Digital interventions for subjective and objective social isolation among individuals with mental health conditions: a scoping review

Background: Social isolation encompasses subjective and objective concepts. Both are associated with negative health consequences and are more prevalent among people with mental health problems than among the general population. To alleviate social isolation, digital interventions have potential as accessible alternatives or adjuncts to face-to-face interventions. This scoping review aimed to describe the types of digital interventions evaluated for feasibility, acceptability and effectiveness in alleviating social isolation among individuals with mental health problems, and to present an overview of the quantitative evidence yielded to inform future intervention design. // Methods: We searched five electronic databases for quantitative and mixed methods studies published between January 2000 and July 2020. Studies were included if they evaluated digital interventions for individuals with mental health conditions, had subjective and/or objective social isolation as their primary outcome, or as one of their outcomes if no primary outcome was specified. Feasibility studies were included if feasibility outcomes were the primary outcomes and social isolation was among their secondary outcomes. A narrative synthesis was conducted to present our findings. The protocol was registered on Open Science Framework (doi:https://doi.org/10.17605/OSF.IO/CNX8A). // Results: Thirty-two studies were included for our review: 16 feasibility studies, seven single-group studies and nine effectiveness trials. There was great variation in the interventions, study designs and sample populations. Interventions included web-based programmes, phone-based programmes, blended interventions, socially assistive robots and virtual reality interventions. Many were feasibility studies, or otherwise not fully powered to detect an effect if one were present, thus preventing clear conclusions about clinical effectiveness. Satisfactory feasibility outcomes indicated potential for future trials to assess these interventions. // Conclusion: Our scoping review identified a range of digital approaches utilized to alleviate social isolation among individuals with mental health disorders. Conclusions regarding clinical effectiveness cannot be reached due to variability of approaches and lack of large-scale randomized controlled trials. To make clear recommendations for digital social isolation interventions, future research needs to be based on rigorous methods and larger samples. Future studies should also focus on utilizing theory-driven approaches and improving existing approaches to advance the field

Digital interventions for subjective and objective social isolation among individuals with mental health conditions: a scoping review

Background: Social isolation encompasses subjective and objective concepts. Both are associated with negative health consequences and are more prevalent among people with mental health problems than among the general population. To alleviate social isolation, digital interventions have potential as accessible alternatives or adjuncts to face-to-face interventions. This scoping review aimed to describe the types of digital interventions evaluated for feasibility, acceptability and effectiveness in alleviating social isolation among individuals with mental health problems, and to present an overview of the quantitative evidence yielded to inform future intervention design. // Methods: We searched five electronic databases for quantitative and mixed methods studies published between January 2000 and July 2020. Studies were included if they evaluated digital interventions for individuals with mental health conditions, had subjective and/or objective social isolation as their primary outcome, or as one of their outcomes if no primary outcome was specified. Feasibility studies were included if feasibility outcomes were the primary outcomes and social isolation was among their secondary outcomes. A narrative synthesis was conducted to present our findings. The protocol was registered on Open Science Framework (doi:https://doi.org/10.17605/OSF.IO/CNX8A). // Results: Thirty-two studies were included for our review: 16 feasibility studies, seven single-group studies and nine effectiveness trials. There was great variation in the interventions, study designs and sample populations. Interventions included web-based programmes, phone-based programmes, blended interventions, socially assistive robots and virtual reality interventions. Many were feasibility studies, or otherwise not fully powered to detect an effect if one were present, thus preventing clear conclusions about clinical effectiveness. Satisfactory feasibility outcomes indicated potential for future trials to assess these interventions. // Conclusion: Our scoping review identified a range of digital approaches utilized to alleviate social isolation among individuals with mental health disorders. Conclusions regarding clinical effectiveness cannot be reached due to variability of approaches and lack of large-scale randomized controlled trials. To make clear recommendations for digital social isolation interventions, future research needs to be based on rigorous methods and larger samples. Future studies should also focus on utilizing theory-driven approaches and improving existing approaches to advance the field

The role of school connectedness and friend contact in adolescent loneliness, and implications for physical health

JI was supported by the Medical Research Council (MC_UU_00022/1) and the Scottish Government Chief Scientist Office (SPHSU16). The HBSC 2013/14 study in Scotland was funded by NHS Health Scotland (now Public Health Scotland).The current study investigated how adolescents' loneliness relates to school connectedness, classmate support, teacher support, and offline and online communication with friends. We also examined the association between loneliness, physical health, and sleep. Data came from the Scottish Health Behavior in School-aged Children (HBSC). The total sample was 2983 adolescents (F = 1479 [49.6%]) aged 14-17 years (M = 15.66, SD = 0.39) from 117 secondary schools in Scotland. Results showed that (1) higher teacher support, classmate support, and offline contact with friends predicted lower levels of loneliness, (2) online friendship engagement predicted higher levels of loneliness, and (3) poor health and sleep were positively associated with loneliness. The study offers new findings, highlighting the role played by classmates/peers and teachers in reducing loneliness. Supporting previous research, we also found associations between loneliness, poor sleep, and worse physical health.Publisher PDFPeer reviewe

