CFC 09

Journal of Personality and Social Psychology, in press

Alone in the Crowd:

The Structure and Spread of Loneliness in a Large Social Network
John T. Cacioppo
University of Chicago
James H. Fowler
University of California, San Diego
Nicholas A. Christakis
Harvard University

Running head: Structure and Spread of Loneliness
Structure and Spread of Loneliness

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Abstract
The discrepancy between an individuals loneliness and the number of connections in a
social network is well documented, yet little is known about the placement of loneliness within,
or the spread of loneliness through, social networks. We use network linkage data from the
population-based Framingham Heart Study to trace the topography of loneliness in peoples
social networks and the path through which loneliness spreads through these networks. Results
indicated that loneliness occurs in clusters, extends up to three degrees of separation, is
disproportionately represented at the periphery of social networks, and spreads through a
contagious process. The spread of loneliness was found to be stronger than the spread of
perceived social connections, stronger for friends than family members, and stronger for women
than for men. The results advance our understanding of the broad social forces that drive
loneliness and suggest that efforts to reduce loneliness in our society may benefit by aggressively
targeting the people in the periphery to help repair their social networks and to create a protective
barrier against loneliness that can keep the whole network from unraveling.

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Alone in the Crowd:
The Structure and Spread of Loneliness in a Large Social Network
Human social isolation is recognized as a problem of vast importance. (Harlow,

Dodsworth, & Harlow, 1965)
Social species do not fare well when forced to live solitary lives. Social isolation
decreases lifespan of the fruit fly, Drosophilia melanogaster (Ruan & Wu, 2008); promotes the
development of obesity and Type 2 diabetes in mice (Nonogaki, Nozue, & Oka, 2007); delays
the positive effects of running on adult neurogenesis in rats (Stranahan, Khalil, & Gould, 2006);
increases the activation of the sympatho-adrenomedullary response to an acute immobilization or
cold stressor in rats (Dronjak, Gavrilovic, Filipovic, & Radojcic, 2004); decreases the expression
of genes regulating glucocorticoid response in the frontal cortex of piglets (Poletto, Steibel,
Siegford, & Zanella, 2006); decreases open field activity, increased basal cortisol concentrations,
and decreased lymphocyte proliferation to mitogens in pigs (Kanitz, Tuchscherer, Puppe,
Tuchscherer, & Stabenow, 2004); increases the 24 hr urinary catecholamines levels and evidence
of oxidative stress in the aortic arch of the Watanabe Heritable Hyperlipidemic rabbit (Nation et
al., 2008); increases the morning rises in cortisol in squirrel monkeys (Lyons, Ha, & Levine,
1995); and profoundly disrupts psychosexual development in rhesus monkeys (Harlow et al.,
1965).
Humans, born to the longest period of abject dependency of any species and dependent
on conspecifics across the lifespan to survive and prosper, do not fare well, either, whether they
are living solitary lives, or whether they simply perceive they live in isolation. The average
person spends about 80% of waking hours in the company of others, and the time with others is
preferred to the time spent alone (Emler, 1994; Kahneman, Krueger, Schkade, Schwarz, &

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Stone, 2004). Social isolation, in contrast, is associated not only with lower subjective wellbeing (Berscheid, 1985; Burt, 1986; Myers & Diener, 1995) but with broad based-morbidity and
mortality (House, Landis, & Umberson, 1988).
Humans are an irrepressibly meaning-making species, and a large literature has
developed showing that perceived social isolation (i.e., loneliness) in normal samples is a more
important predictor of a variety of adverse health outcomes than is objective social isolation
(e.g., (Cole et al., 2007; Hawkley, Masi, Berry, & Cacioppo, 2006; Penninx et al., 1997; Seeman,
2000; Sugisawa, Liang, & Liu, 1994). In an illustrative study, Caspi et al. (Caspi, Harrington,
Moffitt, Milne, & Poulton, 2006) found that loneliness in adolescence and young adulthood
predicted how many cardiovascular risk factors (e.g., body mass index, waist circumference,
blood pressure, cholesterol) were elevated in young adulthood, and that the number of
developmental occasions (i.e., childhood, adolescence, young adulthood) at which participants
were lonely predicted the number of elevated risk factors in young adulthood. Loneliness has
also been associated with the progression of Alzheimers Disease (Wilson et al., 2007), obesity
(Lauder, Mummery, Jones, & Caperchione, 2006), increased vascular resistance (Cacioppo,
Hawkley, Crawford et al., 2002), elevated blood pressure (Cacioppo, Hawkley, Crawford et al.,
2002; Hawkley et al., 2006), increased hypothalamic pituitary adrenocortical activity (Adam,
Hawkley, Kudielka, & Cacioppo, 2006; Steptoe, Owen, Kunz-Ebrecht, & Brydon, 2004), less
salubrious sleep (Cacioppo, Hawkley, Berntson et al., 2002; Pressman et al., 2005), diminished
immunity (Kiecolt-Glaser et al., 1984; Pressman et al., 2005), reduction in independent living
(Russell, Cutrona, De La Mora, & Wallace, 1997; Tilvis, Pitkala, Jolkkonen, & Strandberg,
2000), alcoholism (Akerlind & Hornquist, 1992), depressive symptomatology (Cacioppo et al.,
2006; Heikkinen & Kauppinen, 2004), suicidal ideation and behavior (Rudatsikira, Muula,
Siziya, & Twa-Twa, 2007), and mortality in older adults (Penninx et al., 1997; Seeman, 2000).

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Loneliness has even been associated with gene expression -- specifically, the under-expression of
genes bearing anti-inflammatory glucocorticoid response elements (GREs) and over-expression
of genes bearing response elements for pro-inflammatory NF-B/Rel transcription factors (Cole
et al., 2007),
Adoption and twin studies indicate that loneliness has a sizable heritable component in
children (Bartels, Cacioppo, Hudziak, & Boomsma, 2008; Mcguire & Clifford, 2000) and in
adults (Boomsma, Cacioppo, Slagboom, & Posthuma, 2006; Boomsma, Willemsen, Dolan,
Hawkley, & Cacioppo, 2005; Boomsma, Cacioppo, Muthen, Asparouhov, & Clark, 2007).
Social factors have a substantial impact on loneliness, as well, however. For instance, freshman
who leave family and friends behind often feel increased social isolation when they arrive at
college even though they are surrounded by large numbers of other young adults (e.g., (Cutrona,
1982; Russell, Peplau, & Cutrona, 1980). Lower levels of loneliness are associated with
marriage (Hawkley, Browne, & Cacioppo, 2005; Pinquart & Sorenson, 2003), higher education
(Savikko, Routasalo, Tilvis, Strandberg, & Pitkala, 2005), and higher income (Andersson, 1998;
Savikko et al., 2005), whereas higher levels of loneliness are associated with living alone
(Routasalo, Savikko, Tilvis, Strandberg, & Pitkala, 2006), infrequent contact with friends and
family (Bondevik & Skogstad, 1998; Hawkley et al., 2005; Mullins & Dugan, 1990),
dissatisfaction with living circumstances (Hector-Taylor & Adams, 1996), physical health
symptoms (Hawkley et al., In press), chronic work and/or social stress (Hawkley et al., In press),
small social network (Hawkley et al., 2005; Mullins & Dugan, 1990), lack of a spousal confidant
(Hawkley et al., In press), marital or family conflict (Jones, 1992; Segrin, 1999), poor quality
social relationships (Hawkley et al., In press; Mullins & Dugan, 1990; Routasalo et al., 2006),
and divorce and widowhood (Dugan & Kivett, 1994; Dykstra & De Jong Gierveld, 1999;
Holmen, Ericsson, Andersson, & Winblad, 1992; Samuelsson, Andersson, & Hagberg, 1998).

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The discrepancy between an individuals subjective report of loneliness and the reported
or observed number of connections in their social network is well documented (e.g., see
(Berscheid & Reis, 1998), but few details are known about the placement of loneliness within or
the spread of loneliness through a social network. The association between the loneliness of
individuals connected to each other, and their clustering within the network, could be attributed
to at least three social psychological processes.
First, the induction hypothesis posits that the loneliness in one person contributes to or
causes the loneliness in others. The emotional, cognitive, and behavioral consequences of
loneliness may contribute to the induction of loneliness. For instance, emotional contagion
refers to the tendency for the facial expressions, vocalizations, postures, and movements of
interacting individuals to lead to a convergence of their emotions (Hatfield, Cacioppo, & Rapson,
1994). When people feel lonely, they tend to be shyer, more anxious, more hostile, more socially
awkward, and lower in self esteem (e.g., (Berscheid & Reis, 1998; Cacioppo et al., 2006)).
Emotional contagion could therefore contribute to the spread of loneliness to those with whom
they interact. Cognitively, loneliness can affect and be affected by what one perceives and
desires in their social relationships (Peplau & Perlman, 1982; Rook, 1984; Wheeler, Reis, &
Nezlek, 1983). To the extent that interactions with others in an individuals social network
influences a persons ideal or perceived interpersonal relationship, that persons loneliness
should be influenced. Behaviorally, when people feel lonely they tend to act toward others in a
less trusting and more hostile fashion (e.g., (Rotenberg, 1994); cf. (Berscheid & Reis, 1998;
Cacioppo & Patrick, 2008)). These behaviors, in turn, may lower the satisfaction of others with
the relationship or lead to a weakening of loss of the relationship and a consequent induction of
loneliness in others.

