Research Section Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, 53127, Germany
Department of Psychology, University of Haifa, Haifa, 3498838, Israel.
J Neurosci. 2022 Mar 23;42(12):2570-2583. doi: 10.1523/JNEUROSCI.2029-21.2022. Epub 2022 Feb 14.
Loneliness is a public health concern with detrimental effects on physical and mental well-being. Given phenotypical overlaps between loneliness and social anxiety (SA), cognitive-behavioral interventions targeting SA might be adopted to reduce loneliness. However, whether SA and loneliness share the same underlying neurocognitive mechanisms is still an elusive question. The current study aimed at investigating to what extent known behavioral and neural correlates of social avoidance in SA are evident in loneliness. We used a prestratified approach involving 42 (21 females) participants with high loneliness (HL) and 40 (20 females) participants with low loneliness (LL) scores. During fMRI, participants completed a social gambling task to measure the subjective value of engaging in social situations and responses to social feedback. Univariate and multivariate analyses of behavioral and neural data replicated known task effects. However, although HL participants showed increased SA, loneliness was associated with a response pattern clearly distinct from SA. Specifically, contrary to expectations based on SA differences, Bayesian analyses revealed moderate evidence for equal subjective values of engaging in social situations and comparable amygdala responses to social decision-making and striatal responses to positive social feedback in both groups. Moreover, while explorative analyses revealed reduced pleasantness ratings, increased striatal activity, and decreased striatal-hippocampal connectivity in response to negative computer feedback in HL participants, these effects were diminished for negative social feedback. Our findings suggest that, unlike SA, loneliness is not associated with withdrawal from social interactions. Thus, established interventions for SA should be adjusted when targeting loneliness. Loneliness can cause serious health problems. Adapting well-established cognitive-behavioral therapies targeting social anxiety might be promising to reduce chronic loneliness given a close link between both constructs. However, a better understanding of behavioral and neurobiological factors associated with loneliness is needed to identify which specific mechanisms of social anxiety are shared by lonely individuals. We found that lonely individuals show a consistently distinct pattern of behavioral and neural responsiveness to social decision-making and social feedback compared with previous findings for social anxiety. Our results indicate that loneliness is associated with a biased emotional reactivity to negative events rather than social avoidance. Our findings thus emphasize the distinctiveness of loneliness from social anxiety and the need for adjusted psychotherapeutic protocols.
孤独是一个公共卫生问题,对身心健康有不利影响。鉴于孤独和社交焦虑 (SA) 之间存在表型重叠,针对 SA 的认知行为干预措施可能被采用来减轻孤独感。然而,孤独和社交焦虑是否具有相同的潜在神经认知机制仍然是一个难以捉摸的问题。本研究旨在探讨社交回避的已知行为和神经相关性在多大程度上存在于孤独感中。我们使用了一种预先分层的方法,涉及 42 名(21 名女性)高孤独感 (HL) 和 40 名(20 名女性)低孤独感 (LL) 得分的参与者。在 fMRI 期间,参与者完成了一项社交赌博任务,以衡量参与社交情境的主观价值和对社交反馈的反应。行为和神经数据的单变量和多变量分析复制了已知的任务效应。然而,尽管 HL 参与者表现出更高的 SA,但孤独感与明显不同于 SA 的反应模式相关。具体来说,与基于 SA 差异的预期相反,贝叶斯分析显示,两组参与者在参与社交情境的主观价值和对社会决策的杏仁核反应以及对积极社交反馈的纹状体反应方面具有中等程度的相似性。此外,虽然探索性分析显示 HL 参与者对负面计算机反馈的愉悦感评分降低、纹状体活动增加和纹状体-海马连接减少,但对负面社交反馈的这些影响则减弱。我们的研究结果表明,与 SA 不同,孤独感与回避社交互动无关。因此,针对孤独感,应该调整针对 SA 的既定干预措施。孤独感会导致严重的健康问题。鉴于孤独感和社交焦虑之间存在密切联系,针对社交焦虑的经过充分验证的认知行为疗法的调整可能是减少慢性孤独感的一种有前途的方法。然而,需要更好地了解与孤独感相关的行为和神经生物学因素,以确定孤独个体共享的社交焦虑的具体机制。我们发现,与先前针对社交焦虑的研究结果相比,孤独个体对社会决策和社会反馈的行为和神经反应表现出一致的独特模式。我们的研究结果表明,孤独感与对负面事件的情绪反应偏向有关,而不是社交回避。因此,我们的研究结果强调了孤独感与社交焦虑的独特性,需要调整心理治疗方案。