Julianne Holt-Lunstad

Brigham Young University | BYU · Department of Psychology

While loneliness may motivate individuals to approach others, it may simultaneously increase their focus on self-preservation, resulting in egocentric behavior. Since the evidence linking loneliness and prosociality is inconclusive, the current meta-analysis aims to explore this relationship. Through a systematic search of databases, we identified...

Purpose Loneliness and social isolation are risk factors for poor health, but few effective interventions are deployable at scale. This study was conducted to determine whether acts of kindness can reduce loneliness and social isolation, improve mental health, and neighbourhood social cohesion. Method Three randomized controlled trials (RCTs) were...

Background Social isolation and loneliness can occur in all age groups, and they are linked to increased mortality and poorer health outcomes. There is a growing body of research indicating inconsistent findings on the effectiveness of interventions aiming to alleviate social isolation and loneliness. Hence the need to facilitate the discoverabilit...

Social connection impacts physical health in a variety of ways, including longevity. A diverse and robust body of evidence demonstrates the importance of social connection as a key element of lifestyle relevant to health. Among this evidence, data illustrate the mechanisms linking social connection to health, emphasizing how aspects of social conne...

Social connection is vital to health and longevity. To date, a plethora of instruments exists to measure social connection, assessing a variety of aspects of social connection like loneliness, social isolation, or social support. For comparability and consistency of the published literature and for policy recommendations, consolidation and evaluati...

Loneliness and social isolation have been identified as critical global health issues in the aftermath of the coronavirus disease 2019 (COVID-19) crisis. While there is robust scientific evidence demonstrating the impact of loneliness and social isolation on health outcomes and mortality, there are fundamental issues to resolve so that health autho...

Background There is a growing body of research indicating that social isolation and loneliness can occur in all age groups, and they have been shown to be linked to increased mortality and poorer health outcomes. Hence the need for research on interventions aiming to alleviate social isolation and loneliness. Objectives To map available evidence on...

This is the protocol for an evidence and gap map. The objectives are as follows: This EGM aims to map available evidence on the effects of in‐person interventions to reduce social isolation and/or loneliness across all age groups in all settings.

Over the past decade, the health implications of social isolation and loneliness garnered global attention due in part to a widely cited meta-analysis that benchmarked associations between cigarette smoking and mortality with associations between several social relationships measures and mortality. Leaders in health systems, research, government, a...

National health guidelines provide policy makers and the public with recommendations for various behavioral factors known to promote health and reduce disease risk, such as diet and physical activity. Given public health concerns about social isolation, loneliness, and other forms of lacking social connection, the evidence supports establishing nat...

Background Social relationships are associated with mortality and chronic conditions. However, little is known about the effects of social relationship satisfaction on multiple chronic conditions (multimorbidity). Aims To examine whether social relationship satisfaction is associated with the accumulation of multimorbidity. Methods Data from 7 69...

Loneliness and social isolation have harmful impacts on health and well-being; thus, the social distancing mandates during the COVID-19 pandemic, meant to protect our most vulnerable populations including older adults, may have had unintended consequences. The current study aimed to assess changes in loneliness (prior to and during the pandemic) an...

Psychosocial factors are related to immune, viral, and vaccination outcomes. Yet, this knowledge has been poorly represented in public health initiatives during the COVID-19 pandemic. This review provides an overview of biopsychosocial links relevant to COVID-19 outcomes by describing seminal evidence about these associations known pre-pandemic as...

Charting the Path to Health in Midlife and Beyond: The Biology and Practice of Wellness was a Translational Science Symposium held on Tuesday, September 21, 2021. Foundational psychosocial and behavioral approaches to promote healthy aging and strategies to disseminate this information were discussed. The following synopsis documents the conversati...

There is growing interest in and renewed support for prioritizing social factors in public health both in the USA and globally. While there are multiple widely recognized social determinants of health, indicators of social connectedness (e.g., social capital, social support, social isolation, loneliness) are often noticeably absent from the discour...

Purpose Social restrictions and government-mandated lockdowns implemented worldwide to kerb the SARS-CoV-2 virus disrupted our social interactions, behaviours, and routines. While many studies have examined how the pandemic influenced loneliness and poor mental health, such as depression, almost none have focussed on social anxiety. Further, how th...

