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Loneliness and Social Isolation

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de Jong Gierveld, J., van Tilburg, T.G., & Dykstra, P.A. (2006). Loneliness and
social isolation. Inhandbook
In: Cambridge D. Perlmanof&personal
A. Vangelisti (Eds.), The
relationships Cambridge handbook
/ A.Vangelisti and of
personal relationships
D.Perlman, (pp. 485-500).
eds. Cambridge: Cambridge,
Cambridge UK: Cambridge
University University
Press, 2006. - p. Press.
ISBN-13
485-500. 978-0-521-82617-4 hardback; 978-0-521-53359-1 paperback

CHAPTER 26

Lonelinessand SocialIsolation

Jenrryde JongGierueld
Theouan Tilburg
PearlA. Dvkstra

Given that all people seek happiness and all
people desire to be huppy, the feelings of
loneliness as registered among adolescents,
young adults (Marcoen, Goossens, & Caes,
tg87; Sippola & Bukowski, 1999), midlife
and older adults (see among many others,
Lopata, 1996) reveal a major problem
in society. Although there is a general
core to loneliness - the evaluation of a
discrepancy between the desired and the
achieved network of relationships as a neg-
ative experience - the forms of loneliness
and their antecedents vary enormously
according to personal and contextual deter-
minants. Despite the fact that loneliness
is not treated as a specific clinical entity
[Mijuskovic, ryg6), Russell, Peplau, and
Cutrona [r98o) presented evidence on the
uniqueness of loneliness as a phenomenon
in its own right. After being largely ignored
by social scientists until the mid-zoth
century, an ever-increasing flow of work
sincethe r97os amply testifies to the utility
of loneliness as an important concept.
This chapter addresses the concepts of
loneliness and social isolation using theo-
retical ideas and empirical evidence from
various sources and disciplines including
psychology, sociology, and anthropology.
The Concepts of Loneliness and
Social Isolation
Loneliness
The oldest publication about loneliness is
Ubt, die Eínsamkeít (Zímmermann, ry8j-
1786). More recent effiorts to conceptual-
ize loneliness started in the r95os with the
"Loneliness"
publication by Fromm Reich-
man (r9;q). Empirical researchinto loneli-
nesswas supported by the efforts of Perlman
and Peplau (r98r), who defined loneliness
as
"the
unpleasant experience that occurs
when a person's network of social relations
is deficient in some important way, either
quantitatively or qualitatively" [p. ]r). A
second definition of loneliness, frequently
used in European countries, is formulated
as follows:
Lonelmessis a situation experiencedby
the indiuidual as one where there is
an unpbasant or inadmissible lnck "f

+8s
 486 THE CAMBRIDCE HANDBOOK OF PERSONAL RELATIONSHIPS

(quality ofl certain relationships. This

[r98r) developed a cognitive or cognitive is characl
includes situations, in which the number discrepancy theoretical approach to loneli- ness, ab:
of existing relationships is smaller than ness that focuses on the subjective evalua-
is consiàereddesirable or admissible, as rype of I
tion of relationships in association with the ing a ner
well as situations where the intimacy one
personal standardsfor an optimal network of port fror
wishesfor has not beenrealized. (De Jong
Gieruelà,gB7, p. no) social relationships. The cognitive approach pensate
also considers the activities a person might
[stroebe
Central to both definitions is that loneliness undertake to restore the imbalance between r 9 9 6 ) .T
is a subjective and negative experience, and the actual and the ideal situation. Thus, to the
the outcome of a cognitive evaluation of the a person's position on the subjective con- friends v
match between the quantity and quality of tinuum is affected not only by the type, Weiss [r
existing relationships and relationship stan- nature and the saliency of the contacts reportec
dards. The opposite of lonelinessis belong- missed, but also by the time perspective moved t
ingnessor embeddedness. required to "solve" and upgrade problematic ers. The:
relationships, and the capacities to change intimate
Social Isolation the situation. by the
Social isolation concerns the objective char- others r,
acteristics of a situation and refers to the Typ"t ofLonekness tion bet
absenceof relationships with other people. has aga
The central question is this: To what extent Severalcomponents of lonelinesscan be dis- ]ېfs, f,

is he or she alone? There is a continuum tinguishe d. Zimmerman Q7 8 5/ ry 86) difFer- to bettt

running from social isolation at the one end entiated between a positive and a negative express
to social participation at the other. Persons type of loneliness.The positive type of lone- Giervel
with a very small number of meaningful ties liness is related to situations such as the & Van'
are, by definition, socially isolated. Loneli- voluntary withdrawal from the daily has- Jong G
ness is not directly connected to objective sles of life and is oriented toward hlgher Smit, {
social isolation; the associationis of a more goals: reflection, meditation, and commu- and En
complex nature. nication with God. Nowadays, the posi-
[SELST
