Department of Psychology, Wayne State University, USA; Department of Family Medicine and Public Health Sciences, Wayne State University, USA.
Department of Psychology, Wayne State University, USA.
Psychoneuroendocrinology. 2021 Jun;128:105194. doi: 10.1016/j.psyneuen.2021.105194. Epub 2021 Mar 8.
Experimental and observational evidence agreed on two interconnected biological mechanisms responsible for the links between social isolation/loneliness and health: alterations in the activity of the hypothalamic-pituitary-adrenal (HPA) axis and compromised functioning of the innate immune system. However, most existing studies did not consider the simultaneous impact of social isolation and loneliness on biological outcomes. Further, they only assessed one biological outcome at a time and did not test any moderation by age, despite empirical and theoretical evidence supporting the plausibility of this hypothesis. To address these gaps in the literature, we tested the associations between two indicators of social isolation (living status and frequency of social contacts) and loneliness and daily cortisol secretion and two markers of systemic inflammation (C-reactive protein [CRP] and interleukin-6 [IL-6]) in a sample of adults aged between 25 and 75 years old. Data were drawn from the Midlife in the United States (MIDUS) Refresher study (N = 314). We found that, above and beyond loneliness, living alone was associated with a flattened diurnal cortisol slope (i.e., reduced changes in cortisol levels during waking hours that are indicative of a dysregulated HPA axis) and higher CRP levels. On the other hand, higher loneliness was associated with higher IL-6 levels, above and beyond our measures of social isolation. Loneliness did not mediate any of the effects of social isolation on either cortisol or CRP, and age did not moderate any of the relationships reported above. Our findings support the idea that social isolation and loneliness have unique and independent endocrine and immune effects despite being linked to each other. Understanding the specific biological pathways through which these aspects of social well-being exert their effects on health across the lifespan has critical consequences for both intervention development and public health policies.
实验和观察证据都证实了两个相互关联的生物学机制,它们负责解释社交隔离/孤独与健康之间的联系:下丘脑-垂体-肾上腺 (HPA) 轴活动的改变和先天免疫系统功能受损。然而,大多数现有研究并没有考虑社交隔离和孤独感同时对生物学结果的影响。此外,它们一次只评估一个生物学结果,并且没有测试年龄的任何调节作用,尽管有经验和理论证据支持这一假设的合理性。为了解决文献中的这些空白,我们测试了两个社交隔离指标(居住状况和社交联系频率)以及孤独感与日常皮质醇分泌之间的关联,以及两个全身炎症标志物(C 反应蛋白 [CRP] 和白细胞介素 6 [IL-6])在 25 至 75 岁的成年人样本中。数据来自美国中年研究(MIDUS)更新研究(N=314)。我们发现,除了孤独感之外,独居与日间皮质醇斜率变平有关(即,皮质醇水平在清醒期间的变化减少,这表明 HPA 轴失调)和 CRP 水平升高。另一方面,更高的孤独感与更高的 IL-6 水平有关,这超出了我们对社交隔离的测量。孤独感并没有中介社交隔离对皮质醇或 CRP 的任何影响,年龄也没有调节上述任何关系。我们的研究结果支持这样一种观点,即社交隔离和孤独感具有独特且独立的内分泌和免疫作用,尽管它们相互关联。了解这些社会幸福感方面通过哪些特定的生物学途径对健康产生影响,对于干预措施的发展和公共卫生政策都具有至关重要的意义。