factors primary for…”
BackgroundSwift, H. J., Abrams, D., Lamont, R. A., & Drury, L. (2017) · Social Issues and Policy Review · doi:10.1111/sipr.12031 · Cited by 332
“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
“At present, available research indicates that social cognitively oriented interventions may be effective in alleviating loneliness, although more randomised controlled studies are needed [59].”
BackgroundInterventions for Alleviating Loneliness among Older Persons: A Critical Review
Cohen-Mansfield, J., & Perach, R. (2015) · American Journal of Health Promotion · doi:10.4278/ajhp.130418-lit-182 · Cited by 277
Smith, M. L., Steinman, L. E., & Casey, E. A. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.00403 · Cited by 286
“(54) offer a user typology for selecting appropriate interventions based on what the intervention is targeting.”
BackgroundLoneliness from young adulthood to old age: explaining age differences in loneliness
Hawkley, L. C., Buecker, S., Kaiser, T., & Luhmann, M. (2022) · International Journal of Behavioral Development · doi:10.1177/0165025420971048 · Cited by 281
Hickin, N., Käll, A., Shafran, R., Sutcliffe, S., Manzotti, G., & Langan, D. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102066 · Cited by 295
Relationship between loneliness and mental health in students
Richardson, T., Elliott, P., & Roberts, R. (2017) · Journal of Public Mental Health · doi:10.1108/jpmh-03-2016-0013 · Cited by 256
Rafnsson, S. B., Orrell, M., d’Orsi, E., Hogervorst, E., & Steptoe, A. (2020) · The Journals of Gerontology: Series B · doi:10.1093/geronb/gbx087 · Cited by 262
Steffens, N. K., LaRue, C. J., Haslam, C., Walter, Z. C., Cruwys, T., Munt, K. A., Haslam, S. A., Jetten, J., & Tarrant, M. (2021) · Health Psychology Review · doi:10.1080/17437199.2019.1669481 · Cited by 259
Moeller, R. W., & Seehuus, M. (2019) · Journal of Adolescence · doi:10.1016/j.adolescence.2019.03.006 · Cited by 254
“Considering depression is associated with poor executive functioning (Cacioppo & Hawkley, 2009; Cotrena, Branco, Shansis, & Fonseca, 2016), it could be that the impaired executive function is itself associated with a negative bias in the decoding of social information (Henry, von Hippel, Molenberghs, Lee, & Sachdev, 2…”
BackgroundThe impact of the COVID-19 pandemic on wellbeing and cognitive functioning of older adults
Pue, S. D., Gillebert, C. R., Dierckx, E., Vanderhasselt, M.-A., Raedt, R. D., & den Bussche, E. V. (2021) · Scientific Reports · doi:10.1038/s41598-021-84127-7 · Cited by 272
Jia, R., Ayling, K., Chalder, T., Massey, A., Broadbent, E., Coupland, C., & Vedhara, K. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-040620 · Cited by 329
Safe but Lonely? Loneliness, Anxiety, and Depression Symptoms and COVID-19
Okruszek, Ł., Aniszewska-Stańczuk, A., Piejka, A., Wiśniewska, M., & Żurek, K. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.579181 · Cited by 265
Goll, J. C., Charlesworth, G. M., Scior, K., & Stott, J. C. H. (2015) · PLoS ONE · doi:10.1371/journal.pone.0116664 · Cited by 266
“Additionally, interventions to increase social participation may lead to reductions in loneliness [26].”
BackgroundLoneliness in psychosis: a systematic review
Lim, M. H., Gleeson, J., Álvarez‐Jiménez, M., & Penn, D. L. (2018) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-018-1482-5 · Cited by 252
“Cognitive restructuring about how one feels about their interpersonal relationships has been recommended as one effective strategy to adopt within in loneliness interventions [24].”
BackgroundEvaluation of Social Isolation, Loneliness, and Cardiovascular Disease Among Older Women in the US
Golaszewski, N. M., LaCroix, A. Z., Godino, J., Allison, M., Manson, J. E., King, J. J., Weitlauf, J. C., Bea, J. W., García, L., Kroenke, C. H., et al. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.46461 · Cited by 243
Haslam, C., Cruwys, T., Chang, M. X. L., Bentley, S. V., Haslam, S. A., Dingle, G. A., & Jetten, J. (2019) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000427 · Cited by 207
“There are numerous interventions to tackle loneliness and considerable variability in their effectiveness (Cacioppo et al., 2015; Masi et al., 2011).”
BackgroundInfluentialSocial isolation and loneliness: the new geriatric giants: Approach for primary care.