tive type of loneliness is more frequently Ernst 8
The Relationship Behaeen Social Isolation referred to by a separate concept: privacy. valid ar
and Lonekness Privacy is voluntary; it concerns a freely emotic
chosen situation of [temporary) absence of section
Loneliness is but one of the possible out- contacts with other people. The negative
comes of the evaluation of a situation type of loneliness is related to an unpleas-
characterized by a small number of rela- ant or inadmissible lack of personal rela- Meast
tionships. Socially isolated persons are not tionships and contacts with important oth- Loneli
necessarilylonely, and lonely personsare not ers, as formulated in the definitions given in Lone1
necessarilysocially isolated in an objective this chapter. This is the concept of loneli- those r
sense.An individual who is well positioned ness that is nowadays used in theories and feelinl
in terms of objective social participation can research. Moreover, it is the type of lone- [Borys
occupy virtually any position on the subjec- liness that best fits the everyday concept defici<
tive continuum. Where a person ends up of loneliness. alwayr
on the subjective continuum depends on Weiss (rW ZJ differentiated between emo- direct
his or her relationship standards.Some peo- tional loneliness,stemming from the absence "lc
oÍ
ple with a small number of social contacts of an intimate figure or a close emotional likely
might feel lonely; others might feel sufÊ- attachment [a partner, a best friend), and loneli
ciently embedded. An example of the latter social lonelinessstemming from the absence ing a
situation is that of a person who prefers to be of a broader group of contacts,or an engag- other
alone and opts for privacy as a means toward ing social network [friends, colleagues, and In dl
avoiding undesired social contacts and rela- people in the neighborhood). Emotional mentr
tionships. Acknowledging the importance of loneliness ariseswhen a partner relationship that 1
relationship standards, Perlman and Peplau dissolvesthrough widowhood or divorce and loneli
 LONELINESS AND SOCIAL ISOLATION
is characterized by intense feelings of empti-
ness, abandonment, and forlornness. This
type of loneliness is only solvable by start-
ing a new intimate relationship. Social sup-
port from family and friends cannot com-
pensate the loss of the attachment figure
(Stroebe, Stroebe, Abakoumkin, & Schut,
ryg6). The socialtype of lonelinessis related
to the absence of a wider network of
friends with common interests. According to
Weiss (rgll), social loneliness is frequently
reported by young homemakers, who have
moved to an area where they are newcom-
ers.Their husbands,however supportive and
intimate, cannot fill the gap that is caused
by the absence of a group of friends and
others with whom to socialize. The distinc-
tion between social and emotional loneliness
has again been gaining attention. In recent
years,researchershave used the two types
to better understand the determinants and
expressionsof loneliness.Both the De Jong
Gierveld lonelinessscale [De Jong Gierveld
& Van Tilburg, r999a, rgggb; Dykstra & De
JongGierveld, zoo4; Van Baarsen,Snijders,
Smit, & Van Duijn, zoor) and the Social
and Emotional Loneliness Scale for Adults
(SELSA); [DiTommaso & Spinner; r9g3;
Ernst & Cacioppo, 1999) have proved to be
valid and reliable measuring instruments for
emotional and social loneliness(seethe next
section for addiUonal information').
Measuring Instruments
Loneliness has a negative connotation.
Lonely people carry a social stigma. For
thosereasonsit is embarrassingto talk about
feelings of loneliness, in particular for men
[Borys & Perlman, 1985), and people with
deficiencies in their relationships do not
always admit to being lonely. The use of
"lonely"
direct questions including the words
"loneliness"
or to investigate loneliness is
likely to result in underreporting. Some
loneliness scales consist of items exclud-
ing any reference to loneliness, whereas
other scalesinclude one or more such items.
In discussing different measuring instru-
ments, Shaver and Brennan [r99rJ argued
that the exclusion of explicit references to
loneliness gives rise to disagreements on
+Bt
content validity. In their view, it is unclear
whether one is measuring relationship sat-
isfaction or loneliness. We disagree: Many
instruments are validated by showing they
correlate with self-reports of loneliness. We
describe two loneliness scales that have
no explicit references to loneliness and
have been used in many research projects
[Pinquart & Sórensen,zoorb].
The UCLA Loneliness Scale [Russell,
Peplau, & Cutrona, r98o) has been trans-
lated into several languages.In the original
version, all the items were worded in a neg-
"lonely"
ative or direction. Becauseof con-
cerns about how the negative wording of
the items might affect scores [i.e., response
sets),a revisedversion of the scalewas devel-
oped that included items worded in a lonely
and a nonlonely direction. The wording of
the items and the response format have
been simplified to facilitate administration
of the measure to lesseducated populations
fRussell, ryg6).