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Second, the homophily hypothesis posits that lonely or non-lonely individuals choose one
another as friends and become connected (i.e., the tendency of like to attract like) (Mcpherson,
Smith-Lovin, & Cook, 2001). Byrne (Byrne, 1971)s law of attraction specifies that there is a
direct linear relationship between interpersonal attraction and the proportion of similar attitudes.
The association between similarity and attraction is not limited to attitudes, and the
characteristics on which similarity operates move from obvious characteristics (e.g., physical
attractiveness) to less obvious ones (social perceptions) as relationships develop and deepen
(e.g., (Neimeyer & Mitchell, 1988)). Although feelings of loneliness can be transient, stable
individual differences in loneliness may have sufficiently broad effects on social cognition,
emotion, and behavior to produce similarity-based social sorting.
Finally, the shared environment hypothesis posits that connected individuals jointly
experience contemporaneous exposures that contribute to loneliness. Loneliness, for instance,
tends to be elevated in matriculating students because for many their arrival at college is
associated with a rupture of normal ties with their family and friends (Cutrona, 1982). People
who interact within a social network may also be more likely to be exposed to the same social
challenges and upheavals (e.g., co-residence in a dangerous neighborhood, job loss, retirement).
To distinguish among these hypotheses requires repeated measures of loneliness,
longitudinal information about network ties, and information about the nature or direction of the
ties (e.g., who nominated whom as a friend) (Carrington, Scott, & Wasserman, 2005; Fowler &
Christakis, 2008). With the recent application of innovative research methods to network
linkage data from the population-based Framingham Heart Study, these data are now available
and have been used to trace the distinctive paths through which obesity (Christakis & Fowler,
2007), smoking (Christakis & Fowler, 2008), and happiness (Fowler & Christakis, 2008) spread
through peoples social networks. We sought here to use these methods and data to determine

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the role of social network processes in loneliness, with an emphasis on determining the
topography of loneliness in peoples social networks, the inter-dependence of subjective
experiences of loneliness and the observed position in social networks, the path through which
loneliness spreads through these networks, and factors that modulate its spread.
Methods
Assembling the FHS Social Network Dataset
The Framingham Heart Study (FHS) is a population-based, longitudinal, observational
cohort study that was initiated in 1948 to prospectively investigate risk factors for cardiovascular
disease. Since then, it has come to be composed of four separate but related cohort populations:
(1) the Original Cohort enrolled in 1948 (N=5,209); (2) the Offspring Cohort (the children of
the Original Cohort and spouses of the children) enrolled in 1971 (N=5,124); (3) the Omni
Cohort enrolled in 1994 (N=508); and (4) the Generation 3 Cohort (the grandchildren of the
Original Cohort) enrolled beginning in 2002 (N=4,095). The Original Cohort actually captured the
majority of the adult residents of Framingham in 1948, and there was little refusal to participate.
The Offspring Cohort included offspring of the Original Cohort and their spouses in 1971. The
supplementary, multi-ethnic Omni Cohort was initiated to reflect the increased diversity in
Framingham since the inception of the Original Cohort. For the Generation 3 Cohort, Offspring
Cohort participants were asked to identify all their children and the childrens spouses, and 4,095
participants were enrolled beginning in 2002. Published reports provide details about sample
composition and study design for all these cohorts (Cupples & D'agnostino, 1988; Kannel,
Feinleib, Mcnamara, Garrison, & Castelli, 1979; Quan et al., 1997).
Continuous surveillance and serial examinations of these cohorts provide longitudinal data.
All of the participants are personally examined by FHS physicians and nurses (or, for the small
minority for whom this is not possible, evaluated by telephone) and watched continuously for

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outcomes. The Offspring study has collected information on health events and risk factors roughly
every four years. The Original Cohort has data available for roughly every two years.
Importantly, even participants who migrate out of the town of Framingham (to points throughout
the U.S.) remain in the study and, remarkably, come back every few years to be examined and to
complete survey forms; that is, there is no necessary loss to follow-up due to out-migration in
this dataset, and very little loss to follow-up for any reason (e.g., only 10 cases out of 5,124 in
the Offspring Cohort have been lost).
For the purposes of the analyses reported here, exam waves for the Original cohort were
aligned with those of the Offspring cohort, so that all participants in the social network were
treated as having been examined at just seven waves (in the same time windows as the Offspring,
as noted in Table 1a).
The Offspring Cohort is the key cohort of interest here, and it is our source of the focal
participants (FPs) in our network. However, individuals to whom these FPs are linked in any
of the four cohorts are also included in the network. These linked individuals are termed linked
participants (LPs). That is, whereas FPs will come only from the Offspring Cohort, LPs are
drawn from the entire set of FHS cohorts (including also the Offspring Cohort itself). Hence, the
total number of individuals in the FHS social network is 12,067, since LPs identified in the
Original, Generation 3, and Omni Cohorts are also included, so long as they were alive in 1971
or later. Spouses who list a different address of residence than the FP are termed non-co-resident
spouses. There were 311 FPs with non-co-resident spouses in exam 6 and 299 in exam 7.
The physical, laboratory, and survey examinations of the FHS participants provide a wide
array of data. At each evaluation, participants complete a battery of questionnaires (e.g., the
CES-D measure of depression and loneliness, as described below), a physician-administered

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medical history (including review of symptoms and hospitalizations), a physical examination
administered by physicians on-site at the FHS facility, and a large variety of lab tests.
To ascertain the network ties, we computerized information from archived, handwritten
documents that had not previously been used for research purposes, namely, the administrative
tracking sheets used by the FHS since 1971 by personnel responsible for calling participants in
order to arrange their periodic examinations. These sheets record the answers when all 5,124 of
the FPs were asked to comprehensively identify relatives, friends, neighbors (based on address),
co-workers (based on place of employment), and relatives who might be in a position to know
where the FPs would be in two to four years. The key fact here that makes these administrative
records so valuable for social network research is that, given the compact nature of the
Framingham population in the period from 1971 to 2007, many of the nominated contacts were
themselves also participants of one or another FHS cohort.
We have used these tracking sheets to develop network links for FHS Offspring
participants to other participants in any of the four FHS cohorts. Thus, for example, it is possible
to know which participants have a relationship (e.g., spouse, sibling, friend, co-worker,
neighbor) with other participants. Of note, each link between two people might be identified by
either party identifying the other; this observation is most relevant to the friend link, as we can
make this link either when A nominates B as a friend, or when B nominates A (and, as discussed
below, this directionality is methodologically important and might also be substantively
interesting). People in any of the FHS cohorts may marry or befriend or live next to each other.
Finally, given the high quality of addresses in the FHS data, the compact nature of Framingham,
the wealth of information available about each participants residential history, and new mapping
technologies, we determined who is whose neighbor, and we computed distances between
individuals (Fitzpatrick & Modlin, 1986).

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The measure of loneliness was derived from the Center for Epidemiological Studies
Depression Scale (CES-D) administered between 1983 and 2001 at times corresponding to the
5th, 6th, and 7th examinations of the Offspring Cohort. The median year of examination for
these individuals was 1986 for exam 5, 1996 for exam 6, and 2000 for exam 7. Participants are
asked how often during the previous week they experienced a particular feeling, with 4 possible
answers, 0-1 days, 1-2 days, 3-4 days, and 5-7 days. To convert these categories to days, we
recoded these responses at the center of each range (0.5, 1.5, 3.5, and 6). Factor analyses of the
items from the CES-D and the UCLA loneliness scales indicate they represent two separate
factors, and the I felt lonely item from the CES-D scale loads on a separate factor from the
depression items (Cacioppo et al., 2006). The face-valid nature of the item also supported the
use of the How often I felt lonely item to gauge loneliness.
Table 1b shows summary statistics for loneliness, network variables, and control
variables we use to study the statistical relationship between feeling lonely and being alone.
Statistical Information and Sensitivity Analyses
To distinguish among the induction, homophily, and shared environment hypotheses
requires repeated measures of loneliness, longitudinal information about network ties, and
information about the nature or direction of the ties (e.g., who nominated whom as a friend)
(Carrington et al., 2005; Fowler & Christakis, 2008). For the analyses in Table 2, we averaged
across waves to determine the mean number of social contacts for people in each of the four
loneliness categories. For the analyses in Tables 3-4, we considered the prospective effect of
LPs, social network variables, and other control variables on FPs future loneliness. For the
analyses in Tables 5-8 we conducted regressions of FP loneliness as a function of FPs age,
gender, education, and loneliness in the prior exam, and of the gender and loneliness of an LP in
the current and prior exam. The lagged observations for wave 7 are from wave 6 and the lagged

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observations for wave 6 are from wave 5. Inclusion of FP loneliness at the prior exam eliminates
serial correlation in the errors and also substantially controls for FPs genetic endowment and
any intrinsic, stable tendency to be lonely. LPs loneliness at the prior exam helps control for
homophily (Carrington et al., 2005), which has been verified in monte carlo simulations (Fowler
& Christakis, 2008).
The key coefficient in these models that measures the effect of induction is on the
variable for LP contemporaneous loneliness We used generalized estimating equation (GEE)
procedures to account for multiple observations of the same FP across waves and across FP-LP
pairings (Liang & Zeger, 1986). We assumed an independent working correlation structure for
the clusters (Schildcrout & Heagerty, 2005). These analyses underlie the results presented in
Figures 1-4.
The GEE regression models in the tables provide parameter estimates that are
approximately interpretable as effect sizes, indicating the number of extra days of loneliness per
week the FP experiences given a one unit increase in the independent variable. Mean effect sizes
and 95% confidence intervals were calculated by simulating the first difference in LP
contemporaneous loneliness (changing from 0.5 days feeling lonely to 1.5 days) using 1,000
randomly drawn sets of estimates from the coefficient covariance matrix and assuming all other
variables are held at their means (King, Tomz, & Wittenberg, 2000). We also checked all results
using an ordered logit specification and none of these models changed the significance of any
reported result; we therefore decided to present the simpler and more easily interpretable linear
specifications.
The regression coefficients have mostly the expected effects, such that, for example, FPs
prior loneliness is the strongest predictor for current loneliness. The models in the tables include
exam fixed effects, which, combined with age at baseline, account for the aging of the

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population. The sample size is shown for each model, reflecting the total number of all such ties,
with multiple observations for each tie if it was observed in more than one exam, and allowing
for the possibility that a given person can have multiple ties. As previously indicated, repeated
observations were handled with GEE procedures.
We evaluated the possibility of omitted variables or contemporaneous events explaining
the associations by examining how the type or direction of the social relationship between FP
and LP affects the association between FP and LP. If unobserved factors drive the association
between FP and LP friendship, then directionality of friendship should not be relevant.
Loneliness in the FP and the LP will move up and down together in response to the unobserved
factors. In contrast, if an FP names an LP as a friend but the LP does not reciprocate, then a
causal relationship would indicate that the LP would significantly affect the FP, but the FP would
not necessarily affect the LP.1 The Kamada-Kawai algorithm used to prepare the images in
Figure 1 generates a matrix of shortest network path distances from each node to all other nodes
in the network and repositions nodes so as to reduce the sum of the difference between the
plotted distances and the network distances (Kamada & Kawai, 1989). The fundamental pattern
of ties in a social network (known as the topology) is fixed, but how this pattern is visually
rendered depends on the analysts objectives.
Results
In Figure 1, we show a portion of the social network, which demonstrates a clustering of
moderately lonely (green nodes) and very lonely (blue nodes) people, especially at the periphery
of the network. In the statistical models, the relationships between loneliness and number of
social contacts proved to be negative and monotonic, as illustrated in Figure 1 and documented
in Table 2.

