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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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In the citing paper
“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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Cruwys, T., Haslam, C., Rathbone, J. A., Williams, E., Haslam, S. A., & Walter, Z. C. (2022) · The British Journal of Psychiatry · doi:10.1192/bjp.2021.128 · Cited by 64
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“In the current absence of interventions with established evidence of effectiveness for reducing loneliness in this clinical group [10, 11], the Community Navigator programme offers a preliminarily-tested programme for reducing loneliness for people with complex depression or anxiety, with a programme manual and traini…”
BackgroundMethodOsborn, T. G., Weatherburn, P., & French, R. (2021) · Journal of Adolescence · doi:10.1016/j.adolescence.2021.09.007 · Cited by 73
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Grygiel, P., Humenny, G., Rębisz, S., Bajcar, E. A., & Świtaj, P. (2014) · Journal of Attention Disorders · doi:10.1177/1087054714563791 · Cited by 75
“Consequently, it can be assumed that effective treatments and interventions should not be limited to improving social skills or correcting the maladaptive social cognition of children with ADHD, even if it is the most effective method for reducing loneliness (see Masi et al., 2011).”
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“…em in at ed br oa dl y. between perceived control and loneliness became weaker with higher education, which is in line with previous research suggestion that education functions as a resource buffering the effect of loneliness on numerous psychosocial and physical outcomes (Masi et al., 2011).”
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“Indeed, a meta-analysis on anti-loneliness interventions found that interventions that addressed maladaptive social cognitions reduced feelings of loneliness more than interventions focused on improving social skills, social support, or opportunities for social interaction [109].”
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“Of these strategies, the latter was found to be most successful (Masi et al., 2011).”
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Reducing loneliness and improving well-being among older adults with animatronic pets
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“However, as earlier work with adults already indicated, interventions focusing on cognitive biases are more effective in tackling loneliness (Masi et al., 2011).”
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“Recently, social isolation has been recognised as being different from loneliness, and several authors have called for the phenomena to be treated separately (e.g. Masi et al., 2011; Victor et al., 2009).”
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“Masi and colleagues [48] described a regulatory loop model of loneliness, in which people who are lonely tend to have negative and biased social cognitions [49].”
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“One recent meta-analysis of interventions suggested that effectiveness may be enhanced if interventions targeted common thought process errors that occur with loneliness [26], such as automatic thinking [27] or fears and phobias [28].”
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“A meta-analysis on the effectiveness of interventions for loneliness proved addressing maladaptive social cognition to be the most effective intervention, as compared with interventions directed at improving social skills, enhancing social support or increasing opportunities for social contact.(94) Impaired cognition…”
Self-citationContextual correlates of loneliness in adolescents
Bayat, N., Fokkema, T., Mujakovic, S., & Ruiter, R. A. C. (2021) · Children and Youth Services Review · doi:10.1016/j.childyouth.2021.106083 · Cited by 52
Hyland, K. A., Small, B. J., Gray, J. E., Chiappori, A., Creelan, B., Tanvetyanon, T., Nelson, A. M., Cessna, J. M., Jim, H., & Jacobsen, P. B. (2019) · Psycho-Oncology · doi:10.1002/pon.5072 · Cited by 54
“constraint, reduce perceptions of being stigmatized, and alter cancer‐ related negative social expectations.(41) Patients may, in turn, engage in more social interactions and feel more satisfied with these interactions, thus reducing loneliness and improving outcomes.”
BackgroundStijelja, S., & Mishara, B. L. (2022) · Sexuality & Culture · doi:10.1007/s12119-022-10031-5 · Cited by 52
Depressive and Biopsychosocial Frailty Phenotypes: Impact on Late-life Cognitive Disorders
Panza, F., Solfrizzi, V., Sardone, R., Dibello, V., Castellana, F., Zupo, R., Stallone, R., Lampignano, L., Bortone, I., Mollica, A., et al. (2023) · Journal of Alzheimer s Disease · doi:10.3233/jad-230312 · Cited by 57
“…some primary intervention strategies may reduce the impact of the psychosocial dimension on the biopsy-chosocial frailty phenotype, including social skills improvement, social support enhancement, increased opportunities for social contact, and the management of maladaptive social cognition [168].”