De Jong Gierveld and colleagues con-
ducted qualitative research as the first step
in developing a loneliness scale. The r9B5
version (De Jong Gierveld & Kamphuis,
r9B5; De Jong Gierveld & Van Tilburg,
r999a) consists of rr items. Five items are
positively phrased, and six are negatively
phrased. The reliability and homogeneity
of the scale have proven to be satisfac-
tory in different Dutch samples adopting
difterent modes of data collection [Van
Tilburg & De Leeuru, i99r). Using the scale
in self-administered questionnaires results
in higher scale means than if the scale
is used in face-to-face or telephone inter-
views (De Leeuw, rggz). This finding is in
line with Sudman and Bradburn's (rgl +)
observation that, compared with interviews,
the more anonymous the setting in which
selÊadministered surveys are completed,
the more the results show self-disclosure
and reduce the tendency of respondents to
present themselvesin a favorable light. The
De Jong Gierveld scale was not developed
to assesstypes of loneliness but rather to
measure the severity of feelings of loneli-
ness.Researcherscan chooseto use the scale
as a one-dimensional measure. As a whole,
the scale is moderately, yet sufficiently
488 THE CAMBRIDGE HANDBOOK OF PERSONAL RELATIONSHIPS

homogeneous. The items were, however; suring instruments and research into the alwa
developed with Weiss's (tgl1J distinction determinants of loneliness became more or Pers
between social and emotional loneliness "standardized."
less From that point in time, most
in mind. For that reason, researcherscan loneliness researchin different regions of the very
choose to use two subscales(one for emo- world has been largely comparable in terms spea
tional and one for social loneliness) that have of design and theoretical modeling. Draw- ner t
moderate intercorrelations. ing on the cognitiue approach to loneliness lonel
(Dykstra & De Jong Gierveld, rgg4; Perlman bonc
& Peplau, r98rJ, analysesfocus on subjec- Shah
Conceptual Approaches to tive experiences and on cognitive processes St
Understanding Loneliness that mediate the association between rela- abse
tionship characteristicsand the experience peotr
of loneliness.A shortageof achieved ascom- a kel
Several theoretical approaches have been
pared with desired relationships does not worl
used for analyzing loneliness [Derlega &
directly and inevitably lead to loneliness but posil
Margulis, ry82; Perlman & Peplau, r98r).
is first perceived and evaluated. Social com- with
Weiss (rgl+), a leading proponent of the
parisonsare key to this process.For example, Sóre
attachment perspective, suggestedthat there
social comparison may affect how large and sma
are different provisions of relationships (e.g.,
important a social deficit is believed to be partt
attachment, senseof worth, etc.), each asso-
(Perlman & Peplau, r98r). p€fSt
ciated with a specific type of relationships.
Researchers adopting the cognitive and,
He contended that as long as the provider
approach typically include the following towt
is trustworthy, we can obtain guidance and
characteristicsin their models: [aJ descrip- livin
assistance,often needed during stressful sit-
tive characteristic.s of the social network dissc
uations, and in alleviating loneliness. The
(intimate relationships aswell asthe broader who
main approaches to loneliness focus on
group of acquaintances,colleagues,neigh- parL
individual-level characteristics that predis-
bors, and extended hrJ; ft) relationship and
pose people to become lonely or to persist
standards, [.J personality characteristics are I
in being lonely [Marangoni & Ickes, 1989;
Rokach & Brock, ryg6).ln our view, greater [".g., social skills, selÊesteem, shyness, [Lor
anxiety, introversion); and (d) background ofd
insight into loneliness will be gained by
characteristics (".g., gender and healthJ. cont
bringing together individual level character-
First, we addressvarious components of the inm
istics and contextual characteristics. Exam-
network of social relationships. ings
ples of the latter are sociocultural factors and
sociostructural characteristics of the individ-
& t
unÍ
ual's environment. In this section, we start MARITAL AND PARTNER STATUS
reso
with a description of the individual level
From Durkheim onward, marriage has ings
factors contributing to loneliness. We con-
been seen as an avenue toward alleviat- shor
tinue with the sociocultural factors that con-
ing social isolation and loneliness.Research ship
tribute to loneliness, more specifically, the
has repeatedly shown the protective effect abo'
social standards. Finally, the sociostructural
of an intimate partner bond on the phys-
factors modulating the risks of loneliness are
ical, financial and mental well-being of
addressed, particularly the socioeconomic KIN F
both men and women [Waite & Gallagher,
characteristics of the contextual setting.
zoooJ. Although, in Western and Northern Invc
"ne\M"
Europe partnerships such as consen- part
The Cognitiue Approach to Lonekness
sual unions and "living apart and together" lone
(Individual Leuel)
relationshipsare becoming increasinglypop- the
Thanks to the efforts of Peplau and Perlman ular, it is the content and not the form of ilY, I
[1982) who, at the end of the r97os,brought the partner bond that matters (Coleman, ical
together loneliness researchers from the Ganong, & Fine, 2ooo; De Jong Gierveld, mai
United States, Canada, and Europe, mea- 2oo4; Dykstra, zoo4). A partner does not stre
 LONELINESS AND SOCIAL ISOLATION
always provide protection against loneliness.