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To determine whether the clustering of lonely people shown in Figure 1 could be
explained by chance, we implemented the following permutation test: we compared the observed
network to 1,000 randomly generated networks in which we preserved the network topology and
the overall prevalence of loneliness but in which we randomly shuffled the assignment of the
loneliness value to each node (Szabo & Barabasi, 2007). For this test, we dichotomized
loneliness to be 0 if the respondent said they were lonely 0-1 days the previous week, and 1
otherwise. If clustering in the social network is occurring, then the probability that an LP is
lonely given that an FP is lonely should be higher in the observed network than in the random
networks. This procedure also allows us to generate confidence intervals and measure how far,
in terms of social distance, the correlation in loneliness between FP and LP reaches. As
described below and illustrated in Figure 2, we found a significant relationship between FP and
LP loneliness, and this relationship extends up to three degrees of separation. In other words, a
persons loneliness depends not just on his friends loneliness, but also extends to his friends
friend and his friends friends friend. The full network shows that participants are 52% (95%
C.I. 40% to 65%) more likely to be lonely if a person they are directly connected to (at one
degree of separation) is lonely. The size of the effect for people at two degrees of separation
(e.g., the friend of a friend) is 25% (95% C.I. 14% to 36%) and for people at three degrees of
separation (e.g., the friend of a friend of a friend) is 15% (95% C.I. 6% to 26%). At four degrees
of separation, the effect disappears (2%, 95% C.I. 5% to 10%), in keeping with the three
degrees of influence rule of social network contagion that has been exhibited for obesity,
smoking, and happiness (e.g., (Christakis & Fowler, 2007; Christakis & Fowler, 2008; Fowler &
Christakis, 2008).
The first model in Table 3, depicted in the first three columns, shows that: (1) loneliness
in the prior wave predicts loneliness in the current wave; and (2) current feelings of loneliness

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are much more closely tied to our networks of optional social connections, measured at the prior
wave, than to those that are handed to us upon birth or to demographic features of the
individuals. People with more friends are less likely to experience loneliness in the future, and
each extra friend appears to reduce the frequency of feeling lonely by 0.04 days per week. That
may not seem like much, but there are 52 weeks in a year, so this is equivalent to about two extra
days of loneliness per year; since, on average (in our data) people feel lonely 48 days per year,
having a couple of extra friends decreases loneliness by about 10% for the average person. The
same model shows that the number of family members has no effect at all.
Analyses also showed that loneliness shapes social networks. Model 2 in Table 3,
depicted in the middle three columns, shows that people who feel lonely at an assessment are
less likely to have friends by the next assessment. In fact, compared to people who are never
lonely, they will lose about 8% of their friends on average by the time they take their next exam
in roughly four years. For comparison, and not surprisingly, the results depicted in the third
model in Table 3 (last three columns) show that loneliness has no effect on the future number of
family members a person has. These results are symmetric to both incoming and outgoing ties
(not shown available on request) lonely people tend to receive fewer friendship nominations,
but they also tend to name fewer people as friends. What this means is that loneliness is both a
cause and a consequence of becoming disconnected. These results suggest that our emotions and
networks reinforce each other and create a rich-gets-richer cycle that benefits those with the most
friends. People with few friends are more likely to become lonelier over time, which then makes
it less likely that they will attract or try to form new social ties.
We also find that social connections and the loneliness of the people to whom these
connections are directed interact to affect how people feel. Figure 3 shows the smoothed
bivariate relationship between the fraction of a persons friends and family who are lonely at one

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exam, and the number of days per week that person feels lonely at the following exam. The
relationship is significant and adds an extra quarter day of loneliness per week to the average
person who is surrounded by other lonely people compared to those who are not connected to
anyone who is lonely. In Table 4, we present a statistical model of the effect of lonely and nonlonely LPs on future FP loneliness that includes controls for age, education, and gender. This
model shows that each additional lonely LP significantly increases the number of days a FP feels
lonely at the next exam (p<0.001). Conversely, each additional non-lonely LP significantly
reduces the number of days a participant feels lonely at the next exam (p=0.002). But these
effects are asymmetric: lonely LPs are about two and a half times more influential than nonlonely LPs, and the difference in these effect sizes is itself significant (p=0.01). Thus, the feeling
of loneliness seems to spread more easily than a feeling of belonging.
To study person-to-person effects, we examined the direct ties and individual-level
determinants of FP loneliness. In the GEE models we present in Tables 5-9 we control for
several factors as noted earlier, and the effect of social influence from one person on another is
captured by the Days/Week LP Currently Lonely coefficient in the first row. We have
highlighted in bold the social influence coefficients that are significant. Figure 4 summarizes the
results from these models for friends, spouses, siblings, and neighbors. Each extra day of
loneliness in a nearby friend (who lives within a mile) increases the number of days FP is
lonely by 0.29 days (95% C.I. 0.07 to 0.50, see first model in Table 5a). In contrast, more distant
friends (who live more than a mile away) have no significant effect on FP, and the effect size
appears to decline with distance (second model in Table 5a). Among friends, we can distinguish
additional possibilities. Since each person was asked to name a friend, and not all of these
nominations were reciprocated, we have FP-perceived friends (denoted friends), LPperceived friends (LP named FP as a friend, but not vice versa) and mutual friends (FP and

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LP nominated each other). Nearby mutual friends have a stronger effect than nearby FPperceived friends; each day they are lonely adds 0.41 days of loneliness for the FP (95% CI: 0.14
to 0.67, see third model in the third column of Table 5a). In contrast, the influence of nearby LPperceived friends is not significant (p=0.25, fourth model in the fourth column of Table 5a). If
the associations in the social network were merely due to confounding, the significance and
effect sizes for different types of friendships should be similar. That is, if some third factor were
explaining both FP and LP loneliness, it should not respect the directionality or strength of the
tie.
We also find significant effects for other kinds of LPs. Each day a coresident spouse is
lonely yields 0.10 extra days of loneliness for the FP (95% CI: 0.02 to 0.17, fifth model in Table
5a), while non-coresident spouses have no significant effect (sixth model). Next-door neighbors
who experience an extra day of loneliness increase FPs loneliness by 0.21 days (CI 0.04 to 0.38,
third model in the third column of Table 5b), but this effect quickly drops close to 0 among
neighbors who live on the same block (within 25M, fourth model in Table 5b). All these
relationships indicate the importance of physical proximity, and the strong influence of
neighbors suggests that the spread of loneliness may possibly depend more on frequent social
contact in older adults. But siblings do not appear to affect one another at all (even the ones who
live nearby, see first model in Table 5b), which provides additional evidence that loneliness in
older adults is about the relationships people choose rather than the relationships they inherit.
And spouses appear to be an intermediate category; Table 6 shows that spouses are significantly
less influential than friends in the spread of loneliness from person to person (as indicated by the
significant interaction term in the first row).
Analyses separated by gender suggested that loneliness spreads more easily among
women than among men, and that this holds for both friends and neighbors. As shown in the

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coefficients in the first row of Tables 7 and 8, women are both more likely to be affected by the
loneliness of their friends (Table 7) and neighbors (Table 8), and their loneliness is also more
likely to spread to other people in their social network. The coefficients in bold show that social
influence is greatest when the FP or the LP is female. Women also reported higher levels of
loneliness than men. We are reporting estimates from a linear model, however, so the baseline
rate of loneliness should not affect the absolute differences that we observed. (We would be
more concerned about this possible effect if we were reporting odds ratios or risk ratios that are
sensitive to the baseline.) In a linear model, any additive differences in baseline should be
captured by the sex variable in the model, which does show a significantly higher baseline for
women. However, since we include this control, the baseline difference in men and women
should not affect the interpretation of the absolute number of days each additional day of
loneliness experienced by an LP contributes to the loneliness experienced by an FP.
Finally, our measure of loneliness was derived from the I feel lonely item in the CESD. To address whether our results would change if depression were included in the models, we
created a depression index by summing the other 19 questions in the CES-D (dropping the
question on loneliness). The Pearson correlation between the indices in our data is 0.566. If
depression is causing the correlation in loneliness between social contacts, then the coefficient on
LP loneliness should be reduced to insignificance when we add depression variables to the
models in Table 5. Specifically, we add a contemporaneous and lagged variable for both FPs
and LPs depression. The results in Tables 9a and 9b show that there is a significant association
between FP current depression and FP current loneliness (the eighth row in bold), but other
depression variables have no effect and adding them to the model has little effect on the
association between FP and LP loneliness. Loneliness in nearby friends, nearby mutual friends,

19
immediate neighbors, and nearby neighbors all remain significantly associated with FP
loneliness.
Discussion
The present research shows that what might appear to be a quintessential individualistic
experience loneliness is not only a function of the individual but is also a property of groups
of people. People who are lonely tend to be linked to others who are lonely, an effect that is
stronger for geographically proximal than distant friends yet extends up to three degrees of
separation (friends friends friend) within the social network. The nature of the friendship
matters, as well, in that nearby mutual friends show stronger effects than nearby ordinary friends.
If some third factor were explaining both focal and linked participants loneliness, then
loneliness should not be contingent on the different types of friendship or the directionality of the
tie. These results, therefore, argue against loneliness within networks primarily reflecting shared
environments.
Longitudinal analyses additionally indicated that non-lonely individuals who are around
lonely individuals tend to grow lonelier over time. The longitudinal results suggest that
loneliness appears in social networks through the operation of induction (e.g., contagion) rather
than simply arising from lonely individuals finding themselves isolated from others and choosing
to become connected to other lonely individuals (i.e., the homophily hypothesis). The present
study does not permit us to identify the extent to which the emotional, cognitive, and behavioral
consequences of loneliness contributed to the induction of loneliness. All three contagion
processes are promoted by face-to-face communications and disclosures, especially between
individuals who share close ties, and can extend to friends friends and beyond through a
chaining of these effects. The social network pattern of loneliness and the inter-personal spread
of loneliness through the network therefore appear most consistent with the induction hypothesis.