Evidence suggests social isolation and loneliness are prevalent within the population and may potentially be exacerbated due to the pandemic. Social connections have powerful influences on health and longevity, and lacking social connection qualifies as a risk factor for premature mortality. Evidence from the recent National Academy of Science cons...

Background Community interventions are often promoted as a way of reducing loneliness and social isolation in our neighbourhoods. However, those community interventions are rarely examined within rigorous study designs. One strategy that holds the potential to reduce loneliness and can promote health and wellbeing is doing acts of kindness. The cur...

While a sizable body of research demonstrates the associations between social connection and health, much of the recent focus in the broader public and to some extent among academics has been on loneliness, with more objective/structural aspects often assumed to be proxies for more influential relationship factors such as relationship functions and...

The influence of social relationships extends beyond emotional well-being to influence long-term physical-health outcomes, including mortality risk. Despite the varied measurement approaches used to examine social relationships within the health literature, the data can be synthesized using social connection as an organizing framework. This review...

Background Hospitals, clinics, and health organizations have provided psychosocial support interventions for medical patients to supplement curative care. Prior reviews of interventions augmenting psychosocial support in medical settings have reported mixed outcomes. This meta-analysis addresses the questions of how effective are psychosocial suppo...

Social isolation and loneliness were already pressing concerns prior to the pandemic, but recent trends suggest a potential broadening of this public health crisis. Social connections have potent influences on health and longevity, and lacking social connection qualifies as a risk factor for premature mortality. However, social factors are often ov...

Background/objectives: Physical distancing during the COVID-19 pandemic may have unintended, detrimental effects on social isolation and loneliness among older adults. Our objectives were to investigate 1) experiences of social isolation and loneliness during shelter-in-place orders and 2) unmet health needs related to changes in social interactio...

Purpose Loneliness and social isolation can occur at all stages of the life course and are recognized as a global health priority. The aim of this study was to review existing literature on the economic costs associated with loneliness and social isolation as well as evidence on the cost-effectiveness of interventions to prevent or address loneline...

The article, “The economic costs of loneliness: a review of cost_of_illness and economic evaluation studies”, written by Cathrine Mihalopoulos was originally published electronically on the publisher’s internet portal (currently SpringerLink) on 22 May 2019 with open access.’

The protective influence of social relationships on health is widely documented; however, not all relationships are positive, and negative aspects of relationships may be detrimental. Much less is known about the relationships characterized by both positivity and negativity (i.e., ambivalence). This article provides a theoretical framework for cons...

This letter comments on the letter by Pitkala et al.

Loneliness and social isolation are strongly associated with several adverse health outcomes in older persons including death and functional impairments. The strength of these associations has been compared with smoking. Accordingly, loneliness and isolation have significant public health implications. Despite the adverse impacts of loneliness and...

Previous studies reveal that oxytocin (OT) encourages prosocial behavior in humans; however, animal studies and recent work in humans suggest that OT may also play a role in aggressive behavior and feelings. The present study investigated these competing predictions in the context of a competitive task among 85 healthy human participants (males and...

There is a rich literature on social support and physical health, but research has focused primarily on the protective effects of social relationship. The stress buffering model asserts that relationships may be protective by being a source of support when coping with stress, thereby blunting health relevant physiological responses. Research also i...

Background: In animals, adverse early experience alters oxytocinergic and glucocorticoid activity and maternal behavior in adulthood. This preliminary study explored associations among childhood trauma (loss of a parent or sexual abuse in childhood), maternal self-efficacy, and leukocyte gene expression (mRNA) of oxytocin and glucocorticoid recept...

Social relationships are adaptive and crucial for survival. This review presents existing evidence that our social connections to others have powerful influences on health and longevity and that lacking social connection qualifies as a risk factor for premature mortality. A systems perspective is presented as a framework by which to move social con...

Objectives: The ICU is a complex and stressful environment and is associated with significant psychologic morbidity for patients and their families. We sought to determine whether salivary cortisol, a physiologic measure of acute stress, was associated with subsequent psychologic distress among family members of ICU patients. Design: This is a p...

A robust body of scientific evidence has indicated that being embedded in high-quality close relationships and feeling socially connected to the people in one's life is associated with decreased risk for all-cause mortality as well as a range of disease morbidities. Despite mounting evidence that the magnitude of these associations is comparable to...

