The gender dimensions of mental health during the Covid-19 pandemic: A path analysis.

BACKGROUND: The Covid-19 pandemic has had a substantial population mental health impact, with evidence indicating that mental health has deteriorated in particular for women. This gender difference could be explained by the distinct experiences of women during the pandemic, including the burden of unpaid domestic labour, changes in economic activity, and experiences of loneliness. This study investigates potential mediators in the relationship between gender and mental health during the first wave of the Covid-19 pandemic in the UK. METHODS: We used data from 9,351 participants of Understanding Society, a longitudinal household survey from the UK. We conducted a mediation analysis using structural equation modelling to estimate the role of four mediators, measured during the first lockdown in April 2020, in the relationship between gender and mental health in May and July 2020. Mental health was measured with the 12-item General Health Questionnaire (GHQ-12). Standardized coefficients for each path were obtained, as well as indirect effects for the role of employment disruption, hours spent on housework, hours spent on childcare, and loneliness. RESULTS: In a model controlling for age, household income and pre-pandemic mental health, we found that gender was associated with all four mediators, but only loneliness was associated with mental health at both time points. The indirect effects showed strong evidence of partial mediation through loneliness for the relationship between gender and mental health problems; loneliness accounted for 83.9% of the total effect in May, and 76.1% in July. No evidence of mediation was found for housework, childcare, or employment disruption. CONCLUSION: The results suggest that the worse mental health found among women during the initial period of the Covid-19 pandemic is partly explained by women reporting more experiences of loneliness. Understanding this mechanism is important for prioritising interventions to address gender-based inequities that have been exacerbated by the pandemic.

Can social isolation caused by physical distance in people with psychosis be overcome through a Phone Pal?

The current pandemic has forced many people into self-isolation and to practice social distancing. When people are physically isolated and distant from each other, technology may play a fundamental role by enabling social connection and reducing feelings of loneliness caused by this prolonged social isolation. In response to the COVID-19 pandemic, many mental health services worldwide have had to shift their routine face-to-face outpatient appointments to remote telepsychiatry encounters. The increased pressure on mental health services highlights the importance of community-led health-promotion interventions, which can contribute to preventing mental illness or their relapses, and to reduce the burden on health services. Patients with psychosis are particularly socially isolated, have sedentary lifestyles, and commonly face stigma and discrimination from the general population. At the same time, patients with psychosis value technology, are interested in, use and own smart-phones to digitally connect, and are satisfied with their use. Thus, among psychosocial interventions, a helpful resource may be "Phone Pal," a complex intervention which facilitates remote communication between volunteers and socially isolated patients with psychosis through different smart-phone tools. While "Phone Pal" has been originally developed for people with psychosis, it may also be useful to the wider population, helping to overcome the social isolation caused by physical distancing, particularly in these times of widespread isolation. "Phone Pal" may be a potential public health resource for society, providing important support to those that may need it the most, and possibly benefit most from it.

Impact of loneliness on suicidal ideation during the COVID-19 pandemic: findings from a cross-sectional online survey in Japan.

OBJECTIVES: We aim to reveal how loneliness relates to suicidal ideation following the onset of the COVID-19 pandemic. DESIGN: Cross-sectional online survey. SETTING: Community cohort study in Japan. PARTICIPANTS: The second wave of a large web-based survey, Japan COVID-19 and Society Internet Survey, was conducted in February 2021, and we analysed the data of 6436 men and 5380 women who were aged 20-59 years. MAIN OUTCOME MEASURES: The prevalence ratios (PRs) of suicidal ideation due to loneliness, depression, social isolation and decline in income during the pandemic and other sociodemographic and economic information were adjusted in the analysis. STATISTICAL METHODS: Estimations were conducted by separating a male and female sample. The survey weight (inverse probability weighting) was applied for analyses, and a Poisson regression model was used with all the potential confounders adjected. RESULTS: Overall, 15.1% of male and 16.3% of female participants were found to have had suicidal ideation during the COVID-19 pandemic. Among them, 23% of male and 20% of female participants experienced suicidal ideation for the first time. The results of the Poisson regression suggested that those who were feeling lonely had higher PRs for suicidal ideation (4.83 for men (95% CI, 3.87 to 6.16) and 6.19 for women (95% CI, 4.77 to 8.45)). The relationship between loneliness and suicidal ideation remained robust even after adjusting for depression, although there were declines in PRs. Additionally, the results showed that those who were lonely, and continued to feel lonely during the pandemic, had the highest PRs of suicidal ideation. CONCLUSION: Loneliness had both direct and indirect effects on suicidal ideation mediated through depression. Those who felt lonelier during the pandemic had the highest risk of suicidal ideation. It is necessary to adopt national measures focused on providing psychological support to people who feel lonely to prevent them from taking their own lives.