Interventions for loneliness in older adults: a systematic review of reviews
Patil, U., & Braun, K. L. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1427605 · Cited by 66
“This finding is consistent with the hallmark meta-analysis by Masi et al. (35) on subjects of any age.”
ResultBouwman, T., Aartsen, M., van Tilburg, T. G., & STEVENS, N. L. (2016) · Journal of Social and Personal Relationships · doi:10.1177/0265407516659158 · Cited by 54
“Interventions that address maladaptive social cognition are more successful than interventions focusing on creating opportunities to meet others, teaching social skills, or increasing social support (Masi et al., 2010).”
BackgroundThe role of religion in protecting older Romanian migrants from loneliness
Ciobanu, R. O., & Fokkema, T. (2016) · Journal of Ethnic and Migration Studies · doi:10.1080/1369183x.2016.1238905 · Cited by 59
“Secondly, despite repeated disappointing outcomes of loneliness interventions aimed at bringing people together and improving their social network (Cattan et al. 2005; Findlay 2003; Hagan et al. 2014; Masi et al. 2011; Windle, Francis, and Coomber 2011) it is often assumed that an active problem-focused coping strateg…”
BackgroundLoneliness in senior housing communities
Taylor, H. O., Wang, Y., & Morrow-Howell, N. L. (2018) · Journal of Gerontological Social Work · doi:10.1080/01634372.2018.1478352 · Cited by 53
Wilson, S. J., Woody, A., Padin, A. C., Lin, J., Malarkey, W. B., & Kiecolt‐Glaser, J. K. (2018) · Annals of Behavioral Medicine · doi:10.1093/abm/kay064 · Cited by 59
“A meta-analysis attempting to identify empirically supported treatments for loneliness using evidence from randomized controlled trials concluded that increasing social support is not enough to combat loneliness on its own [54].”
BackgroundMethodSocial Media and Loneliness - Forever connected?
Yavich, R., Davidovitch, N., & Frenkel, Z. (2019) · Higher Education Studies · doi:10.5539/hes.v9n2p10 · Cited by 56
The influence of grafting on crops’ photosynthetic performance
Fullana‐Pericàs, M., Conesa, M. À., Pérez‐Alfocea, F., & Galmés, J. (2019) · Plant Science · doi:10.1016/j.plantsci.2019.110250 · Cited by 52
Adams, R. N., Mosher, C. E., Rand, K. L., Hirsh, A. T., Monahan, P. O., Abonour, R., & Kroenke, K. (2017) · Quality of Life Research · doi:10.1007/s11136-017-1518-4 · Cited by 49
“Although efficacious loneliness-reduction interventions have been developed [17], these interventions have rarely targeted cancer populations.”
BackgroundShapira, S., Cohn‐Schwartz, E., Yeshua‐Katz, D., Aharonson‐Daniel, L., Clarfield, A. M., & Sarid, O. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182010563 · Cited by 57
“The pandemic increases situational loneliness, and interventions that foster social connections and social support can be more effective compared with interventions that teach social skills, which are more relevant for chronic loneliness [26].”
BackgroundPatulny, R., & Bower, M. (2022) · Australian Journal of Social Issues · doi:10.1002/ajs4.223 · Cited by 63
Vanhalst, J., Rassart, J., Luyckx, K., Goossens, E., Apers, S., Goossens, L., & Moons, P. (2013) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2013.03.027 · Cited by 51
Gratitude and Loneliness: Enhancing Health and Well-Being in Older Adults
Bartlett, M. Y., & Arpin, S. N. (2019) · Research on Aging · doi:10.1177/0164027519845354 · Cited by 58
Desire to Belong Affects Instagram Behavior and Perceived Social Support
Wong, D., Amon, K. L., & Keep, M. (2019) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2018.0533 · Cited by 58
“As such, individuals who feel a sense of belonging report greater relationship satisfaction, 26 higher self-esteem, 27 reduced loneliness, 28 and better social and psychological functioning.”