Persons with a partner who is not their
most supportive network member tend to be
very lonely 0á" Tilburg, 1988). Generally
speaking, howeveq persons with a part-
ner bond tend to be better protected from
loneliness than persons without a partner
bond [Dannenbeck, r995; Wenger, Davies,
Shahtahmasebi,& Scott, r996).
Several mechanisms can explain why the
absenceof a partner in the household makes
people more vulnerable to loneliness. First,
a key structuring influence in the social net-
work is missing: The size and broader com-
position of the network are strongly linked
with the presence of a partner (Pinquart &
Sórensen,zoora). Personsliving alone have
smaller networks than those living with a
partner. Second, when help is needed, the
persons living alone lack in-house support
and, by definition, have to orient themselves
toward others outside the household. Third,
living alone is, in many cases,the result of the
dissolution of a partner relationship. Those
who remain alone after the death of the
partner are specifically at risk of loneliness,
and the effects on the intensity of loneliness
are recognizable over a long period of time
(Lopata, ryg6; Stevens,rg8gJ. The effects
of divorce on loneliness are also known to
continue over long periods of time: Divorce
in middle adulthood continues to affect feel-
ings of loneliness even at older ages(Dykstra
& De Jong Gierveld, zoo4). Remarriage,
unmarried cohabitation, and dating help to
resolve loneliness to a certain extent. Find-
ingsreported by Petersand Liefbroer [1997)
show that previous disruptions of partner-
ships have an efFect on loneliness over and
above current partner status.
KIN RELATIONSHIPS
Involvement in relationships other than a
partner can also help to prevent or alleviate
loneliness.Hagestad [r98r, 1998) described
the socially integrative role of the fam-
ily, arguing that communication and histor-
ical conversations across generations help
maintain continuity across life phases and
strengthen a senseof belonging. The central-
+89
ity of the parent-child bond in people's lives
is undisputed [Rossi & Rossi, r99o). Adult
children are an important source of compan-
ionship, closeness,and sharing, particularly
for those who live alone. Dykstra [1993) and
Pinquart (zoo1J have shown, for example,
that contacts with children are more likely
to reduce loneliness among formerly married
than among married older adults. Divorce
often impairs the relationship between par-
ents and children, especially in the case of
fathers (Kaufman &Uhlenberg, 1998;Kitson
& Morgan, rggo). The low level of contact
with adult children is the reason divorced
fathers tend to be lonelier than divorced
mothers fPinquart, zoo3). Siblings are spe-
cial in many ways (Bedford, r989; Cicirelli,
rggr; Connidis, 1989; Gold, 1987): There
is the common blood tie, the shared his-
tory of growing up together and of having
the same background. The loss of a sibling
has been found to contribute to loneliness
among older persons (Gold, rg8Z). Siblings
serve a particularly important function in
alleviating the loneliness of those who lack
the intimate attachment of a partner and
have no children (Pinquart, zooT).
NONKIN RELATIONSHIPS
The importance of friends for psychologi-
calwell-being is well documented (Blieszner
& Adams, r99z; Rawlins, rgg5): the joy of
spending time together, the compassion evi-
dent in keeping up with personal ups and
downs, and the exchange of ideas. Rela-
tionships with friends, colleagues,and other
nonkin relationships serve to connect peo-
ple to circles outside their immediate fam-
ily. The benefits of belonging to a set of
interlocking networks can lower the risks of
social loneliness [Connidis & Davies, r99o)
Wagner, Schutze, & Lang, r999J. More-
ove{, best friends can step in and function
as confidants and in doing so help allevi-
ate emotional loneliness, in particulaq, for
never partnered or childless adults [Dykstra,
rgg3; Pinquart, zoq). Involvement in
formal organizations is another source of
sociability: Church attendance, activities in
voluntary associations,and volunteer work
4go THE CAMBRIDGE HANDBOOK OF PERSONAL RELATIONSHIPS

bring people together and are a means of partner and start upgrading the advantages lone
forming attachments [Pilusuk & Minkleq of being single (Dykstra & De Jong Gierveld, ferer
r98oJ and in this way help to prevent or rgg4; Stevens,rgSq). In doing so, they free relu,
combat loneliness [Van Tilburg, De Jong the way for other relationships. The less dire,
Gierveld, Lecchini, & Marsiglia, r9g8). importance attached to having a partner, the tion
less lonely the widowed were found to be. r 9 85
SIZE AND COMPOSITION OF THE NETWORK for r
Generally speaking, as the number of rela- PERSONALITY CHARACTERISTICS nom
tionships in the social network increases Peoplewith poor social skills and psycholog- soci
and as the amount of emotional and social ical resources are likely to experience diffr- lines
support exchanged increases, the intensity culty developing and maintaining relation- 1999
of loneliness decreasesfVan Tilburg, r988). ships, and for that reason might feel lonely first
The four closest ties in a person's network [Windle & Woods, zoo4). Similarly, people