Temporal dynamics in mental health symptoms and loneliness during the COVID-19 pandemic in a longitudinal probability sample: a network analysis.

Figuring out which symptoms are central for symptom escalation during the COVID-19 pandemic is important for targeting prevention and intervention. Previous studies have contributed to the understanding of the course of psychological distress during the pandemic, but less is known about key symptoms of psychological distress over time. Going beyond a pathogenetic pathway perspective, we applied the network approach to psychopathology to examine how psychological distress unfolds in a period of maximum stress (pre-pandemic to pandemic onset) and a period of repeated stress (pandemic peak to pandemic peak). We conducted secondary data analyses with the Understanding Society data (N = 17,761), a longitudinal probability study in the UK with data before (2019), at the onset of (April 2020), and during the COVID-19 pandemic (November 2020 & January 2021). Using the General Health Questionnaire and one loneliness item, we computed three temporal cross-lagged panel network models to analyze psychological distress over time. Specifically, we computed (1) a pre-COVID to first incidence peak network, (2) a first incidence peak to second incidence peak network, and (3) a second incidence peak to third incidence peak network. All networks were highly consistent over time. Loneliness and thinking of self as worthless displayed a high influence on other symptoms. Feeling depressed and not overcoming difficulties had many incoming connections, thus constituting an end-product of symptom cascades. Our findings highlight the importance of loneliness and self-worth for psychological distress during COVID-19, which may have important implications in therapy and prevention. Prevention and intervention measures are discussed, as single session interventions are available that specifically target loneliness and worthlessness to alleviate mental health problems.

Increased prevalence of loneliness and associated risk factors during the COVID-19 pandemic: findings from the Canadian Longitudinal Study on Aging (CLSA).

BACKGROUND: Older adults have been disproportionately impacted by COVID-19 and related preventative measures undertaken during the pandemic. Given clear evidence of the relationship between loneliness and health outcomes, it is imperative to better understand if, and how, loneliness has changed for older adults during the COVID-19 pandemic, and whom it has impacted most. METHOD: We used "pre-pandemic" data collected between 2015-2018 (n = 44,817) and "during pandemic" data collected between Sept 29-Dec 29, 2020 (n = 24,114) from community-living older adults participating in the Canadian Longitudinal Study on Aging. Loneliness was measured using the 3-item UCLA Loneliness Scale. Weighted generalized estimating equations estimated the prevalence of loneliness pre-pandemic and during the pandemic. Lagged logistic regression models examined individual-level factors associated with loneliness during the pandemic. RESULTS: We found the adjusted prevalence of loneliness increased to 50.5% (95% CI: 48.0%-53.1%) during the pandemic compared to 30.75% (95% CI: 28.72%-32.85%) pre-pandemic. Loneliness increased more for women (22.3% vs. 17.0%), those in urban areas (20.8% vs. 14.6%), and less for those 75 years and older (16.1% vs. 19.8% or more in all other age groups). Loneliness during the pandemic was strongly associated with pre-pandemic loneliness (aOR 4.87; 95% CI 4.49-5.28) and individual level sociodemographic factors [age < 55 vs. 75 + (aOR 1.41; CI 1.23-1.63), women (aOR 1.34; CI 1.25-1.43), and no post-secondary education vs. post-secondary education (aOR 0.73; CI 0.61-0.86)], living conditions [living alone (aOR 1.39; CI 1.27-1.52) and urban living (aOR 1.18; CI 1.07-1.30)], health status [depression (aOR 2.08; CI 1.88-2.30) and having two, or ≥ three chronic conditions (aOR 1.16; CI 1.03-1.31 and aOR 1.34; CI 1.20-1.50)], health behaviours [regular drinker vs. non-drinker (aOR 1.15; CI 1.04-1.28)], and pandemic-related factors [essential worker (aOR 0.77; CI 0.69-0.87), and spending less time alone than usual on weekdays (aOR 1.32; CI 1.19-1.46) and weekends (aOR 1.27; CI 1.14-1.41) compared to spending the same amount of time alone]. CONCLUSIONS: As has been noted for various other outcomes, the pandemic did not impact all subgroups of the population in the same way with respect to loneliness. Our results suggest that public health measures aimed at reducing loneliness during a pandemic should incorporate multifactor interventions fostering positive health behaviours and consider targeting those at high risk for loneliness.

Belonging Together: Friendship, Hope, and Well-Being Among Young Adults.

Preventing and reducing loneliness is crucial to well-being and good health. While long thought to be a problem specific to the elderly or infirm, over the past decade the prevalence of loneliness across age cohorts has become increasingly apparent, and calls for a systematic public health approach to the problem have grown louder. This essay uses Vivek Murthy's Together: The Healing Power of Human Connection in a Sometimes Lonely World (2020) as a point of departure to explore the value of human connection in general-and friendship in particular-as a means to both abating the pernicious individual and societal impact of loneliness and building a foundation for a renewal of the common good. Friendship as a form of human connection is then applied to understanding and addressing the overlapping mental health challenges of American college students and resettled refugee youth.