The efficacy of cognitive-behavioural group therapy for loneliness via inter-relay-chat among people with physical disabilities

This study examines the efficacy of psychotherapeutic services via computer-mediated communication (CMC). Its main purpose is to determine if goal-oriented cognitive-behavioural group teletherapy via IRC can reduce feelings of loneliness among chronically lonely people with physical disabilities. Using a comparison design with pretest, post-test, follow-up and waiting-list control, 19 participants formed seven groups of 2–3 people. Participants completed an in-person individual assessment during which individualized therapeutic goals were enumerated. They also attended twelve 2-hour group intervention sessions via inter-relay-chat (IRC). Results indicate that participants felt less lonely after intervention. Moreover, participants who completed intervention felt less lonely at post-test than a similar group that had been placed in a waiting-list control. Furthermore, results indicate that gains were maintained at a 4-month follow-up. The results of this study are discussed, along with participants' comments about the intervention, its practical implications and some special considerations for teletherapy, as well as future directions for research

Understanding the Influencing Factors and Mechanism of Social Compensation for Chinese Older Adults Using Social Media in the Context of Smart Home: A Qualitative Analysis

As a new generation of necessary terminals for future homes, smart homes have become one of the essential mediums for smart aging at home. This paper aims to explore how older adults who age at home can overcome the digital divide of the new medium and achieve social participation in the home context to realize active aging. Based on the theory of social compensation, we select the smart-home smart screen, a representative new medium product in China, and carry out open coding, spindle coding, selective coding, and theoretical construction of the original interview data through the grounded theory research method. The results show that the main factors affecting the social compensation of older adults to smart home social media include user interface quality, interaction quality, content quality, and service quality, and these four factors are used as external variables to compensate older adults socially, thereby stimulating the emotional experience and perception changes at the cognitive level of older adults and then affecting the adoption and acceptance of smart home social media by older adults. This study refines the factors influencing the older adults' use of smart home social media from the perspective of social compensation. It explains the mechanism of acceptable behavior of older adults, bridging the gap in previous literature on the influencing factors and behavioral mechanisms of older adults of smart home social media. This paper provides a theoretical basis and guidance for the subsequent academic research and software development practice of social media under new technological devices to further help older adults in China achieve active and healthy aging

Towards a better understanding of loneliness in autistic adults: examining measurement tools and lived experiences

Loneliness is a universal feeling that people might feel when there is a gap between the ideal and actual states of their social relationships. Historically, it has been thought that autistic people do not have a desire for social connection and instead show a preference for aloneness. However, recent research, coupled with first-hand accounts of autistic individuals, has shown that not only do autistic people experience loneliness, but they may be particularly vulnerable to it (e.g., due to the challenges they experience in social environments and/or due to a lack of supportive environments in which to cultivate social relationships). To date, there has been limited research on loneliness in autistic adults. In this thesis, I used both quantitative and qualitative methods to further our current understanding of loneliness in autistic adults, with a focus on examining the measures used to assess loneliness in autistic adults, as well as autistic people’s lived experiences of loneliness. In Chapter One, I introduce my motivation for this research as a neurodivergent individual and provide an overview of research into both autism and loneliness. In Chapter Two, I use a systematic review to synthesise the current evidence base on loneliness in autistic adults, and to identify gaps in research that can guide subsequent work. In Chapter Three, I use mixed-methods to examine if, and how accurately, existing measures of loneliness capture the experiences of autistic adults. In Chapter Four, I use qualitative methods to explore the unique experience of loneliness in autistic adults. In Chapter Five, I use mixed- methods to investigate experiences of loneliness in autistic adults before, and during the early stages of, the COVID-19 pandemic. In Chapter Six, I discuss the contributions of my research to knowledge on autistic adults’ experiences of loneliness, outline future directions for such work, highlight the strengths and limitations of my research, and present my personal reflections

An investigation of simulated and real touch on feelings of loneliness

As a social species, humans deprived of contact find loneliness a potentially distressing condition. Recent research emphasises the influence of touch on alleviating loneliness. This research found that touch reduces feelings of neglect, a subscale of loneliness. Affectionate touch, which demonstrates care or affection, has been previously linked to well-being in couples. Here, we investigated whether the effect of simulated touch during a video conversation might be sufficient to influence feelings of loneliness. Sixty participants answered a survey about their home life and relationships, including items that assessed the frequency of touch and feelings of loneliness. Following this, they participated in an online video call with three conditions: audio only, audio and video, or audio, video with simulated touch (a virtual ‘high-five’). Finally, immediately after the call, they repeated the loneliness questionnaire. We found that loneliness scores were reduced following the call, but there was no difference among conditions and no effect of a virtual touch. However, we did find a significant association between the frequency of touch in a relationship and the expression of loneliness, with individuals in low-touch relationships having loneliness scores more comparable to single participants than to those in high-touch relationships. Additionally, extraversion played a major role in moderating the effect of touch in relationships. These results emphasise the importance of physical contact in lowering feelings of loneliness within relationships and the ability of calls to lower feelings of loneliness, regardless of whether they include video or simulated touch