provide the greatest degree of protection with a neurotic or anxious personality might
HEAL
against loneliness.The protection provided harbor unrealistic relationship standards,
by additlonal relationships is marginal [Van and their unmet social needs might give rise Lon,
Tilburg, r99o). Diversity acrossrelationship to feelings of loneliness fcf Jones & Carver, mea
types also servesto protect againstloneliness. 199r). Feeling socially uncomfortable, fear are
People with networks composed of both of intimacy, being easily intimidated by sure
strong and weak ties are less prone to loneli- others, being unable to communicate ade- repc
ness than people with strong ties only [Van quately to others and developmental deficits Ha1
Tilburg, r99o). Moreove4,research(Dykstra, 200,
such as childhood neglect and abandonment
rygo; Silverstein & Chen, ryg6) has shown are reported by lonely people as the main ry9
that people with networks that consist causesof their feelings of loneliness (Rokach Wes
primarily or entirely of kin ties are more & Brock, 1996). Characteristicssuch as low The
vulnerable to loneliness than people with self-esteem, shyness and low assertiveness ciati
more heterogeneous networks. Those who can predispose people to loneliness and not'
are dependent on family members for social might also make it more difÊcult to recover rese
contacts because they lack alternatives tend from loneliness(Peplau & Perlman, r98zJ. nisrr
to have the highest levels of loneliness. lines
et a
GENDER
Lovi
RELATIONSHIPS STANDARDS
Chodorow [rqZ8) described the gender- ume
The cognitive approach to lonelinessempha- specific socialization of men and women, ness
sizes that people evaluate whether their arguing that men and women differ in the relat
relationships measure up to their standards. values they ascribe to different types of rela- an i.
Standards might be what a person aims for tionships. Men socialized to be emotion- lone
in relationships [".g., a certain degreeof inti- ally independent prefer undemanding rela- Tilbr
macy, of frequency of contactsJ. Standards tionships and tend to rely on their wives shov
might also be desires to have specific types and partners for social and emotional sup- ing s
of relationships [".g., an intimate partneq, port. Women are socialized to have more Poor
best friends, supportive colleagues). Stan- complex affective needs in which an exclu- and
dards develop over the course of life. Child- sive relationship to a man is not enough. NCSS
hood experiences shape needs and desires Results from a meta-analysis fPinquart & ally
for attachment (Bowlby, ry74), which are Sórensen,zoon) of roz studies that investi- noc
altered with new relationship experiences. gated gender difterences in loneliness show relat
Standards regarding partner relationships that women report significantly higher lev- sible
are a casein point. Researchhas shown that els of loneliness than men. This is more ciatir
over the course of time, men and women pronounced in studies in which loneli- (see
who have lost their partner by death start ness is measured with single-item indica- Lon<
downplaying the advantages of having a tors than for studies using higher quality inb
 LONELINESS AND SOCIAL ISOLATION
loneliness measuring instruments. This dif-
ference might be related to men's greater
reluctance to report loneliness in responseto
direct questions [see the measurement sec-
tion of this chapter; and Borys & Perlman,
rqSS). In multivariate analysescontrolling
for marital status, partner history, socioeco-
nomic factors, and the functioning of the
social network, the efFectof gender on lone-
liness decreases (Baltes, Freund, & Horgas,
1999) and becomes insignificant for those in
first marriages [Dykstra, zoo4).
HEALTH
Loneliness is associated with a variety of
measures of physical health. Those who
are in poor health, whether this is mea-
sured objectively or subjectively, tend to
report higher levels of loneliness (Havens, &
Hall, zoor; Kramer, Kapteyn, Kuik, & Deeg,
2ooz; Mullins, Hall Elston, & Gutkowski,
g96; Penninx et aI., rggg; Steverink,
Westerhof, Bode, & Dittmann-Kohli, zoor).
The causalmechanismsunderlying the asso-
ciation between loneliness and health are
not well understood, although new lines of
research on the psychophysiology mecha-
nisms and other pathways connecting lone-
liness and health outcomes [see Cacioppo
et a1., zooz; Hawkley & Cacioppo, zooj)
Loving, Heffneq, & Kiecolt-Glaser, this vol-
ume). Does Poor health lead to loneli-
ness via difficulties in maintaining social
relationships? Or does poor health lead to
an increase in support and a decrease in
lonelinessTPenninx et al. frqqq) and Van
Tilburg and Broese van Groenou (zooz)
showed that investing in relationships by giv-
ing support might pay off in times of need:
Poor health mobilizes network members
and increases support giving. Does loneli-
nessproduce Poor health? Could they mutu-
ally influence each other? Perhaps there is
no direct causation but rather an indirect
relationship through a third factor. One pos-
sible reason for the loneliness-health asso-
ciation involves preventive health behaviors
[see Cacioppo, Hawkley, & Bernston, zoo3).