20
If loneliness is contagious, what if anything keeps the contagion in check? An
observation by Harlow and colleagues in their studies of social isolation in rhesus monkeys
offers a clue. When the isolate monkeys were reintroduced into the colony, (Harlow et al., 1965)
noted that most of these isolate animals were driven off or eliminated. Our results suggest that
humans may similarly drive away lonely members of their species, and that feeling socially
isolated can lead to one becoming objectively isolated. Loneliness not only spreads from person
to person within a social network, but it reduces the ties of these individuals to others within the
network. As a result, loneliness is found in clusters within social networks, is disproportionately
represented at the periphery of social networks, and threatens the cohesiveness of the network.
The collective rejection of isolates observed in humans and other primates may therefore serve to
protect the structural integrity of social networks.
The findings in the present study that loneliness spreads more quickly among friends than
family further suggest that the rejection of isolates to protect social networks occurs more
forcibly in networks that we select rather than in those we inherit. This effect may be limited to
older populations, however. The mean age in our sample was 64 years, and elderly adults have
been found to reduce the size of their networks to focus on those relationships that are relatively
rewarding, with costly family ties among those that are trimmed (Carstensen, 2001). Although a
spouses loneliness was related to an individuals subsequent loneliness, friends appeared to have
more impact on loneliness than spouses. The gender differences we observed may contribute to
this finding. Wheeler et al. (Wheeler et al., 1983) reported that loneliness is related to how much
time male and female participants interact with women each day, and we found that the spread of
loneliness was stronger for women than for men. Research is needed to address whether the
absence of an effect of spouses and family members on the loneliness is more typical of older
than younger adults and women than men.

21
Fowler and Christakis (Fowler & Christakis, 2008) found that happiness also occurred in
clusters and spread through networks. Several important differences have emerged in the
induction of happiness and the induction of loneliness, however. First, Fowler and Christakis
(2008) found happiness to be more likely to spread through social networks than unhappiness.
The present research, in contrast, indicates that the spread of loneliness is more powerful than the
spread of nonloneliness. Negative events typically have more powerful effects than positive
events (i.e., differential reactivity; (Cacioppo & Gardner, 1999), so Fowler and Christakis
(2008) findings about the spread of happiness through social networks is distinctive. Whereas
laboratory studies are designed to gauge differential reactivity to a positive or negative event, the
Fowler and Christakis (2008) study also reflects peoples differential exposure to happy and
unhappy events. Thus, happiness may spread through networks more than unhappiness because
people have much more frequent exposures to friends expressing happiness than unhappiness.
Loneliness does not have a bipolar opposite like happiness, but rather is like hunger,
thirst, and pain in that its absence is the normal condition rather than an evocative state
(Cacioppo & Patrick, 2008). Furthermore, as an aversive state, loneliness may motivate people
to seek social connection (whatever the response of others to such overtures), which has the
effect of increasing the likelihood that those proximal to a lonely individual will be exposed to
loneliness. Together, these processes may make loneliness more contagious than nonloneliness.
A second difference between the spread of happiness and loneliness concerns the effect
of gender. Fowler and Christakis (2008) found no gender differences in the spread of happiness,
whereas we found that loneliness spreads much more easily among women than men. Women
may be more likely to express and share their emotions with, and be more attentive to, the
emotions of others (Hatfield et al., 1994), but the spread of happiness as well as loneliness
should be fostered similarly among women were this a sufficient cause. There is also a stigma

22
associated with loneliness, particularly among men; women are more likely to engage in intimate
disclosures than men; and relational connectedness is more important for women than men
(Brewer & Gardner, 1996; Hawkley et al., 2005; Shaver & Brennan, 1991). These processes may
explain the greater spread of loneliness among women relative to men. The present results,
however, clearly show that gender, like proximity and type of relationship, influences the spread
of loneliness.
A limitation of all social network analyses is that the studies are necessarily bound their
sample. The compact nature of the Framingham population in the period from 1971 to 2007 and
the geographical proximity of the influence mitigate this constraint, but we nevertheless
considered whether the results might have changed with a larger sample frame that includes all
named individuals who were themselves not participants in the Framingham Heart Study. For
instance, we calculated the statistical relationship between the tendency to name people outside
the study and loneliness. A Pearson correlation between the number of contacts named outside
the study and loneliness is not significant and actually flips signs from one exam to another
(exam 6: 0.016, p=0.39; exam 7: 0.011, p=0.53). This result suggests that the sampling frame
is not biasing the average level of loneliness in the target individuals we are studying.
A second possible limitation is that we included all participants in the analysis. It is
possible that the death or loss of certain critical social network members during the study
systematically affect how lonely FPs felt across time. To address this possibility, we restricted
analysis to those individuals (both FPs and LPs) who remained alive at the end of the study. If
death is the only or most important source of network loss that causes the association between FP
and LP loneliness, then removing observations of people who died during the study should
reduce the association to insignificance. Results of these analyses show that the restriction has
no effect on the association between FP and LP loneliness. Loneliness in nearby friends, nearby

23
mutual friends, spouses, and immediate neighbors all remain significantly associated with FP
loneliness. The death of critical network members, therefore, does not appear to account for our
results.
Prior research has shown that disability is a predictor of loneliness (Hawkley et al., In
press). A related issue, therefore, is whether the disability status of FPs factor into our findings.
To address this issue, we created a disability index by summing five questions from the Katz
Index of Activities of Daily Living about the subjects ability to independently dress themselves,
bathe themselves, eat and drink, get into and out of a chair, and use the toilet. The Pearson
correlation between the indices in our data is 0.06 (n.s.). If disabilities are affecting the
correlation in loneliness between social contacts, then the coefficient on LP loneliness may be
reduced to insignificance when we add disability variables to the models in Table 5.
Specifically, we add a contemporaneous and lagged variable for both FPs and LPs disability
index. The results of these ancillary analyses indicated that loneliness in nearby friends, nearby
mutual friends, immediate neighbors, and nearby neighbors all remain significantly associated
with FP loneliness. Thus, disability does not appear to account for our findings.
In conclusion, the observation that loneliness can be passed from person to person is
reminiscent of sociologist Emile Durkheims famous observation about suicide. He noticed that
suicide rates stayed the same across time, and across groups, even though the individual
members of those groups came and went. In other words, whether people took their own lives
depended on the kind of society they inhabited. Although suicide, like loneliness, has often been
regarded as entirely individualistic, Durkheims work indicates that suicide is driven in part by
larger social forces. Although loneliness has a heritable component, the present study shows it
also to be influenced by broader social network processes. Indeed, we detected an extraordinary
pattern at the edge of the social network. On the periphery, people have fewer friends, which

24
makes them lonely, but it also drives them to cut the few ties that they have left. But before they
do, they tend to transmit the same feeling of loneliness to their remaining friends, starting the
cycle anew. These reinforcing effects mean that our social fabric can fray at the edges, like a
yarn that comes loose at the end of a crocheted sweater. An important implication of this finding
is that interventions to reduce loneliness in our society may benefit by aggressively targeting the
people in the periphery to help repair their social networks. By helping them, we might create a
protective barrier against loneliness that can keep the whole network from unraveling.

25
Acknowledgements
The research was supported by National Institute on Aging Grants No. R01AG034052-01
(to JTC) and P01AG031093 and R01AG24448 (to NAC). Address correspondence to John T.
Cacioppo, Department of Psychology, University of Chicago, Chicago, IL, 60637,
[email protected]; James H. Fowler, Department of Political Science, University of
California, San Diego, CA 92093, [email protected]; or Nicholas A. Christakis, Department of
Health Care Policy, Harvard Medical School, and Department of Sociology, Harvard University,
Cambridge, MA 02138, [email protected].

26
References
Adam, E. K., Hawkley, L. C., Kudielka, B. M., & Cacioppo, J. T. (2006). Day-to-day
dynamics of experience--cortisol associations in a population-based sample of older adults.
Proceedings of the National Academy of Science USA, 103(45), 17058-17063.
Akerlind, I., & Hornquist, J. O. (1992). Loneliness and alcohol abuse: a review of
evidences of an interplay. Soc Sci Med, 34(4), 405-414.
Andersson, L. (1998). Loneliness research and interventions: a review of the literature.
Aging & Mental Health, 2(4), 264-274.
Bartels, M., Cacioppo, J. T., Hudziak, J. J., & Boomsma, D. I. (2008). Genetic and
environmental contributions to stability in loneliness throughout childhood. Am J Med Genet B
Neuropsychiatr Genet, 147(3), 385-391.
Beck, N. (2001). TIME-SERIES-CROSS-SECTION DATA: What Have We Learned in
the Past Few Years? Annual Review of Political Science, 4(1), 271-293.
Berscheid, E. (1985). Interpersonal attraction. In L. G. & A. E. (Eds.), The Handbook of
Social Psychology (3 ed., pp. 413-484). New York: Random House.
Berscheid, E., & Reis, H. T. (1998). Attraction and close relationships. In G. D. T., F. S.
T. & G. Lindzey (Eds.), The Handbook of Social Psychology (4 ed., Vol. 2, pp. 193-281). New
York: McGraw Hill.
Bondevik, M., & Skogstad, A. (1998). The oldest old, ADL, social network, and
loneliness. Western Journal of Nursing Research, 20(3), 325-343.
Boomsma, D., Cacioppo, J., Slagboom, P., & Posthuma, D. (2006). Genetic Linkage and
Association Analysis for Loneliness in Dutch Twin and Sibling Pairs Points to a Region on
Chromosome 12q2324. Behavior Genetics, 36(1), 137-146.