Projecting loneliness into the past and future: implications for self-esteem and affect
Teneva, N., & Lemay, E. P. (2020) · Motivation and Emotion · doi:10.1007/s11031-020-09842-6 · Cited by 58
Schetter, C. D. (2017) · American Psychologist · doi:10.1037/amp0000158 · Cited by 53
On social health: history, conceptualization, and population patterning
Doyle, D. M., & Link, B. G. (2024) · Health Psychology Review · doi:10.1080/17437199.2024.2314506 · Cited by 65
“Meta-analyses of diverse loneliness interventions among adults (Masi et al., 2011) as well as youth (Eccles & Qualter, 2021) reveal consistent and moderate average e ff ect sizes across reviews, with high variability in e ff ect sizes between interventions.”
Cognitive problems among breast cancer survivors: loneliness enhances risk
Jaremka, L. M., Peng, J., Bornstein, R. A., Alfano, C. M., Andridge, R., Povoski, S. P., Lipari, A. M., Agnese, D. M., Farrar, W. B., Yee, L. D., et al. (2014) · Psycho-Oncology · doi:10.1002/pon.3544 · Cited by 50
“Consistent with this argument, a recent metaanalysis concluded that the most effective loneliness intervention is cognitive behavioral therapy focused on maladaptive social cognition [30].”
Loneliness predicts self-reported cold symptoms after a viral challenge.
LeRoy, A. S., Murdock, K. W., Jaremka, L. M., Loya, A., & Fagundes, C. P. (2017) · Health Psychology · doi:10.1037/hea0000467 · Cited by 52
Tucker, J. S., Rodriguez, A., Green, H. D., & Pollard, M. (2022) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2022.109285 · Cited by 50
“As such, mitigation strategies to address adults’ feelings of loneliness early in the pandemic, perhaps based on cognitive behavioral therapy approaches that have been found effective in reducing loneliness (Masi et al., 2011) may have had long-term beneficial effects on adults’ drinking behavior during the pandemic.”
Autism, Discrimination and Masking: Disrupting a Recipe for Trauma
Cleary, M. L., West, S., Kornhaber, R. A., & Hungerford, C. L. (2023) · Issues in Mental Health Nursing · doi:10.1080/01612840.2023.2239916 · Cited by 61
A pilot study of virtual support for grief: Feasibility, acceptability, and preliminary outcomes
Knowles, L. M., Stelzer, E., Jovel, K. S., & O'Connor, M. (2017) · Computers in Human Behavior · doi:10.1016/j.chb.2017.04.005 · Cited by 49
“O’Connor and colleagues (2014) examined the prelimi nary feasibility, acceptability and efficacy of a VR support group format for careg iv rs of Alzheimer’s patients who did not want to leave their home to participate in a suppor t group.”
BackgroundDunn, C., & Sicouri, G. (2022) · Behaviour Change · doi:10.1017/bec.2022.13 · Cited by 48
The loneliness of the long-distance (PhD) researcher
Cantor, G. N. (2019) · Psychodynamic Practice · doi:10.1080/14753634.2019.1645805 · Cited by 53
Ascanio, J. H., de Torres, L. Á. P., Rich‐Ruiz, M., González‐Santos, J., Mielgo‐Ayuso, J., Gonzalez-Bernal, J. J., & ASyS Study Collaborative Group (2022) · Nursing Open · doi:10.1002/nop2.1277 · Cited by 51
Tough, H., Brinkhof, M. W. G., & Fekete, C. (2022) · BMC Public Health · doi:10.1186/s12889-022-14127-3 · Cited by 48
“Cognitive behavioural therapy has been shown to improve perceived social support [55] and is described as a promising approach to intervene on maladaptive social cognitions in relation to feelings of loneliness or low belongingness which may be a direct result of caregiving [56].”
BackgroundCaple, V., Maude, P., Walter, R., & Ross, A. (2023) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12945 · Cited by 60
Choking Under Social Pressure: Social Monitoring Among the Lonely
Knowles, M. L., Lucas, G. M., Baumeister, R. F., & Gardner, W. L. (2015) · Personality and Social Psychology Bulletin · doi:10.1177/0146167215580775 · Cited by 48
“Interventions such as cognitive-behavioral therapy, which focuses on changing such cognitions, have fared best in methodologically rigorous studies (Masi et al., 2011).”