Lonely individuals are less likely to engage
in behaviors such as exercise, remember-
4gr
ing to take medications or see their doc-
tors, good nutrition, and relaxation fAartsen,
zooj; Mahon, Yarcheski,& Yarcheski,zoor;
Pérodeau& du-Fort, zooo).
Loneliness in Context
Empirical studies have focused on
individual-level determinants of loneli-
ness. Much less attention has been paid
to the ways in which social isolation and
loneliness are patterned socially. A relatively
new area of research concerns [a) the soci-
etal patterning of standards for evaluating
one's social network of relationships and
O) the societal patterning of social and
economic resources contributing to social
integration. These contextual-level factors
aftect the intensity of loneliness either
indirectly via the composition and size of
the individual's network of relationships or
directly via differences in the evaluation of
a given context. DifFerencesbetween neigh-
borhoods in mutual concern for the other's
well-being are an example of societal pat-
terning of resources at the contextual level.
As Thomése, Van Tilburg, and Knipscheer
(zoo3) showed, as mutual concern for the
other's well-being and the shared feeling
of community embeddedness increase,
the risk of loneliness at the individual
level decreases.
In this section, we first address the out-
comes of international comparative research
into the relationship on socially differen-
tiated standards and loneliness. Next we
discuss theoretical ideas on contextual diÊ
ferences in social and economic resources
and loneliness.
NORMATIVE CLIMATE
People's relationship standards are shaped
by the normative climate in which they find
themselves.The normative climate in and of
itself can be conducive to loneliness. Norms
and values afFect people's ideas about the
optimal size of the network, and the obliga-
tions and duties of family members.
Johnson and Mullins (rq8Z) suggested
that lonelinessis high in collectivist-oriented
communities where sensitivitv to social
492 THE CAMBRIDGE HANDBOOK OF PERSONAL RELATIONSHIPS

exclusion is stronger than in individualis- (imamoflu, Ktiller, imamoflu, & Kuller, numb
tic communities. This hypothesis has been rgg3; Jylha & Jokela,1990). Findingsshowed sion
tested in a number of studies on differ- that although living alone became progres- resou
ences between North America and Europe. sively less common from Northern Europe encin
Rokach, Orzeck, Cripps, Lackovic-Grgin, to Southern Europe, experiences of loneli- being
and Penezic [zoor) compared Canadians ness progressively increased. According to exclu
and Croatians [from central-south Europe) the authors the crossnational differences are those
assumingthat North American culture poses attributable to differences in normative cli- and tl
a lower loneliness risk than European cul- mate. Living alone generally gives rise to In
ture because of its emphasis on individ- loneliness,but this is the more so in coun- conor
ual achievement and impersonal relation- tries where older adults without a partner resea
ships. However; their findings revealed that are expected to live with their families [..g., One I
Canadiansexperiencedmore lonelinessthan Greece, Italy) and the less so in countries tigate
Croatians. Van Tilburg, Havens, and De where older adults without a partner prefer nomi
Jong Gierveld [zoo4) observed, in line to live alone (".g., Finland). uals'
with Johnson and Mullins's hypothesis,that In general, the problems of lonely peo- and n
the likelihood of being emotionally lonely ple cannot be regarded as individual failures O'
among older adults without a partner and only. Characteristics of the societal context, indus
of being socially lonely among all older such asprevailing standardsconcerning mat- and r
adults in the study was highest in Tuscany, rimony and the nuclear family, the emphasis persir
Italy, followed by the Netherlands and Man- on individual fulfillment, and high expec- from
itoba, Canada. Swedish centenarians were tations about romantic relationships might cente
more often lonely, in contrast to centenar- also be consideredloneliness-provokingfac- main.
ians in Georgia, United States,who seldom tors, especially so for those living on their nomi
reported being lonely [Martin, Hagberg, & own and parents without parents [Ernst & tions
Poon, rggT). Stack's[rqq8) analysisofWorld C aci oppo,1999). that '
Values Surveys data showed that adults in well-
Italy and Japan reported more loneliness consi
SOCIOECONOMIC CONTEXT
than adults in the United Statesand Canada, cial r
whereas adults in a number of Western and Perlman and Peplau(r98r) arguedthat in any ACTOS
Northern European countries as well as in setting, factors that increasethe frequency of neigh
Australia reported lesslonelinessthan in the interaction and foster group cohesivenessare mech
United States and Canada [after controlling likely to affect the incidence of loneliness.In beinp
for several individual characteristics such our view, the dimension of socioeconomic of so
as marital and parental status, self-reported equality versusinequality is among these fac- own.