Social connections, cognitive reserve, and cognitive function in later life

Background: Good social connections have been identified as a factor that may be associated with healthy cognitive function in later life. In line with cognitive reserve theory, good social connections may provide mental stimulation through complex interaction with others and hence build cognitive reserve and maintain healthy cognitive function. However, there is considerable inconsistency in findings reported by studies that examine this association. Inconsistency in findings may be attributed to the heterogeneity of concepts potentially associated with social connections and to the variation in approaches to measuring and defining these concepts. Aims: To assess the association between aspects of social connections and cognitive function in later life. This thesis introduces a novel element by considering the moderating role of cognitive reserve in this association. Method: A scoping review was conducted to establish which concepts are used within the literature to describe social connections and how these are measured and defined. Next, a systematic review and meta-analysis was conducted to identify evidence regarding the association between social isolation and cognitive function in published studies. Empirical work was conducted using cross-sectional and longitudinal data from the Cognitive Function and Ageing Study–Wales (CFAS-Wales) to determine the associations between social isolation, cognitive reserve, and cognitive function in healthy older people. Extending this approach further, these associations were examined in two groups potentially at risk of social isolation: older people with depression or anxiety and older people living alone. Finally, empirical work was completed using the Platform for Research Online to investigate Genetics and Cognition in Ageing (PROTECT) to assess how satisfaction with social contact may be associated with cognitive function compared to a structural measure of isolation. Results: A lack of social connections was associated with poor cognitive function in later life. For people with depression or anxiety, these associations may be better explained by mood-related symptoms than social connections. People who live alone in later life were at no greater risk of poor cognitive function compared to those living with others. Satisfaction with social contact was associated with poor cognitive function but a structural measure of social isolation was not. Conclusions: Social connections play an important role in building cognitive reserve and protecting people against poor cognitive function in later life. People who are vulnerable to social isolation have different needs to those who are less vulnerable. Satisfaction with social contact is often neglected in measures that assess structural aspects of social connections but may be a better predictor of cognitive function

Self-esteem and Social Media Dependency: A Comparative Analysis of Welsh- and English-Medium Pupils’ Perceptions

Despite not being officially recognized as an addiction, studies suggest social media dependency [SMD] retains similar traits as substance-based addictions and that adolescents are a group particularly at risk. Studies have shown significant positive correlations between SMD and depression, loneliness, and social anxiety. SMD has also shown a significant negative association with self-esteem. Research has yet to explore these relationships within a minority versus majority language comparative context, which is the objective of the thesis. The thesis used cross-sectional and longitudinal analyses (three equally-spaced timepoints over nine-months) incorporating quantitative and qualitative designs. There were 1,709 participants (Welsh/Bilingual-medium schools = 844; English-medium schools = 865) aged 12- to 15-years with a mean age of 13.61 years (standard deviation ±.933). All schools were State-maintained and located within Wales. At timepoint one, five Welsh/Bilingual- and four English-medium schools took part. Two Welsh/Bilingual-medium schools dropped out after timepoint one. SMD analysis (Chapter Four) showed a difference between school types but no difference between Welsh/Bilingual-medium attending first language Welsh- [FLWs] and English-speakers [FLEs]. The suggested reason for the difference between the school types was a marginalization of Welsh/Bilingual-medium FLWs’ and FLEs’ first languages within the social media and school environments, respectively. A difference in self-esteem (Chapter Five), depression, loneliness, and social anxiety (Chapter Six) scores was shown for FLWs and FLEs, also, with FLEs showing the poorer scores. The suggested reason was FLWs benefiting in terms of social identification processes and close affiliation to the Welsh language, culture, and community. Structural equation modeling [SEM] (Chapter Seven) indicated that first language mattered whenever SMD predicted self-esteem, depression, loneliness, and social anxiety. Longitudinal analyses (Chapter Eight) showed no difference in FLWs’ and FLEs’ SMD representation at low, medium and high levels over time, but a greater number of FLEs were represented at low self-esteem levels over time. Qualitative analysis (Chapter Nine) suggested FLWs identified a greater array of technical barriers to using Welsh on social media. In conclusion, the suggestion is an individual’s first language matters regarding self-esteem, depression, loneliness, and social anxiety, but not SMD. However, whenever SMD acts as a predictor variable, an individual’s first language appears to play a pivotal role