This paper reviews the research on relationships and mental health. Individuals who are more mentally healthy are more likely to select into relationships, but relationships are also demonstrably associated with mental health. The type of relationship matters—evidence suggests that more established, committed relationships, such as marriage, are as...

For most adults, sleep is a dyadic behavior. Only recently have studies explored the dynamic association between sleep and relationship functioning among bed partners. The current study is the first to examine bidirectional associations between changes in insomnia and changes in marital quality over time, in the context of a marital therapy trial....

A recent meta-analysis has shown that loneliness and social isolation are risk factors for coronary heart disease and stroke.1 These latest findings, specific to cardiovascular outcomes, are consistent with substantial research indicating broad health risks (eg, immune functioning, cardiovascular functioning, cognitive decline) associated with the...

Social relationships have long been linked to health outcomes. To understand this association various disciplines have approached the empirical understanding of this association from different theoretical and methodological approaches. This article will summarize the historical background of these approaches, the evidence linking social networks to...

The purpose of this study was to explore and compare high-fidelity and low-fidelity Emotionally Focused Couples Therapy sessions across the course of treatment. Data were taken from sessions 3, 7, and 11 from two different couples. Grounded theory was used to identify emerging themes from the data. Further, a word frequency query was performed to u...

Oxytocin is implicated in social behaviors: maternal care, social bonding, desire for physical closeness, and sexual response. Evidence suggests oxytocin may be important for stress regulation and modulate cardiovascular functioning with oxytocin as a possible pathway to the well-established links between social relationships and physical health. I...

Data was drawn from 15 sessions of couple's therapy where clinicians attempted to apply the EFT model. Results provide initial support for the Emotionally Focused Therapy —Therapist Fidelity Scale (EFT-TFS) as a reliable and useful measure of fidelity. In addition, results suggest the measure can discriminate effectively (95% correct classification...

Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social isolation and loneliness and to examine possible moderators. We conducted a literature search of studies (January 1980 to February 2014) using MED...

Spirituality involves a feeling of profound personal connection to a sacred reality (e.g., God), and is often characterized by experiences of comfort and peace. The neuropeptide oxytocin appears to be a plausible biological mediator of such spiritual experiences, as oxytocin is closely linked with social affiliation, intimacy, and stress-attenuatio...

Objective: The protective influence of social relationships on health is well documented; however, not all relationships are positive and negative aspects of relationships may be detrimental. Relatively less is known about the relationships characterized by both positivity and negativity (i.e., ambivalence). The goal of this study was to examine t...

This longitudinal dyadic clinical process study used coded data from eleven couples to determine the influence of therapist warmth behaviors on couples' warmth behaviors over time in therapy. A mixed effects model was used to examine within- and between-individual variability. Men and women were modeled separately. A series of two-level multilevel...

Prior studies report that couples with higher relationship quality show higher oxytocin (OT) levels, yet other studies report those with higher distress have increased OT. This study investigated these competing predictions in the context of a support enhancement intervention among 34 young married couples (N = 68). Preintervention marital quality...

Current literature on cognitive functioning in pregnancy and postpartum is mixed, with most research showing deficits in memory and attention during pregnancy or no difference between pregnant participants and controls with little emphasis on the postpartum period. In the current study, we used a longitudinal controlled design and 42 primarily not...

Mexican Americans typically have better cardiovascular health than Caucasians, despite being relatively economically disadvantaged. Given research indicating the importance of relationship quality on one's health, our study examined whether certain relationship orientations (eg, communal or exchange) differed between Caucasians and Mexican American...

Social relationships benefit not only mental health but also physical health. This review addresses the following questions: (1) What is the overall magnitude of the effect of social relationships on risk for premature death? (2) How generalized is the effect and are there factors known to influence this association? (3) What are the likely pathway...

Mothers in numerous species exhibit heightened aggression in defense of their young. This shift typically coincides with the duration of lactation in nonhuman mammals, which suggests that human mothers may display similarly accentuated aggressiveness while breast feeding. Here we report the first behavioral evidence for heightened aggression in lac...

Oxytocin (OT) activity increases in response to stress as well as to warm social contact. Subclinical depression is associated with higher stress but less reward from social contacts. The present investigation was intended to examine whether husbands and wives with high depressive symptomatology scores have increased plasma and salivary OT that may...