27
Boomsma, D., Willemsen, G., Dolan, C., Hawkley, L., & Cacioppo, J. (2005). Genetic
and Environmental Contributions to Loneliness in Adults: The Netherlands Twin Register Study.
Behavior Genetics, 35(6), 745-752.
Boomsma, D. I., Cacioppo, J. T., Muthen, B., Asparouhov, T., & Clark, S. (2007).
Longitudinal genetic analysis for loneliness in Dutch twins. Twin Res Hum Genet, 10(2), 267273.
Brewer, M. B., & Gardner, W. (1996). Who is this we? Levels of collective identity
and self representations. Journal of Personality and Social Psychology, 71, 83-93.
Burt, R. S. (1986). Strangers, friends, and happiness. In GSS Technical Report No. 72.
Chicago: National Opinion Research Center, University of Chicago.
Byrne, D. (1971). The Attraction Paradigm. New York: Academic Press.
Cacioppo, J. T., & Gardner, W. L. (1999). Emotion. Annual Review of Psychology, 50,
191-214.
Cacioppo, J. T., Hawkley, L. C., Berntson, G. G., Ernst, J. M., Gibbs, A. C., Stickgold,
R., et al. (2002). Do lonely days invade the nights? Potential social modulation of sleep
efficiency. Psychological Science, 13(4), 384-387.
Cacioppo, J. T., Hawkley, L. C., Crawford, L. E., Ernst, J. M., Burleson, M. H.,
Kowalewski, R. B., et al. (2002). Loneliness and health: potential mechanisms. Psychosom Med,
64(3), 407-417.
Cacioppo, J. T., Hawkley, L. C., Ernst, J. M., Burleson, M., Berntson, G. G., Nouriani,
B., et al. (2006). Loneliness within a nomological net: An evolutionary perspective. Journal of
Research in Personality, 40(6), 1054-1085.
Cacioppo, J. T., & Patrick, B. (2008). Loneliness: Human nature and the need for social
connection. New York: W. W. Norton & Company.

28
Carrington, P. J., Scott, J., & Wasserman, S. (2005). Models and methods in social
network analysis. Cambridge: Cambridge University Press.
Carstensen, L. L. (2001). Selectivity theory: Social activity in life-span context. In A. J.
Walker, M. Manoogian-O'Dell, A. McGraw & D. L. G. White (Eds.), Families in later life (pp.
265-275). Thousand Oaks, CA: Pine Forge Press.
Caspi, A., Harrington, H., Moffitt, T. E., Milne, B. J., & Poulton, R. (2006). Socially
isolated children 20 years later: risk of cardiovascular disease. Arch Pediatr Adolesc Med,
160(8), 805-811.
Christakis, N. A., & Fowler, J. H. (2007). The Spread of Obesity in a Large Social
Network over 32 Years. N Engl J Med, 357(4), 370-379.
Christakis, N. A., & Fowler, J. H. (2008). The collective dynamics of smoking in a large
social network. New England Journal of Medicine, 358(21), 2249-2258.
Cole, S. W., Hawkley, L. C., Arevalo, J. M., Sung, C. Y., Rose, R. M., & Cacioppo, J. T.
(2007). Social regulation of gene expression in human leukocytes. Genome Biology, 8(9),
R189.181-R189.113.
Cupples, L. A., & D'Agnostino, R. B. (1988). Survival following initial cardiovascular
events: 30 year follow-up. In W. B. Kannel, P. A. Wolf & R. J. Garrison (Eds.), The
Framingham Study: An epidemiological investigation of cardiovascular disease (pp. 88-2969).
Bethesda, MD: NHLBI, NIH.
Cutrona, C. E. (1982). Transition to college: Loneliness and the process of social
adjustment. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory,
research, and therapy (pp. 291-309). New York: John Wiley & Sons.

29
Dronjak, S., Gavrilovic, L., Filipovic, D., & Radojcic, M. B. (2004). Immobilization and
cold stress affect sympatho-adrenomedullary system and pituitary-adrenocortical axis of rats
exposed to long-term isolation and crowding. Physiology and Behavior, 81(3), 409-415.
Dugan, E., & Kivett, V. R. (1994). The importance of emotional and social isolation to
loneliness among very old rural adults. Gerontologist, 34(3), 340-346.
Dykstra, P. A., & de Jong Gierveld, J. (1999). [Differential indicators of loneliness
among elderly. The importance of type of partner relationship, partner history, health,
socioeconomic status and social relations]. Tijdschrift Voor Gerontologie En Geriatrie, 30(5),
212-225.
Emler, N. (1994). Gossip, reputation and adaptation. In G. R. F. & B.-Z. e. A. (Eds.),
Good gossip (pp. 34-46). Lawrence, KS: University of Kansas Press.
Fitzpatrick, G. L., & Modlin, M. J. (1986). Direct-Line Distances: International Edition.
Metuchen, NJ: The Scarecrow Press.
Fowler, J. H., & Christakis, N. A. (2008). Estimating peer effects on health in social
networks: a response to Cohen-Cole and Fletcher; and Trogdon, Nonnemaker, and Pais. Journal
of Health Economics, 27(5), 1400-1405.
Fowler, J. H., & Christakis, N. A. (2008). Dynamic Spread of Happiness in a Large
Social Network: Longitudinal Analysis Over 20 Years in the Framingham Heart Study. British
Medical Journal, 337, a2338.
Harlow, H. F., Dodsworth, R. O., & Harlow, M. K. (1965). Total social isolation in
monkeys. Proceedings of the National Academy of Sciences of the United States of America,
54(1), 90-97.
Hatfield, E., Cacioppo, J. T., & Rapson, R. L., 2, 96-99. (1994). Emotional contagion.
New York: Cambridge University Press.

30
Hawkley, L. C., Browne, M. W., & Cacioppo, J. T. (2005). How Can I Connect With
Thee?. Let Me Count the Ways. Psychological Science, 16(10), 798-804.
Hawkley, L. C., Hughes, M. E., Waite, L. J., Masi, C. M., Thisted, R. A., & Cacioppo, J.
T. (In press). From social structure factors to perceptions of relationship quality and loneliness:
The Chicago Health, Aging, and Social Relations Study. Journal of Gerontology: Social
Sciences.
Hawkley, L. C., Masi, C. M., Berry, J. D., & Cacioppo, J. T. (2006). Loneliness is a
unique predictor of age-related differences in systolic blood pressure. Psychol Aging, 21(1), 152164.
Hector-Taylor, L., & Adams, P. (1996). State versus trait loneliness in elderly New
Zealanders. Psychological Reports, 78(3 Pt 2), 1329-1330.
Heikkinen, R.-L., & Kauppinen, M. (2004). Depressive symptoms in late life: a 10-year
follow-up. Archives of gerontology and geriatrics, 38(3), 239-250.
Holmen, K., Ericsson, K., Andersson, L., & Winblad, B. (1992). Subjective loneliness--a
comparison between elderly and relatives. Vard i Norden, 12(2), 9-13.
House, J. S., Landis, K. R., & Umberson, D. (1988). Social relationships and health.
Science, 241(4865), 540-545.
Jones, D. C. (1992). Parental Divorce, Family Conflict and Friendship Networks. Journal
of Social and Personal Relationships, 9(2), 219-235.
Kahneman, D., Krueger, A. B., Schkade, D. A., Schwarz, N., & Stone, A. A. (2004). A
Survey Method for Characterizing Daily Life Experience: The Day Reconstruction Method.
Science, 306(5702), 1776-1780.
Kamada, T., & Kawai, S. (1989). An algorithm for drawing general undirected graphs.
Information Processing Letters, 31(1), 7-15.

31
Kanitz, E., Tuchscherer, M., Puppe, B., Tuchscherer, A., & Stabenow, B. (2004).
Consequences of repeated early isolation in domestic piglets (Sus scrofa) on their behavioural,
neuroendocrine, and immunological responses. Brain, Behavior, and Immunity, 18(1), 35-45.
Kannel, W. B., Feinleib, M., McNamara, P. M., Garrison, R. J., & Castelli, W. P. (1979).
An investigation of coronary heart disease in families. The Framingham offspring study. Am J
Epidemiol, 110(3), 281-290.
Kiecolt-Glaser, J. K., Ricker, D., George, J., Messick, G., Speicher, C. E., Garner, W., et
al. (1984). Urinary cortisol levels, cellular immunocompetency, and loneliness in psychiatric
inpatients. Psychosom Med, 46(1), 15-23.
King, G., Tomz, M., & Wittenberg, J. (2000). Making the most of statistical analyses:
Improving interpretation and presentation. American Journal of Political Science, 44(2), 341355.
Lauder, W., Mummery, K., Jones, M., & Caperchione, C. (2006). A comparison of health
behaviours in lonely and non-lonely populations. Psychology, Health & Medicine, 11(2),
233 - 245.
Liang, K.-Y., & Zeger, S. L. (1986). Longitudinal Data Analysis Using Generalized
Linear Models. Biometrika, 73(1), 13-22.
Lyons, D. M., Ha, C. M., & Levine, S. (1995). Social effects and circadian rhythms in
squirrel monkey pituitary-adrenal activity. Hormones and Behavior, 29(2), 177-190.
McGuire, S., & Clifford, J. (2000). Genetic and Environmental Contributions to
Loneliness in Children. Psychological Science, 11(6), 487-491.
McPherson, M., Smith-Lovin, L., & Cook, J. M. (2001). BIRDS OF A FEATHER:
Homophily in Social Networks. Annual Review of Sociology, 27(1), 415.