health, socioeconomicstatus,education, and tors. Unfortunately empirical research con- a dirr
gender). The assumed dlchotomy of two necting socioeconomic inequality [a con- persc
types of cultures might be too simple. Dif- cept at the contextual level) to individual cono
ferences within a cultural system are over- lonelinessis virtually nonexistent. Phillipson is an
looked. Considerable variability exists within [zoo4) has started a program of research tual l
North America, for example, as illustrated in the United Kingdom that is oriented comÍ
by research among immigrants and people toward investigatingthe consequencesof the persc
born and raisedin North America where the deepening social and economic inequality leadi
experience of loneliness differed by country and the socially deprived circumstances of W
of origin and cultural background [Good- groups of impoverished inhabitants of urban ( r gg,
win, Cook, & Yung, zoor; Rokach & Sharma, neighborhoods compared with the affluent socie
1996). No one has yet offered a comprehen- subgroups, taking loneliness as the depen- uct 1
sive explanation to account for the range of dent variable [Phillipson, zoo4). Research incor
cultural differences that have been found. by Scharf Phillipson, and Smith [zoo4) in cludr
A set of studies has examined differ- some of the most deprived neighborhoods Co-o
encesin older adult lonelinessacrossEurope of the United Kingdom indicated significant with
 LONELINESS AND SOCIAL ISOLATION
numbers of people prone to social exclu-
sion (".g., from social relations, material
resources, and basic services) and experi-
encing neighborhood exclusion. The risk of
being affected by multiple forms of social
exclusion and loneliness was greatest for
those belonging to minority ethnic groups
and the age group of 7j years and over.
In our view, the links between socioe-
conomic inequality and loneliness are a
research area worth pursuing. In doing so,
one can learn from research that inves-
tigates the relationship between socioeco-
nomic inequalities and indicators of individ-
uals' well-being, such as health, morbidity,
and mortality.
O'Rand (zoor) postulated that across
industrialized countries, major structural
and demographic changes have generated
persistent social inequalities and shifts away
from social welfare policies toward market-
centered strategies for income and health
maintenance. In her view, the growing eco-
nomic and social inequalities within popula-
tions form the fundamental social condition
that yields negative outcomes in health and
well-being. O'Rand's concept of inequality
consistsof economic, social, and psychoso-
cial components and operates multilevel:
across societal planes, the state, and the
neighborhood to the individual. The causal
mechanism by which inequality affects well-
being operatesthrough people's perceptions
of societal fairness more than directly on its
own. O'Rand distinguished, on one hand,
a direct pathway connecting inequality and
persons' well-being via individuals' socioe-
conomic resources.On the other hand, there
is an indirect pathway by which contex-
tual level inequality and atomizaiíon at the
community level reduce trust and increase
persons' perceptions of relative deprivation,
leading to negative outcomes.
Within the same paradigm, Wilkinson
(rqg+) investigated the relationship between
societal characteristics- grossnational prod-
uct per capita and differences in relative
income and life expectancy. He con-
cluded that the Organization for Economic
Co-operation and Development countries
with the longest life expectancy are not the
497
wealthiest but those with the smallest spread
of incomes and the smallest proportion of
the population in relative poverty. Wilkinson
(rgg+) postulated that the link between
socioeconomic inequalities and health or
mortality is mediated by cognitíue processes
of social comparison, feelingsof deprivation
and disadvantagethat can leadto depression.
Kawachi, Kennedy, Lochner, and Prothow-
Stith (rggl) provided evidence for the link
between social inequality at the macro-
level and perceived fairness and distrust at
the microlevel. Using General Social Sur-
vey data from the United States,they found
an inverse relationship between the degree
of income inequality at the state level and
the perceived lack of fairness and mistrust.
The perceived lack of fairness was oper-
"Most
ationalized with the item, people
would try to take advantage of you if they
got a chance," and social mistrust with the
"Generally
item, speaking, would you say
that most people can be trusted or that
you can't be too careful in dealing with
people?" The concept of trust is also central
in Ross,Mirowsky, and Pribesh's[zoor) work
on neighborhood disadvantage and pow-
edessness.Neighborhood disadvantage was
measured as the sum of the percentage of
households with incomes below the federal
poverty line and the percentage of female-
headed households with children. Results
indicated that when controlled for individ-
ual disadvantage,residents of disadvantaged
neighborhoods experienced lower levels of
trust. Mistrust and absenceof faith in other
people promoted and reinforced a senseof
powerlessness.
The promise of the previously described
theoretical ideas for researchinto loneliness
is that contextual and individual determi-
nants might be integrated under an over-
arching cognitive theory, connecting social
and economic inequality to the cognitive
processesof persons' perceptions of soci-
etal fairness and trust, which in turn affect
people's vulnerability to social isolation and
loneliness. In the near future, the analy-
sesand description of the core mechanisms
of the overarching cognitive theory needs
attention. Until now this type of multilevel
494 THE CAMBRIDGE HANDBOOK OF PERSONAL RELATIONSHIPS
research is scarce. Moreover, some of the
central theoretical concepts need better def-
initions and valid and reliable measuring
instruments. We need to work toward a
research and sample design that enables
multilevel research into social isolation
and loneliness.
