Lonely, socially integrated, or supported?: Overlap and uniqueness of constructs and how they are (often) measured

Lonely, socially integrated, or supported?: Overlap and uniqueness of constructs and how they are (often) measured

(This is partly written in response to comments on another post http://goo.gl/RFI2ng ) 

Bei Bei, there are many ways to measure loneliness, and even the definition can be somewhat nebulous as there are a number of closely related (or perhaps dimensions of the same) construct.  Words used include: loneliness, social support, social isolation, social integration, social connection, and social networks.  Frequently, the same concept may be described from the opposite angle (e.g., lonely vs. socially connected).  A second aspect is whether the measurement is objective (e.g., size of social network; number, frequency, or length of social contacts) or subjective (e.g., I get to talk with friends as much as I want).

Unfortunately, the scientific literature is often not very consistent in the use of terminology.  For example, studies may talk about isolation, but the measure is a subjective measure of social support, and the direction is simply reversed.

By far the most frequently assessed is what I would consider subjective perceptions of social support.  For example, people would be asked to rate how much they agree with the following statements:

Social Provisions Scale; Russell & Cutrona, 1984

“There are people I can depend on to help me if I really need it.”

“I feel part of a group of people who share my attitudes and beliefs.”

“I lack a feeling of intimacy with another person.”

Medical Outcomes Study Social Support Survey; Sherbourne & Stewart, 1991

“People sometimes look to others for companionship, assistance, or other types of support. How often is each of the following kinds of support available to YOU if you need it?” (ranging from none of the time to all of the time):

“Someone you can count on to listen to you when you need to talk”

“Someone to love and make you feel wanted”

Sources of Social Support Scale; Carver, 2006

 “How much does your partner listen to and try to understand your worries about __?” (originally used for women in the context of breast cancer, so was worry about cancers, but has been adapted to other cases)

But there are other self-report scales that focus less on support, such as

New York University Loneliness; Rubenstein & Shaver, 1982

“How often do you feel lonely?”

“When I am completely alone, I feel lonely.”

If you were to look at the correlations between scales measuring social support and loneliness (or isolation, or, …) they are quite strong, pearson correlations ranging from .5 to .8.  This is not terribly surprising, given that if you “lack a feeling of intimacy with another person” you probably also “feel lonely”.  Conversely, if you “always have someone to love and make you feel wanted”, you are probably do not feel very lonely.

As is frequently the case, correlations between subjective and objective measures are typically much lower than between subjective measures.  That is, counting the number of friends a person has, or counting the number of different people someone knows in different categories (e.g., how many work friends, how many personal friends, how many family members you talk to in a week) or how frequently you have interactions with people in different domains, does not correlate as highly with subjective measures.

Plausibly, there are a number of reasons for this.  There may be so-called common method bias.  That is, subjective measures may be more related to each other because they are all filled out by the person, and that person may consistently over (or under) estimate.  Another difference is that in subjective measures, a person has the opportunity to incorporate individual differences.  For example, as Jorah Lavin commented, some individuals may feel alone even in a crowd of people, whereas for others being in a large group may make them feel well connected.  Consequently, simply finding out the quantity of social interactions, may not capture the feeling of connection (or of isolation and loneliness).  To address this, sometimes researchers will attempt to assess not only the quantity of social connections, but also the quality.  Objective indices could include time spent together.  Or some combination of objective (quantity, frequency, and time) plus subjective (e.g., how close are you to person XX).  Indeed, individual differences can be to the point where some people feel better when they are alone.  Individual differences in desire for many contacts and large social engagement versus more alone time is partly captured by extraversion (or the opposite, introversion; which is one of the core factors in the Big 5 theory of personality).

So getting back to the question of how loneliness is measured, it depends**.  If one operationalizes loneliness objectively as quantity, frequency, and time spent with other people, then as you said it really is not about feelings of loneliness.  Other approaches just ask people to report their feelings of loneliness.  This is nice in that it really captures each individuals experience (rather than shoving everyone into a cookie cutter mold), but the downside is that as other aspects of the person change (for example, becoming depressed), feelings of loneliness may change, regardless of how much support or presence of others is actually there.