Growing research has demonstrated a link between spiritual well-being and better health; however, little is known about possible physiological mechanisms. In a sample of highly religious healthy male and female adults (n = 100) ages 19-59 (m = 28.28) we examined the influence of spiritual well-being, as measured by the Functional Assessment of Chro...

Mothers in numerous species exhibit heightened aggression in defense of their young. This shift typically coincides with the duration of lactation in nonhuman mammals, which suggests that human mothers may display similarly accentuated aggressiveness while breast feeding. Here we report the first behavioral evidence for heightened aggression in lac...

Abstract translated into Japanese by Hideko Cannell. (0.02 MB DOC)

PRISMA checklist. (0.06 MB DOC)

Review protocol. (0.05 MB DOC)

Abstract translated into Spanish by Rod Veas. (0.03 MB DOC)

The quality and quantity of individuals' social relationships has been linked not only to mental health but also to both morbidity and mortality. This meta-analytic review was conducted to determine the extent to which social relationships influence risk for mortality, which aspects of social relationships are most highly predictive, and which fact...

Although there is substantial evidence that social relationships and marriage may influence both psychological and physical health, little is known about the influence of children. This study examined the competing predictions regarding the directional influence of parental status and its interaction with gender-given that mothers are typically dis...

Social relationships are a fundamental part of our lives and may have both positive and negative effects on physical health; thus, this study examined how and why individuals would maintain ambivalent relationships, as previous research indicates that such relationships may be potentially detrimental. Specifically we examined the influence of exter...

The Social Relationships Index (SRI) was designed to examine positivity and negativity in social relationships. Unique features of this scale include its brevity and the ability to examine relationship positivity and negativity at the level of the specific individual and social network. The SRI's psychometric properties were examined in three studi...

This study examined the influence of relationship-specific dimensions of social support (i.e., support, depth, conflict) on nocturnal blood pressure (BP) dipping and mental health (i.e., satisfaction with life, stress, and depression) among 303 normotensive and un-medicated hypertensive males and females ages 20–68. Results revealed that support wa...

To investigate whether a support intervention (warm touch enhancement) influences physiological stress systems that are linked to important health outcomes. Growing evidence points to a protective effect of social and emotional support on both morbidity and mortality. In this study, 34 healthy married couples (n = 68), aged 20 to 39 years (mean = 2...

Both social support and hostility have been reliably associated with important health outcomes including coronary heart disease (CHD). One potential pathway by which these variables may influence CHD is via their impact on cardiovascular reactivity (CVR). Although social support has been generally associated with beneficial effects on cardiovascula...

Having close social relationships and being married specifically have been reliably associated with health benefits including lower morbidity and mortality. The purpose of this study was to examine the influence of marital status, relationship quality, and network support on measures of psychological and cardiovascular health. We examined ambulator...

Drawing from the Stereotyped Task Engagement Process (Smith, Educational Psychology Review, 16: 177–206, 2004) we compared undergraduate women in Pakistan majoring in science (51%) and non-science (49%) on their self-reported academic experiences. Results showed women in science fields who were gender atypical reported higher levels of stigma consc...

Social relationships are reliably related to rates of morbidity and mortality. One pathway by which social relationships may influence health is via the impact of relationship quality on cardiovascular reactivity during social interactions. This study examined the effects of the quality of a friendship on cardiovascular reactivity when speaking abo...

To investigate if diurnal cortisol variation is associated with nocturnal blood pressure (BP) dipping. In this study, 302 healthy adults (51% female; average age 31 years) underwent 24-hour ambulatory BP assessment with BP measured randomly approximately every 20 minutes during waking hours and every hour during sleep. Salivary cortisol was obtaine...

The major aim of this chapter is to provide a detailed overview of the links between stress and illness with an emphasis on underlying physiological and stress component processes. It has been almost 50 years since the publication of the classic book by Hans Selye (1956) on stress, adaptation, and disease. In his formulation of the general adaptati...

Although age differences in cardiovascular function are well documented, little research has provided longitudinal evidence for age-related changes in cardiovascular reactivity to stress. In this study, the authors report such data from a follow-up of their prior work (B. N. Uchino, D. Uno, J. Holt-Lunstad, & J. B. Flinders, 1999) with participants...