BackgroundBoekhout, J. M., Peels, D. A., Berendsen, B., Bolman, C. A. W., & Lechner, L. (2017) · JMIR Research Protocols · doi:10.2196/resprot.8093 · Cited by 49
“Another significant feature of older adults, who are less physically active, is not having a life partner [6,15].”
BackgroundLoneliness in Men 60 Years and Over: The Association With Purpose in Life
Neville, S. J., Adams, J., Montayre, J., Larmer, P. J., Garrett, N., Stephens, C. V., & Alpass, F. (2018) · American Journal of Men s Health · doi:10.1177/1557988318758807 · Cited by 48
What Really Matters for Loneliness Among Left-Behind Children in Rural China: A Meta-Analytic Review
Chai, X., Du, H., Li, X., Su, S., & Lin, D. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00774 · Cited by 61
Naudé, B., Rigaud, A., & Pino, M. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2021.751150 · Cited by 46
“Indeed, the difficulties to establish new relationships due to health conditions and/or the need for functional assistance (4), or the decline of family visits over time (5), contribute to loneliness and social isolation in this population, at the expense of their wellbeing (6), quality of life (7) and cognitive funct…”
BackgroundFriendship and Mental Health Functioning
King, A. R., Russell, T. D., & Veith, A. C. (2016) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780190222024.003.0015 · Cited by 47
Understanding loneliness and social relationships in autism: The reflections of autistic adults
Elmose, M. (2019) · Nordic Psychology · doi:10.1080/19012276.2019.1625068 · Cited by 57
“…interventions aimed at loneliness and social isolation as either focusing on improving social skills, enhancing social support, increasing social opportunities or changing cognitions found interventions aimed at changing cognitions to be most efficient (Masi, Chen, Hawkley, & Cacioppo, 2011).”
Reframing Time Spent Alone: Reappraisal Buffers the Emotional Effects of Isolation
Rodriguez, M., Bellet, B. W., & McNally, R. J. (2020) · Cognitive Therapy and Research · doi:10.1007/s10608-020-10128-x · Cited by 55
Neves, B. B., Waycott, J., & Maddox, A. (2021) · Sociological Research Online · doi:10.1177/13607804211029298 · Cited by 52
“In the last decade, several technology-based interventions to address loneliness in later life emerged based on the potential of new information and communication technologies to create opportunities for social connectedness (Masi et al., 2011; Poscia et al., 2018).”
BackgroundLim, M. H., & Gleeson, J. (2014) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2014.00154 · Cited by 47
“Pers Soc Psychol Rev (2011) 15(3):219–66.”
BackgroundInfluentialWolf, L., Davis, M. C., Yeung, E. W., & Tennen, H. A. (2015) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2014.12.018 · Cited by 49
“Such strategies are in line with findings from treatment studies for lonely individuals suggesting that interventions need to address maladaptive cognitions that prevent beneficial social interactions [34].”
ResultAdams, R. N., Mosher, C. E., Abonour, R., Robertson, M. J., Champion, V. L., & Kroenke, K. (2016) · Oncology nursing forum · doi:10.1188/16.onf.156-163 · Cited by 47
Chang, E. C., Chang, O. D., Martos, T., Sallay, V., Lee, J., Stam, K. R., Batterbee, C. N.-H., & Yu, T. (2017) · The Family Journal · doi:10.1177/1066480717711102 · Cited by 47
Perfiles de soledad y aislamiento social en población urbana
Badía, J. G., Comice, P., Belchín, A., Erdozain, M. Á., Cáliz, L., Torres, S., & Rodríguez, R. (2019) · Atención Primaria · doi:10.1016/j.aprim.2018.09.012 · Cited by 49
Lü, L., Jing, X., Lv, S., Liang, J., Tian, L., Li, H., Puts, M. T. E., & Xu, Y. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-1427-1 · Cited by 47
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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