Coping and Interventions
Some individuals recover from lonelinessby
using their own strategies,or by letting time
do the healing. Others require outside pro-
fessional help. The most obvious approach
is to help people develop satisfyingpersonal
relationships (Rook, ry84). This can be done
by improving how they interact with oth-
ers through social skills training or forms of
psychotherapy aimed at changing dysfunc-
tional interpersonal dispositions(".g., fear of
rejection). It can also be done by improving
opportunities for interactions through pro-
grams aimed at removing barriers for social
interaction (e.g., providing transportationJ
or at bringing people together [".g., discus-
sion groups). Pilusuk and Minkler [r98o)
emphasized the importance of develop-
ing programs that have opportunities for
so-called unintentional network building,
that is, the development of friendships is
a by-product of the shared activity, not
the explicit purpose. Nevertheless,programs
with an explicit focus on improving personal
relationships have proven to be effective.
In the Netherlands, the Friendship Enrich-
ment Program [FEP) in which participants
are taught how to nourish friendships and go
about making friends has been successfulin
alleviating loneliness(Stevens,2oor; Stevens
& Van Tilburg, zooo). The beneficial effects
of the FEP might be limited to specific
groups, however. The authors noted that the
participants were selÊselectedand wanted
to learn about friendship. The FEP might
work best for individuals who actively want
to become less lonely. Moreove4 given that
only women participated in the evaluation
study, the question of whether men will also
benefit from the FEP cannot be answered.
Interventions aimed at improving rela- AnI
tionships might not always be feasible or
appropriate, as in the case of people who It is
have unrealistically demanding or excessive direc
needs for support. Such people are more is, th
likely to benefit from cognitive interven- peop
tions aimed at modifying relationship expec- tive r
tations. Individuals with severely limited discr
physical mobility are likely to benefit from tity (
interventions aimed at increasingtheir reper- ship
toire of rewarding solitary activities. Rook from
[rq8+) pointed out that although encour- o8Y,
aging lonely individuals to develop enjoy- unde
able solitary activities seemslike a last resort, the c
solitary activities relieve people from depen- doinl
dence on others and thus may increasetheir as ag
senseof personal control. the s
In a recent review of interventions tar- ity cl
geting social isolation among the elderly, have
Findlay (zoo3) lamented the lack of evi- effec
dence showing that they work. Few evalu- econ
ative studies on the effectiveness of lone- or co
liness interventions have been carried out. Futu
The few studies that have been done are whic
flawed by weak methodologies. Findlay con- ship
cluded that future programs aimed at reduc- contr
ing social isolation should have evaluation
built into them at inception. This advice is
heeded in a program of researchthat is cur-
rently being carried out under the auspices Refe
of the Sluyterman van Loo Foundation in the
Netherlands. This foundation commissioned Aarts
r7 interventions aimed at reducing loneliness bet
among the elderly under the condition that age
their effectivenesswould be evaluated by the Un
three authors of this chapter together with Balte
Tineke Fokkema of the Netherlands Inter- A.
disciplinary Demographic Institute. The Ag
interventions are diverse (".g., home vis- IE
to
its by volunteers, social program for nurs-
Ca
ing home residents, educational program
Bedfc
for the hearing impaired, Internet usage).
ofr
Under our supervision,the collection of data ica
has been standardized as far as possible.
Blies
Key variables such as loneliness, marital his- shi;
tory, social network characteristics,relation-
Borys
ship standards, and health and personality en(
characteristicsare measured the same way in cha
each of the projects. All but two of the inter- Bowl
ventions are randomized control trials. A me
first report is scheduledfor the end of zoo5. Ins
 LONELINESS AND SOCIAL ISOLATION
An Evaluative Conclusion
It is broadly agreed that loneliness is not
directly connected to social isolation, that
is, the absence of relationships with other
people. Loneliness is defined as the nega-
tive outcome of a cognitive evaluation of a
discrepancy between (the quality and quan-
tity of) existing relationships and relation-
ship standards. An increasing flow of work
from disciplines such as psychology, sociol-
ogy, and anthropology has broadened the
understanding of the mechanisms behind
the onset and continuation of loneliness. In
doing so, next to background variables such
as age, gender, and health, characteristics of
the social network of relationships, personal-
ity characteristics,and relationship standards
have been addressed.The socially isolating
effects of deprivations brought by social and
economic circumstances at the community
or country level require further exploration.
Future research should address the ways in
which people's evaluationsof their relation-
ship networks are affected by the normative
context in which thev find themselves.
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