Why do we know so little about how to cure loneliness?

The New Statesman, by Jason Murugesu

 

If you only listened to Mark Zuckerberg, you’d be forgiven for thinking that he’s personally eradicated loneliness. The international media frenzy that Tracey Crouch’s appointment as the UK’s first Loneliness Minister suggests otherwise.

Scientists believe loneliness evolved so that we would prioritise being around others, and refrain from spending too much time by ourselves.

While we may all sometimes feel lonely, chronic loneliness can be a difficult affliction to escape. Perhaps counter-intuitively, a study in 2013 found that adolescents and young adults were most at risk of experiencing chronic loneliness. Teenagers do seem to grow out of it though, with risk for chronic loneliness not peaking again till after 65.

Loneliness is hard to quantify. It is not as simple as saying that the more friends you have, the less lonely you are.

Professor James Goodwin, the Chief Scientist of Age UK, tells me that his day-to-day experience at the charity has made it “evident that loneliness is a real problem in this country”. The charity has found that two million people in the UK feel “ignored or invisible”.

Chronic loneliness, unlike normal feelings of loneliness which might make us more likely to message a friend or go see family, is a dysfunction.

A series of studies using eye-tracking software found that lonelier people were more likely to be vigilant for socially threatening behaviour, which led to the prominent “hypervigilance for social threat hypothesis.”

However, large scale research into loneliness is extremely limited. Most studies are cross sectional: they compare two or more different groups of people. The problem with a condition like loneliness is that it is affected by so many factors, so no two groups of people are the same.

The best research into loneliness should in theory be longitudinal, looking at a specific group of people over a set period of time.

In other words, it should follow someone from their youth to old age, in order to better appreciate the influence that an individual’s circumstances will have on the results. Comparing two unrelated groups of people completely loses this nuance.

A good example of the pitfalls of cross-sectional, rather than longditudinal studies, are those which look at how coffee drinking affects how long someone lives for. If you compare a group that drinks coffee to one that does not you will find that the group who drinks coffee live longer. However, the fact that the group who drink coffee were more likely to be wealthy enough to get a coffee more regularly and thus be more likely to live longer is missed.

Dr Mai Stafford’s research at UCL uses a longditudinal approach to studying lonliness. She is using the MRC National Survey of Health and Development (a study of 5,000 people born in 1946 and who have been followed up every few years or so) to determine whether someone’s relationships in their youth affect their likeliness of being lonely in old-age.

Regarding her yet unpublished research, Stafford notes she has found that “we find that poor social relationship quality in each of these life stages [childhood, early and mid-adult] is linked to greater loneliness in later life.”

Research into how effective loneliness interventions is even more lacking. There have been no major studies on the topic, and most interventions currently employed are based on small-scale studies and anecdotal evidence.

However, what evidence we do have suggests those who feel most lonely are the the most susceptible to intervention techniques to tackle it. Age UK, employing the widely used UCLA Loneliness scale found that their befriending services in which a volunteer visits the participant weekly was most effective with those who reported feeling the most lonely.

Goodwin says that Age UK found that “social capital is responsible for up to 55 per cent of wellbeing in the older population.” However, Goodwin argues that this finding is not reflected in how the NHS trains its doctors, saying little significance is given to “social prescribing”, the idea that many problems, especially in the older community, can be treated by funding more community practices.

A another study published last year on the effectiveness of London’s free bus for over 60s found that the resultant increased public transportation had led to reduced levels of loneliness (again using the UCLA Loneliness Scale). Studies like this however, are also few and far between, and there is conflicting evidence.

Stafford says her research found “that participation in organised activities is only very weakly related to loneliness levels whereas informal contact with family and friends is much more strongly related to loneliness.” She goes on to say that this “would suggest that providing organised opportunities to meet people will not be the full solution to ending loneliness and that helping people to connect will also be important.”

It’s clear the lack of research on the topic, and resulting incoherency of what we know about loneliness, makes it very hard to identify the best way to tackle it.

It’s clear new Loneliness Minister Crouch has a lot to grapple with, which makes it fortunate that the Government has said she will have a “newly formed loneliness team” to help.

Unfortunately we doubt it will be quite as well-resourced as Zuckerberg.