32
Mullins, L. C., & Dugan, E. (1990). The influence of depression, and family and
friendship relations, on residents' loneliness in congregate housing. Gerontologist, 30(3), 377384.
Myers, D. G., & Diener, E. (1995). Who is happy? Psychological Science, 6(1), 10-19.
Nation, D. A., Gonzales, J. A., Mendez, A. J., Zaias, J., Szeto, A., Brooks, L. G., et al.
(2008). The effect of social environment on markers of vascular oxidative stress and
inflammation in the Watanabe heritable hyperlipidemic rabbit. Psychosom Med, 70(3), 269-275.
Neimeyer, R. A., & Mitchell, K. A. (1988). Similarity and Attraction: A Longitudinal
Study. Journal of Social and Personal Relationships, 5(2), 131-148.
Nonogaki, K., Nozue, K., & Oka, Y. (2007). Social Isolation Affects the Development of
Obesity and Type 2 Diabetes in Mice. Endocrinology, 148(10), 4658-4666.
Penninx, B. W., van Tilburg, T., Kriegsman, D. M., Deeg, D. J., Boeke, A. J., & van Eijk,
J. T. (1997). Effects of social support and personal coping resources on mortality in older age:
the Longitudinal Aging Study Amsterdam. Am J Epidemiol, 146(6), 510-519.
Peplau, L., & Perlman, D. (1982). Perspectives on loneliness. In L. Peplau & D. Perlman
(Eds.), Loneliness: A source book of current theory, research and therapy (pp. 1-18). New York:
John Wiley.
Pinquart, M., & Sorenson, S. (2003). Risk factors for loneliness in adulthood and old age
- a meta-analysis. In (Vol. 19, pp. 111-143).
Poletto, R., Steibel, J. P., Siegford, J. M., & Zanella, A. J. (2006). Effects of early
weaning and social isolation on the expression of glucocorticoid and mineralocorticoid receptor
and 11beta-hydroxysteroid dehydrogenase 1 and 2 mRNAs in the frontal cortex and
hippocampus of piglets. Brain Research, 1067(1), 36-42.

33
Pressman, S. D., Cohen, S., Miller, G. E., Barkin, A., Rabin, B. S., & Treanor, J. J.
(2005). Loneliness, social network size, and immune response to influenza vaccination in college
freshmen. Health Psychol, 24(3), 297-306.
Quan, S. F., Howard, B. V., Iber, C., Kiley, J. P., Nieto, F. J., O'Connor, G. T., et al.
(1997). The Sleep Heart Health Study: design, rationale, and methods. Sleep, 20(12), 1077-1085.
Rook, K. S. (1984). Promoting social bonding: Strategies for helping the lonely and
socially isolated. American Psychologist, 39(12), 1389-1407.
Rotenberg, K. (1994). Loneliness and interpersonal trust. Journal of Social and Clinical
Psychology, 13(2), 152-173.
Routasalo, P. E., Savikko, N., Tilvis, R. S., Strandberg, T. E., & Pitkala, K. H. (2006).
Social contacts and their relationship to loneliness among aged people - a population-based
study. Gerontology, 52(3), 181-187.
Ruan, H., & Wu, C. F. (2008). Social interaction-mediated lifespan extension of
Drosophila Cu/Zn superoxide dismutase mutants. Proceedings of the National Academy of
Sciences of the United States of America, 105(21), 7506-7510.
Rudatsikira, E., Muula, A. S., Siziya, S., & Twa-Twa, J. (2007). Suicidal ideation and
associated factors among school-going adolescents in rural Uganda. BMC Psychiatry, 7, 67.
Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The revised UCLA Loneliness Scale:
concurrent and discriminant validity evidence. J Pers Soc Psychol, 39(3), 472-480.
Russell, D. W., Cutrona, C. E., de la Mora, A., & Wallace, R. B. (1997). Loneliness and
nursing home admission among rural older adults. Psychology and Aging., 12(4), 574-589.
Samuelsson, G., Andersson, L., & Hagberg, B., 4, 361-378. (1998). Loneliness in relation
to social, psychological and medical variables over a 13-year period: A study of the elderly in a
Swedish rural district. Journal of Mental Health and Aging, 4, 361-378.

34
Savikko, N., Routasalo, P., Tilvis, R. S., Strandberg, T. E., & Pitkala, K. H. (2005).
Predictors and subjective causes of loneliness in an aged population. Archives of gerontology and
geriatrics, 41(3), 223-233.
Schildcrout, J. S., & Heagerty, P. J. (2005). Regression analysis of longitudinal binary
data with time-dependent environmental covariates: bias and efficiency. Biostatistics, 6(4), 633652.
Seeman, T. (2000). Health Promoting Effetcs of Friends and Family on Health Outcomes
in Older Adults. American Journal of Health Promotion, 14(6), 362-370.
Segrin, C. (1999). Social skills, stressful events, and the development of psychosocial
problems. Journal of Social & Clinical Psychology, 18, 14-34.
Shaver, P. R., & Brennan, K. A. (1991). Measures of depression and loneliness. In J. P.
Robinson, P. R. Shaver & L. S. Wrightsman (Eds.), Measures of personality and social
psychological attitudes: Measures of social psychological attitudes (Vol. 1, pp. 195-289). San
Diego, CA: Academic Press, Inc.
Steptoe, A., Owen, N., Kunz-Ebrecht, S. R., & Brydon, L. (2004). Loneliness and
neuroendocrine, cardiovascular, and inflammatory stress responses in middle-aged men and
women. Psychoneuroendocrinology, 29(5), 593-611.
Stranahan, A. M., Khalil, D., & Gould, E. (2006). Social isolation delays the positive
effects of running on adult neurogenesis. Nature Neuroscience, 9(4), 526-533.
Sugisawa, H., Liang, J., & Liu, X. (1994). Social networks, social support, and mortality
among older people in Japan. Journal of Gerontology, 49(1), S3-13.
Szabo, G., & Barabasi, A. L. (2007). Network Effects in Service Usage. Retrieved
December 12, 2007, from http://lanl.arxiv.org/abs/physics/0611177

35
Tilvis, R. S., Pitkala, K. H., Jolkkonen, J., & Strandberg, T. E. (2000). Social networks
and dementia. Lancet, 356(9223), 77-78.
Wei, P. A. N. (2002). Goodness-of-fit Tests for GEE with Correlated Binary Data.
Scandinavian Journal of Statistics, 29(1), 101-110.
Wheeler, L., Reis, H., & Nezlek, J. (1983). Loneliness, social interaction, and sex roles. J
Pers Soc Psychol, 45(4), 943-953.
Wilson, R. S., Krueger, K. R., Arnold, S. E., Schneider, J. A., Kelly, J. F., Barnes, L. L.,
et al. (2007). Loneliness and risk of Alzheimer disease. Arch Gen Psychiatry, 64(2), 234-240.

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Footnotes
1. We explored the sensitivity of our results to model specification by conducting
numerous other analyses each of which had various strengths and limitations, but none of which
yielded substantially different results than those presented here. For example, we experimented
with different error specifications. Although we identified only a single close friend for most of
the FPs, we studied how multiple observations on some FPs affected the standard errors of our
models. Huber-White sandwich estimates with clustering on the FPs yielded very similar results.
We also tested for the presence of serial correlation in the GEE models using a Lagrange
multiplier test and found none remaining after including the lagged dependent variable (Beck,
2001).

37
Table 1a: Survey Waves and Sample Sizes of the Framingham Offspring Cohort (Network
FPs)
Number
Survey
Alive and
% of adults
Wave/
Time
N alive
18+
N
participating
Physical
period
examined
Exam
Exam 1
1971-75
5124
4914
5,124
100.0
Exam 2
1979-82
5053
5037
3,863
76.7
Exam 3
1984-87
4974
4973
3,873
77.9
Exam 4
1987-90
4903
4903
4,019
82.0
Exam 5
1991-95
4793
4793
3,799
79.3
Exam 6
1996-98
4630
4630
3,532
76.3
Exam 7
1998-01
4486
4486
3,539
78.9
Table 1b. Summary Statistics
Variable
Current Number of Days Per Week Feeling Lonely
Mean
S.D.
Min.
Max
0.853
0.964
0.5
Lonely
0.940
1.086
0.5
Current Number of Family Members
2.819
3.071
23
Prior Wave Number of Family Members
3.035
3.255
26
Current Number of Close Friends
0.897
0.894
Prior Wave Number of Close Friends
0.951
0.911
Female
0.549
0.498
Years of Education
13.573
2.409
17
Age
63.787
11.848 29.667 101.278
Prior Wave Number of Days Per Week Feeling

38
Table 2. Mean total number of social contacts for people in each of the four loneliness
categories
Felt lonely 0-1 days last week

Mean Number of Social Contacts

(Friends and Family Combined)
4.03
3.88
3.76
3.42
Standard
Error
0.05
0.11
0.21
0.28

39
Table 3. Prospective Influence of Friends and Family on Loneliness and Vice Versa
----------------------Current Wave---------------------Days/Week
Number
Number
Feel Lonely
of Friends
of Family
Coef
S.E.
p
Coef
S.E.
p
Coef S.E.
p
Prior Wave Days/Week Feel
Lonely
Prior Wave Number of
Friends
Prior Wave Number of
Family
Age
Years of Education
Female
Exam 7
Constant
Deviance
Null Deviance
N
0.257
0.021
0.000
-0.010
0.004
0.010
-0.007
0.006
0.227
-0.040
0.013
0.002
0.900
0.007
0.000
-0.029
0.007
0.000
-0.001
0.004
0.797
-0.003
0.002
0.046
0.933
0.003
0.000
0.006
0.001
0.000
-0.002
0.000
0.000
0.002
0.001
0.003
-0.014
0.006
0.019
0.003
0.002
0.145
-0.005
0.003
0.033
0.124
0.024
0.000
-0.016
0.009
0.067
0.014
0.012
0.240
0.043
0.022
0.057
0.007
0.009
0.419
0.041
0.012
0.001
0.112
0.196
0.569
0.092
0.075
0.223
-0.275
0.089
0.002
5065
720
1288
5656
4866
57349
6083
6083
6083
Results for linear regression of FPs loneliness, number of friends, and number of family
members at current exam on prior loneliness, number of friends, and number of family plus other
covariates. Models were estimated using a general estimating equation (GEE) with clustering on
the FP and an independent working covariance structure (Liang & Zeger, 1986; Schildcrout &
Heagerty, 2005). Models with an exchangeable correlation structure yielded poorer fit. Fit
statistics show sum of squared deviance between predicted and observed values for the model
and a null model with no covariates (Wei, 2002). The main results (coefficients in bold) show
that number of friends is associated with a decrease in future loneliness and loneliness is
associated with a decrease in future friends.

