Even before the pandemic, social isolation and loneliness were described as significant public health problems. What experts began calling a “loneliness epidemic” has only worsened since that time. Recent surveys indicate that approximately half of U.S. adults report experiencing loneliness, with some of the highest rates among young adults. In May of this year, the United States Surgeon General Dr. Vivek Murthy released a new Surgeon General Advisory calling attention to the public health crisis of loneliness, isolation, and lack of connection in our country and highlighting the deleterious effects of loneliness on our health and well-being.
Daphne Holt, MD, PhD, Co-Director of the MGH Psychosis Clinical and Research Program and her colleagues have been studying social functioning and behaviors in adults with psychosis. Their research has focused on personal space, the preferred or most comfortable distance that one individual maintains in relationship to another nearby person. Like eye contact and facial expressions, personal space is an important component of social communication.
In social settings, some individuals with schizophrenia have a tendency to keep themselves at a distance and may be more comfortable with a larger personal space. This type of social distancing or withdrawal may convey a lack of desire for social connection; however, previous studies have observed that loneliness is commonly reported in this population. One study reported that the prevalence of loneliness in people with psychotic disorders was about 80% – more than twice the rate observed in the general population.
Some of the most debilitating aspects of schizophrenia and other psychotic disorders are impairments in social perception, motivation, and behavior. Ultimately these impairments can lead to social isolation and loneliness, factors that have been associated with poor cardiometabolic health and early mortality. However, the relationships between psychological and neurobiological impairments in social perception and motivation and social isolation and loneliness in individuals with psychosis remain incompletely understood.
Holt believes that abnormalities in the processing of social information may contribute to social distancing in individuals with psychotic disorders and may also play a role in isolation and loneliness. She is hopeful that interventions targeting these abnormalities may help to improve social functioning and improve overall outcomes in those with schizophrenia.
Holt and her team at MGH, in collaboration with Daniel Fulford, PhD from Boston University, are now recruiting for a study examining loneliness in individuals with serious mental illness and healthy individuals. They plan to use a variety of neuroimaging techniques to better understand the changes in brain function and connectivity associated with social isolation and loneliness and to elucidate, in individuals with psychotic disorders, how abnormal responses to social stimuli are linked to isolation and loneliness. This study will also measure transient changes in social isolation and loneliness using smartphone assessments. They also hope to determine how markers of social isolation and loneliness affect real-world functioning, as well as cardiometabolic health and immune function. Ultimately a more nuanced understanding of social dysfunction in psychosis and related experiences of isolation and loneliness may provide the basis for novel approaches for preventing or treating deficits in social behaviors and reducing functional disability and poor physical health that diminish the quality and length of life for many individuals with severe mental illness.
You can learn more about this study by contacting Daniel Johnson by email at [email protected] or at (617) 643-2726. Additional information on the study can also be found HERE.
Read More
Fulford D, Holt DJ. Social Withdrawal, Loneliness, and Health in Schizophrenia: Psychological and Neural Mechanisms. Schizophr Bull. 2023 Jul 7.
Holt DJ, Boeke EA, Coombs G 3rd, DeCross SN, Cassidy BS, Stufflebeam S, Rauch SL, Tootell RB. Abnormalities in personal space and parietal-frontal function in schizophrenia. Neuroimage Clin. 2015 Aug 6;9: 233-43. Free article.
Zapetis SL, Nasiriavanaki Z, Luther L, Holt DJ. Neural Correlates of Variation in Personal Space and Social Functioning in Schizophrenia and Healthy Individuals. Schizophr Bull. 2022 Sep 1; 48(5):1075-1084.
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Alone in the Crowd (Harvard Medicine)
Daphne Holt, MD, PhD is the Co-Director of the MGH Psychosis Clinical and Research Program, Director of the MGH Resilience and Prevention Program, and an Associate Professor in Psychiatry at Harvard Medical School. Using functional neuroimaging in combination with physiology, behavioral tasks and clinical assessments, she has investigated the neurocognitive basis of the core symptoms of psychotic illness, including delusions, negative affect and social impairment. Her research has also focused on identifying changes in brain function and behavior linked with risk for serious mental illness and has been developing novel interventions to increase resilience and potentially prevent serious mental illnesses in at-risk youth.