The research I have read suggests that objective measures of social connection with people defined as close friends or partners, rather than measures for everyone, or even measures of time with adult children or other family, that is most strongly correlated with subjective perceptions of loneliness.  This supports the notion that a crowd of people, but perhaps not including any close friends may not make one feel less lonely; but that even having one close friend or partner who you can spend a lot of time with may dispel feelings of loneliness.

Getting to Nomen Kultur’s comment, having some time away from people, alone, or quiet time is not the same as feeling or being lonely.  Typically, even with quite extraverted individuals who both have a lot of social contact and do not feel lonely, they still spend some time alone.  For relatively more introverted individuals, this is even more true.

This brings us to the topic of why do people feel lonely?  If it is not the mere presence of others, what is it?  Theories of loneliness (and social support, and …) often draw from attachment theory and also from evolutionary theory.  My knowledge of attachment theory is comparatively poor, so I will focus on evolutionary theory.  The argument goes something like this:

Human beings are social creatures.  To reproduce and even at other times to maximize survival, we rely on the presence of others.  In a hunter-gatherer society, if you were excluded from the tribe, and had to provide your own shelter, gather/hunt your own food, fend of wild animals or other enemies alone, this would be virtually a death sentence.  Even being relegated to the sidelines could mean less access to partners to reproduce with, less resources for children you did have (threatening their survival), etc.  Consequently, there should be selection for developing and maintaining social connections.

Jumping away from general ideas about why it happens, we can think about how it happens.  Lab studies (fMRI) suggest that being socially rejected actually triggers activity in the same brain regions (notably the dorsal anterior cingulate cortex) that process the affective (not proprioceptive) component of physical pain.  Being isolated literally hurts.  Conversely, “reward” centers in the brain activate with social connection and closeness.  These two processes serve to reward actions that result in developing and maintaining social bonds, and motivate to avoid actions that would jeopardize those (pain is a powerful motivator).

Virtually everyone would feel lonely in the complete absence of social connections and contact.  However, considering individual differences the amount or quantity needed varies.  One way to think of subjective or perceived loneliness, is when there is a discrepancy between the amount of connection and closeness desired and that actually obtained.  For some people, one or two close friends seen each week may be sufficient, whereas others may need daily contact.  In either case, we would expect feelings of loneliness to increase as the discrepancy between desired and obtained levels increases.

Depression prospectively predicts social withdrawal, so there is good reason that depression and loneliness co-occur.  At the same time, there is an affective component to depression.  Other literature suggests that affect can regulate the experience and perception of things, including pain.  For example, people’s mood changes how distressing or uncomfortable physical pain is in lab studies where the objective experience is identical.  Making a conceptual leap:

1) induced mood regulates affective experience of physical pain

2) Social rejection activates the same brain regions that process physical pain

3) It seems plausible that mood could regulate the affective experience of social rejection (actually, I think there may be some research here, but I just do not know it off hand).

In theory, if one was interested in “just” loneliness.  You could try to estimate separately how much objective change in social integration is associated with depression, what the relation of mood/affect is to feelings of loneliness, and then, you could use those estimates to control out the effect of depression on perceptions of loneliness via mood/affect (but not via objective changes in social integration, i.e., do not control out the fact that depressed people also tend to socially withdraw).  The exercise would be difficult, and I am not clear what great insight it would yield, but would be fascinating nonetheless.  Of course, social withdrawal probably also leads to changes in affect, potentially very quickly, so properly assessing depressions effect on affect directly versus via social withdrawal which then affects affect would be even more challenging.

Some Links

Sources of Social Support Scale: http://www.psy.miami.edu/faculty/ccarver/sclSSSS.html

New York University Loneliness: http://ajeducation.com/psy/quizes/lonely.htm

**I love giving that answer.  It is so deliciously true, and yet utterly unsatisfying to the asker.

#psychology #loneliness #measurement

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