40
Table 4. Influence of Number of Lonely LPs on FP Loneliness
Prior Wave Number of Lonely LPs

Prior Wave Number of Non-Lonely LPs
Prior Wave Days/Week Feel Lonely
Age
Years of Education
Female
Exam 7
Constant
Deviance
Null Deviance
N
Current Wave
Days/Week
Feel Lonely
Coef. S.E.
p
0.064 0.017 0.000
-0.024 0.008 0.002
0.230 0.022 0.000
0.003 0.002 0.030
-0.003 0.006 0.641
0.121 0.025 0.000
0.053 0.024 0.027
0.037 0.206 0.858
3487
3831
4879
Results for linear regression of FPs loneliness, on prior loneliness, number of lonely friends and
family (>1 day of loneliness per week), number of non-lonely friends and family (0-1 days of
loneliness per week), and other covariates. Models were estimated using a general estimating
equation (GEE) with clustering on the FP and an independent working covariance structure
(Liang & Zeger, 1986; Schildcrout & Heagerty, 2005). Models with an exchangeable correlation
structure yielded poorer fit. Fit statistics show sum of squared deviance between predicted and
observed values for the model and a null model with no covariates (Wei, 2002). The main
results (coefficients in bold) show that number of lonely LPs is associated with an increase in
future loneliness and the number of non-lonely LPs is associated with a decrease in future
loneliness. Moreover, the lonely LP effect is significantly stronger than the non-lonely LP effect
(p=0.01, calculated by drawing 1000 pairs of coefficients from the coefficient covariance matrix
produced by the model).

41
Table 5a: Association of LP Loneliness and FP Loneliness
LP Type
Days/Week LP Currently
Lonely
Days/Week LP Lonely in
Prior Wave
Days/Week FP Lonely in
Prior Wave
Exam 7
FPs Age
FP Female
FPs Years of Education
Constant
Deviance
Null Deviance
N
Nearby
Friend
Distant
Friend
Nearby
Mutual
Friend
0.29
(0.11)
0.12
(0.05)
0.31
(0.13)
0.11
(0.09)
0.01
(0.01)
0.18
(0.09)
0.00
(0.01)
-0.30
(0.43)
236
375
472
-0.08
(0.05)
0.11
(0.05)
0.39
(0.09)
0.05
(0.07)
0.01
(0.01)
0.06
(0.08)
-0.01
(0.02)
-0.04
(0.60)
677
899
1014
0.41
(0.13)
0.16
(0.09)
0.28
(0.14)
0.04
(0.16)
0.01
(0.01)
0.17
(0.14)
0.01
(0.02)
-0.78
(0.60)
138
285
214
Nearby
LPPerceived
Friend
Coresident
Spouse
Non
Coresident
Spouse
0.35
(0.30)
0.02
(0.08)
0.10
(0.05)
-0.07
(0.09)
0.01
(0.01)
0.12
(0.14)
0.05
(0.03)
-0.89
(0.71)
122
145
274
0.10
(0.04)
0.03
(0.02)
0.21
(0.04)
0.08
(0.03)
0.00
(0.00)
0.11
(0.03)
0.00
(0.01)
0.48
(0.20)
1575
1734
3716
0.08
(0.05)
0.06
(0.05)
0.04
(0.05)
0.01
(0.08)
-0.01
(0.00)
0.04
(0.08)
-0.05
(0.02)
1.65
(0.51)
275
290
592
Coefficients and standard errors in parenthesis for linear regression of days per week FP feels
lonely on covariates are shown. Observations for each model are restricted by type of
relationship (e.g., the leftmost model includes only observations in which the FP named the LP
as a friend in the previous and current period, and the friend is nearby i.e. lives no more
than 1 mile away). Models were estimated using a general estimating equation with clustering on
and a null model with no covariates (Wei, 2002).

42
Table 5b: Association of LP Loneliness and FP Loneliness
LP Type
Days/Week LP
Currently Lonely
Days/Week LP
Lonely in Prior
Wave
Days/Week FP
Lonely in Prior
Wave
Exam 7
FPs Age
FP Female
FPs Years of
Education
Constant
Deviance
Null Deviance
N
Nearby
Sibling
Distant
Sibling
Immediate
Neighbor
Neighbor
within 25M
Neighbor
within
100M
Co-worker
0.00
(0.03)
-0.02
-0.03
(0.01)
0.03
0.21
(0.09)
0.08
0.04
(0.02)
0.03
-0.05
(0.03)
-0.02
0.00
(0.03)
-0.02
(0.02)
0.18
(0.01)
0.18
(0.06)
0.39
(0.02)
0.22
(0.03)
0.08
(0.02)
0.18
(0.05)
0.00
(0.05)
0.00
(0.00)
0.10
(0.05)
-0.01
(0.02)
0.82
(0.43)
1065
1140
2124
(0.04)
0.03
(0.04)
0.00
(0.00)
0.06
(0.04)
0.00
(0.01)
0.71
(0.29)
3729
3954
6168
(0.19)
0.25
(0.13)
0.00
(0.00)
0.14
(0.12)
0.02
(0.04)
-0.33
(0.68)
205
366
364
(0.04)
0.12
(0.06)
0.01
(0.00)
0.17
(0.06)
0.00
(0.02)
-0.01
(0.34)
1618
1930
1904
(0.06)
-0.01
(0.10)
-0.01
(0.01)
0.22
(0.09)
0.01
(0.02)
1.02
(0.39)
5738
6278
6888
(0.05)
0.00
(0.05)
0.00
(0.00)
0.10
(0.05)
-0.01
(0.02)
0.82
(0.43)
636
665
1330
as a sibling in the previous and current period, and the sibling is nearby i.e. lives no more

43
Table 6. Influence of Type of Relationship on Association Between LP Loneliness and FP
Loneliness
LP is Spouse * Days/Week LP Currently
Lonely
Days/Week LP Currently Lonely
LP is Spouse (Instead of Friend)
Days/Week LP Lonely in Prior Wave
Days/Week FP Lonely in Prior Wave
Exam 7
FPs Age
Female
Constant
Deviance
Null Deviance
N
Coef.
S.E.
-0.274
0.364
0.165
0.046
0.227
0.082
0.000
0.117
-0.005
0.232
910
1056
2094
0.138
0.131
0.092
0.022
0.046
0.031
0.002
0.032
0.006
0.204
0.047
0.005
0.074
0.033
0.000
0.009
0.914
0.000
0.470
0.255
Results for linear regression of days per week FP feels lonely at next exam on covariates are
shown. Sample includes all spouses and nearby friends (nearby = less than a mile away). The
interaction term in the first row tests the hypothesis that spouses have less influence than friends
on loneliness. Models were estimated using a general estimating equation (GEE) with clustering
on the FP and an independent working covariance structure (Liang & Zeger, 1986; Schildcrout &
and a null model with no covariates (Wei, 2002). The results show that spouses exert
significantly less influence on each other than friends.

44
Table 7: Association of LP Loneliness and FP Loneliness in Friends, By Gender
LP Type = Friend Within 2 Miles
Days/Week LP
Currently Lonely
Days/Week LP
Lonely in Prior
Wave
Days/Week FP
Lonely in Prior
Wave
Exam 7
FPs Age
FPs Years of
Education
Constant
Deviance
Null Deviance
N
LP Male
LP
Female
FP & LP
Male
FP & LP
Female
FP & LP
Opposite
Gender
0.33
(0.15)
0.01
0.02
(0.05)
0.05
0.25
(0.13)
0.01
0.05
(0.04)
0.03
0.36
(0.15)
0.01
-0.02
(0.11)
0.04
(0.04)
0.35
(0.05)
0.37
(0.07)
0.36
(0.04)
0.38
(0.06)
0.15
(0.05)
0.31
(0.07)
0.79
(0.18)
0.16
(0.09)
0.01
(0.01)
-0.01
(0.01)
-0.33
(0.57)
57
73
195
(0.11)
0.12
(0.12)
0.00
(0.01)
0.00
(0.02)
-0.10
(0.71)
142
218
194
(0.19)
0.15
(0.10)
0.01
(0.01)
-0.01
(0.01)
-0.46
(0.63)
58
72
174
(0.11)
0.13
(0.11)
0.00
(0.01)
0.01
(0.02)
0.09
(0.64)
144
221
215
(0.04)
0.07
(0.07)
0.01
(0.01)
-0.02
(0.01)
0.09
(0.52)
38
42
166
(0.11)
0.09
(0.11)
0.00
(0.01)
0.00
(0.02)
0.27
(0.71)
123
190
186
(0.21)
0.41
(0.26)
0.02
(0.02)
0.05
(0.03)
-1.85
(1.04)
23
58
37
FP Male
FP
Female
0.03
(0.03)
0.04
relationship (e.g., the leftmost model includes only observations in which the FP is a male) all
LPs in this table are friends who live within two miles. Models were estimated using a general
estimating equation with clustering on the FP and an independent working covariance structure
(Liang & Zeger, 1986; Schildcrout & Heagerty, 2005). Models with an exchangeable correlation
structure yielded poorer fit. Fit statistics show sum of squared deviance between predicted and
observed values for the model and a null model with no covariates (Wei, 2002).

