Better Together: Effects and Treatments of Loneliness and Social Isolation Across the Schizophrenia Spectrum

Abstract

Individuals with schizophrenia (ISZ) are among the most socially isolated and stigmatized individuals in our society. Mounting evidence suggests powerful detrimental effects of loneliness as a result of dissonance between desired and present social interaction across virtually all populations. While it has previously been hypothesized that due to negative symptoms such as social anhedonia, ISZ do not experience loneliness, research confirms that ISZ are extremely affected by loneliness and rank it as a top difficulty. It has also been suggested that as in other forms of sensory deprivation, hallucinations and delusions may emerge or become exacerbated in psychosis-prone individuals when prolonged social isolation triggers over-activation of the social brain network, thus fabricating spurious social meaning.

The effects of isolation and loneliness on the perception of social stimuli were systematically tested with computerized human detection tasks across three demographic groups including ISZ. Results indicate that social exclusion significantly augments participant’s BM perception, and that symptom levels are associated with poorer extraction of social information. We next sought to test plausible remediation of loneliness through an exposure based social interaction group using the unique social bonding principles of singing, and a social skill-building computerized intervention. The results demonstrate that group singing is beneficial for reducing loneliness and increasing self-perceived well-being, while social skills training is beneficial for increasing emotion recognition and confidence in social abilities. Together, these two novel and low-burden interventions may serve as a powerful multi-arm intervention strategy for eradicating isolation and loneliness in vulnerable populations.