Freedman, A., & Nicolle, J. (2020) · PubMed · Cited by 249
Deckx, L., van den Akker, M., & Buntinx, F. (2014) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2014.05.002 · Cited by 206
Reducing social isolation and loneliness in older people: a systematic review protocol
Landeiro, F., Barrows, P., Musson, E. N., Gray, A. M., & Leal, J. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-013778 · Cited by 250
Cené, C. W., Beckie, T. M., Sims, M., Suglia, S. F., Aggarwal, B., Moise, N., Jiménez, M. C., Gaye, B., & McCullough, L. D. (2022) · Journal of the American Heart Association · doi:10.1161/jaha.122.026493 · Cited by 243
Astell‐Burt, T., Hartig, T., Putra, I. G. N. E., Walsan, R., Dendup, T., & Feng, X. (2022) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2022.157521 · Cited by 232
Stress and perceived social isolation (loneliness)
Campagne, D. M. (2019) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2019.02.007 · Cited by 240
A Meta-Analysis of the Relations Between Three Types of Peer Norms and Adolescent Sexual Behavior
van de Bongardt, D., Reitz, E., Sandfort, T. G. M., & Deković, M. (2014) · Personality and Social Psychology Review · doi:10.1177/1088868314544223 · Cited by 246
Forsman, A. K., Nordmyr, J., & Wahlbeck, K. (2011) · Health Promotion International · doi:10.1093/heapro/dar074 · Cited by 225
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“Indeed, loneliness interventions that addressed maladaptive social cognition (including attribution style) had a larger effect size compared to any other type of intervention (i.e., addressing social support, social skills, and opportunities for social interventions; Masi et al. 2011).”
BackgroundNewall, N. E. G., & Menec, V. H. (2019) · Journal of Social and Personal Relationships · doi:10.1177/0265407517749045 · Cited by 208
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
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Factors associated with suicidal thoughts in a large community study of older adults
Almeida, O. P., Draper, B., Snowdon, J. A., Lautenschlager, N. T., Pirkis, J., Byrne, G. J., Sim, M., Stocks, N., Flicker, L. A., & Pfaff, J. J. (2012) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.112.110130 · Cited by 206
Reducing loneliness amongst older people: a systematic search and narrative review
Hagan, R. J., Manktelow, R., Taylor, B. J., & Mallett, J. (2014) · Aging & Mental Health · doi:10.1080/13607863.2013.875122 · Cited by 231
“Masi et al. (2011) are concerned that interventions that reduce social isolation do not necessarily reduce loneliness, supporting not only Weiss’ contention that there are different types of loneliness, but also Victor et al.’s (2009) assertion that social isolation is distinct from loneliness.”
BackgroundDavies, K., Maharani, A., Chandola, T., Todd, C. J., & Pendleton, N. (2021) · The Lancet Healthy Longevity · doi:10.1016/s2666-7568(20)30038-6 · Cited by 219
Social Pain and Physical Pain: Shared Paths To Resilience
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Loneliness across time and space
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“Masi’s meta-analysis in 2011 [34] has been considered one of the most comprehensive reviews to date examining interventions for loneliness, identifying four main types of intervention.”
BackgroundOn the reciprocal association between loneliness and subjective well-being
VanderWeele, T. J., Hawkley, L. C., & Cacioppo, J. T. (2012) · American Journal of Epidemiology · doi:10.1093/aje/kws173 · Cited by 187
“6 standard deviations) were those using a cognitive-behavioral approach (52).”
Self-citationMenec, V. H., Newall, N. E., Mackenzie, C. S., Shooshtari, S., & Nowicki, S. (2019) · PLOS ONE · doi:10.1371/journal.pone.0211143 · Cited by 192
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Self-citationVanhalst, 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 216
“, enhancing social support and increasing opportunities for social contact) were less effective compared to interventions addressing maladaptive social cognitions (Masi et al. 2011).”
BackgroundA Practical Approach to Assessing and Mitigating Loneliness and Isolation in Older Adults
Perissinotto, C. M., Holt‐Lunstad, J., Periyakoil, V. S., & Covinsky, K. E. (2019) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15746 · Cited by 209
Kahlon, M. K., Aksan, N., Aubrey, R., Clark, N., Cowley-Morillo, M., Jacobs, E. A., Mundhenk, R., Sebastian, K. R., & Tomlinson, S. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.0113 · Cited by 184
“Logistic mixed-effect regressions were run in addition to linear mixed-effect regressions when instruments had well-established clinical cutoffs for mild (5-9), moderate (10-19), or severe (>20) depression (PHQ-8)18 or anxiety (GAD-7)19 to gauge clinical significance.”
Method
Metadata
- Authors
- Masi, C. M., Chen, H.-Y., Hawkley, L. C., & Cacioppo, J. T.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Masi, Christopher M.
- Venue
- Personality and Social Psychology Review
- Publisher
- SAGE Publications
- Published
- 2010-08-17
- Volume
- 15
- Issue
- 3
- Pages
- 219-266
- ISSN
- 1088-8683 (ISSN-L)
- 1532-7957
- PMC
- PMC3865701
- OpenAlex
- W2138867401
- Cited by
- 1,995
- References
- 168
- Citations by year
- 2026: 149 · 2025: 211 · 2024: 212 · 2023: 205 · 2022: 214 · 2021: 231 · 2020: 221 · 2019: 130 · 2018: 90 · 2017: 92 · 2016: 54 · 2015: 67 · 2014: 46 · 2013: 40 · 2012: 18
- FWCI
- 4.14
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Personality and Social Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99 RG999999, 5r01ag036433-02)
- National Institute on Aging (R01-AG036433, K08AG027200, R01AG034052)
- 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, social skills training, social support, social contact, intervention effectiveness, moderators, randomized controlled trials, non-randomized studies
- MeSH terms
- Adult, Health Promotion, Humans, Loneliness, Psychotherapy, Research Design, Social Adjustment, Social Perception, Social Support
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