45
Table 8: Association of LP Loneliness and FP Loneliness in Neighbors, By Gender
LP Type = Neighbor Within 25 Meters
Days/Week LP
Currently Lonely
Days/Week LP
Lonely in Prior
Wave
Days/Week FP
Lonely in Prior
Wave
Exam 7
FPs Age
FPs Years of
Education
Constant
Deviance
Null Deviance
N
LP Male
LP
Female
FP & LP
Male
FP & LP
Female
FP & LP
Opposite
Gender
0.19
(0.08)
0.07
-0.06
(0.04)
0.05
0.14
(0.06)
0.06
0.00
(0.06)
0.02
0.24
(0.09)
0.08
0.01
(0.06)
0.02
(0.02)
0.16
(0.05)
0.27
(0.04)
0.20
(0.05)
0.31
(0.03)
0.14
(0.07)
0.31
(0.03)
0.20
(0.06)
0.18
(0.08)
0.00
(0.00)
0.02
(0.02)
0.04
(0.40)
127
137
353
(0.07)
0.02
(0.19)
-0.01
(0.01)
-0.03
(0.04)
1.25
(1.02)
571
684
535
(0.07)
0.04
(0.14)
0.00
(0.01)
-0.01
(0.03)
0.84
(0.69)
244
264
352
(0.07)
0.16
(0.11)
0.00
(0.01)
-0.02
(0.03)
0.76
(0.72)
473
574
536
(0.07)
0.18
(0.08)
0.00
(0.01)
0.03
(0.02)
-0.23
(0.57)
26
29
140
(0.08)
0.10
(0.17)
0.00
(0.01)
-0.04
(0.05)
1.12
(1.23)
350
454
323
(0.06)
0.06
(0.12)
0.00
(0.00)
-0.01
(0.02)
0.86
(0.52)
318
342
425
FP Male
FP
Female
0.05
(0.06)
0.00
relationship (e.g., the leftmost model includes only observations in which the FP is a male) all
LPs in this table are non-related neighbors who live within 25 meters. Models were estimated
using a general estimating equation with clustering on the FP and an independent working
covariance structure (Liang & Zeger, 1986; Schildcrout & Heagerty, 2005). Models with an
exchangeable correlation structure yielded poorer fit. Fit statistics show sum of squared
deviance between predicted and observed values for the model and a null model with no
covariates (Wei, 2002).

46
Table 9a: Association of LP Loneliness and FP Loneliness Controlling for Depression
(Compare with Table 5a)
LP Type
Nearby
Friend
Days/Week LP Currently
Lonely
Days/Week LP Lonely in
Prior Wave
Days/Week FP Lonely in
Prior Wave
Exam 7
Distant
Friend
Nearby
Mutual
Friend
Nearby
LPPerceived
Friend
Coresident
Spouse
Non
Coresident
Spouse
0.28
-0.09
0.37
0.33
0.03
-0.05
(0.12)
(0.06)
(0.15)
(0.28)
(0.04)
(0.07)
0.13
0.07
0.13
0.02
0.01
-0.03
(0.07)
(0.05)
(0.12)
(0.07)
(0.02)
(0.04)
0.13
0.14
0.17
0.05
0.11
0.00
(0.13)
(0.07)
(0.17)
(0.06)
(0.04)
(0.06)
-0.03
-0.08
-0.18
-0.24
0.00
-0.07
(0.09)
(0.09)
(0.13)
(0.11)
(0.03)
(0.09)
FPs Age
0.00
0.01
0.01
0.02
0.00
0.00
(0.00)
(0.01)
(0.01)
(0.01)
(0.00)
(0.00)
FP Female
-0.01
0.01
-0.07
0.11
0.05
0.00
(0.08)
(0.07)
(0.15)
(0.14)
(0.03)
(0.07)
-0.01
0.01
0.01
0.04
0.01
-0.02
(0.02)
(0.02)
(0.02)
(0.02)
(0.01)
(0.01)
FP Current Depression
0.07
0.08
0.07
0.06
0.05
0.06
Index
(0.02)
(0.01)
(0.04)
(0.02)
(0.01)
(0.02)
FP Depression Index in
0.00
-0.01
-0.01
-0.02
0.00
0.00
Prior Wave
(0.02)
(0.01)
(0.02)
(0.01)
(0.00)
(0.01)
LP Current Depression
-0.01
0.01
-0.02
0.00
0.01
0.01
Index
(0.01)
(0.01)
(0.02)
(0.01)
(0.00)
(0.01)
LP Depression Index in
-0.02
-0.01
-0.01
0.00
0.00
0.00
Prior Wave
(0.01)
(0.01)
(0.01)
(0.01)
(0.00)
(0.01)
Constant
0.11
-0.44
-0.25
-1.23
-0.07
0.47
(0.41)
(0.54)
(0.70)
(0.57)
(0.20)
(0.35)
Deviance
157
405
87
80
959
146
Null Deviance
353
765
266
126
1422
219
N
396
826
182
232
3040
492
as a friend in the previous and current period, and the friend is nearby i.e. lives no more

47
Table 9b: Association of LP Loneliness and FP Loneliness Controlling for Depression
(Compare with Table 5b)
LP Type
Days/Week LP
Currently Lonely
Days/Week LP
Lonely in Prior
Wave
Days/Week FP
Lonely in Prior
Wave
Exam 7
Nearby
Sibling
Distant
Sibling
Immediate
Neighbor
Neighbor
within
25M
Neighbor
within
100M
Co-worker
0.00
(0.03)
-0.02
-0.03
(0.01)
0.03
0.21
(0.09)
0.08
0.04
(0.02)
0.03
-0.05
(0.03)
-0.02
0.00
(0.03)
-0.02
(0.02)
0.18
(0.01)
0.18
(0.06)
0.39
(0.02)
0.22
(0.03)
0.08
(0.02)
0.18
(0.05)
(0.04)
(0.19)
(0.04)
(0.06)
(0.05)
0.00
0.03
0.25
0.12
-0.01
0.00
(0.05)
(0.04)
(0.13)
(0.06)
(0.10)
(0.05)
FPs Age
0.00
0.00
0.00
0.01
-0.01
0.00
(0.00)
(0.00)
(0.00)
(0.00)
(0.01)
(0.00)
FP Female
0.10
0.06
0.14
0.17
0.22
0.10
(0.05)
(0.04)
(0.12)
(0.06)
(0.09)
(0.05)
FPs Years of
-0.01
0.00
0.02
0.00
0.01
-0.01
Education
(0.02)
(0.01)
(0.04)
(0.02)
(0.02)
(0.02)
FP Current
0.07
0.08
0.07
0.06
0.05
0.06
Depression Index
(0.02)
(0.01)
(0.04)
(0.02)
(0.01)
(0.02)
FP Depression Index
0.00
-0.01
-0.01
-0.02
0.00
0.00
in Prior Wave
(0.02)
(0.01)
(0.02)
(0.01)
(0.00)
(0.01)
LP Current
-0.01
0.01
-0.02
0.00
0.01
0.01
Depression Index
(0.01)
(0.01)
(0.02)
(0.01)
(0.00)
(0.01)
LP Depression Index
-0.02
-0.01
-0.01
0.00
0.00
0.00
in Prior Wave
(0.01)
(0.01)
(0.01)
(0.01)
(0.00)
(0.01)
Constant
0.82
0.71
-0.33
-0.01
1.02
0.82
(0.43)
(0.29)
(0.68)
(0.34)
(0.39)
(0.43)
Deviance
659
2114
103
896
3323
301
Null Deviance
991
3127
360
1699
5244
630
N
1748
5054
300
1562
5540
1140
as a sibling in the previous and current period, and the sibling is nearby i.e. lives no more

48
Figure 1. Loneliness Clusters in the Framingham Social Network. This graph shows the
largest component of friends, spouses, and siblings at exam 7 (centered on the year 2000). There
are 1,019 individuals shown. Each node represents a participant and its shape denotes gender
(circles are female, squares are male). Lines between nodes indicate relationship (red for
siblings, black for friends and spouses). Node color denotes the mean number of days the FP and
all directly connected (distance 1) LPs felt lonely in the past week, with yellow being 0-1 days,
green being 2 days, and blue being greater than 3 days or more. The graph suggests clustering in
loneliness and a relationship between being peripheral and feeling lonely, both of which are
confirmed by statistical models discussed in the main text.

49
Figure 2. Social Distance and Loneliness in the Framingham Social Network. This figure
shows for each exam the percentage increase in the likelihood a given FP is lonely if a friend or
family member at a certain social distance is lonely (where lonely is defined as feeling lonely
more than once a week). The relationship is strongest between individuals who are directly
connected, but it remains significantly greater than zero at social distances up to 3 degrees of
separation, meaning that a persons loneliness is associated with the loneliness of people up to 3
degrees removed from them in the network. Values are derived by comparing the conditional
probability of being lonely in the observed network with an identical network (with topology and
incidence of loneliness preserved) in which the same number of lonely participants are randomly
distributed. LP social distance refers to closest social distance between the LP and FP (LP =
distance 1, LPs LP = distance 2, etc.). Error bars show 95% confidence intervals.

50
Figure 3. Lonely LPs in the Framingham Social Network. This plot shows that the number of
days per week a person feels lonely in exams 6 and 7 is positively associated with the fraction of
their friends and family in the previous exam who are lonely (those who say they are lonely more
than one day a week). Blue line shows smoothed relationship based on bivariate LOESS
regression, and dotted lines indicate 95% confidence intervals. The results show that people
surrounded by other lonely people themselves are more likely to feel lonely in the future.

51
Figure 4. LP Type and Loneliness in the Framingham Social Network. This figure shows
that friends, spouses, and neighbors significantly influence loneliness, but only if they live very
close to the FP. Effects are estimated using generalized estimating equation (GEE) linear models
of linear on several different sub-samples of the Framingham Social Network; see Tables 5a and
5b.

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Journal of Personality and Social Psychology, in press

Alone in the Crowd:

Running head: Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Human social isolation is recognized as a problem of vast importance. (Harlow,

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Current Number of Family Members

Prior Wave Number of Family Members

Current Number of Close Friends

Prior Wave Number of Close Friends

11.848 29.667 101.278

Prior Wave Number of Days Per Week Feeling

Structure and Spread of Loneliness

Felt lonely 0-1 days last week

Mean Number of Social Contacts

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Prior Wave Number of Lonely LPs

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness

Structure and Spread of Loneliness