Positive and negative experiences with the COVID-19 pandemic among lonely and non-lonely populations in Germany.

The COVID-19 pandemic is causing an epidemic of loneliness. Previous studies have shown the differences in positive and negative experiences of lonely and non-lonely people in a non-pandemic setting. However, it is unclear how the drastic alteration of the COVID-19 pandemic may influence peoples' reactions and beliefs, especially among those who feel lonely. Our study aims to examine the positive and negative experiences among lonely and non-lonely people. We undertook a cross-sectional online survey of the general population in Germany (N = 1,758) from May 2020 to May 2022. We assessed their feelings of loneliness with the short eight-item UCLA Loneliness Scale (ULS-8), their positive and negative experience of living in the COVID-19 pandemic as well as their psychological distress regarding the pandemic with the COVID-19 Peritraumatic Distress Index (CPDI). We found lonely individuals (ULS-8 score ≥ 16) reported fewer positive experiences of living in the COVID-19 pandemic, for example, less time with loved ones [z (1, 756) = -2.5, p = 0.012] and less sense of togetherness [z (1, 756) = -2.39, p = 0.017] as compared to non-lonely individuals. Meanwhile, they experienced more negative experiences, for example, worry and fear [z (1, 756) = 6.31, p < 0.001] compared with non-lonely individuals. Interestingly, lonely people were less likely to view the pandemic as a conspiracy than non-lonely people were [z (1, 756) = -3.35, p < 0.001]. Our results may give insight into attribution bias and the negative affect of lonely people during the COVID-19 pandemic as well as highlight the experience of non-lonely people and raise the question of differences in conspiracy beliefs. For pandemic preparedness and response, decision-makers may focus on interventions to foster social cohesion, empower people, build resilience, and most importantly provide timely social care.

Decreased Frequency of Small Talk Due to the COVID-19 Pandemic Has Deteriorated Mental Health: Findings From Longitudinal Surveys of Middle-Aged and Older People in Japan.

The coronavirus disease 2019 (COVID-19) has reduced opportunities for small talk. As small talk involves socializing, such deprivation can be stressful. This study examined the association between the change in the frequency of small talk from before to during the pandemic and the mental health of middle-aged and older people. We obtained data from web-based longitudinal surveys for members of a Japanese social networking service. People who felt their small talk frequency decreased during the pandemic compared with the prepandemic period had lower psychological well-being and greater loneliness than those who did not. Our study quantitatively revealed the importance of small talk during the pandemic in maintaining people's mental health.

Predictors and consequences of loneliness during the COVID-19 Pandemic.

The COVID-19 pandemic has created a global context in which social isolation has become normative in order to reduce the risk of COVID-19 transmission. As a result of social distancing policies, the risk for loneliness and associated decline in quality of life has increased. The current study examined factors associated with loneliness and quality of life during the COVID-19 pandemic cross-sectionally (n = 797) and longitudinally (n = 395). Older age and larger social network size were associated with less loneliness, whereas having multiple physical or mental health diagnoses was associated with greater loneliness. Greater virtual social contact was also associated with increased loneliness. Greater loneliness was associated with all domains of quality of life both cross-sectionally and longitudinally. Understanding factors associated with loneliness is critical to developing effective strategies at reducing loneliness and improving quality of life during the pandemic. Contrary to popular perceptions, older age was associated with less loneliness and more virtual social contact was associated with more loneliness. Thus, it may be prudent to deemphasize virtual social contact in public campaigns and to emphasize safe methods of interacting in person.

Ageing and Loneliness in Times of Pandemic: A Scoping Review.

Society is immersed in a process of demographic transformation of great relevance: the ageing of the population. During the ageing stage, relevant changes occur, such as age-related losses, lack of formal and informal support or changes in social roles, which can cause situations of isolation or loneliness in older people. After the Spanish government decreed a state of alarm throughout the national territory in response to the arrival of SARS-CoV2, the confinement of the entire population was established, and only essential services and authorized persons could continue to carry out their daily activities and professional tasks. In addition, since the beginning of the pandemic, older people were considered high-risk people, a circumstance that increased their isolation situation. OBJECTIVE: Understand, organize and systematically analyse the scientific evidence generated in relation to the impact that the COVID-19 pandemic has had on the processes and feelings of isolation and loneliness of the elderly population, from the beginning of the health crisis until the date of search. MATERIALS AND METHODS: a scoping review was conducted using the methodology of Arksey and O'Malley, which included a review of the studies available in the online databases Proquest, Scopus and WOS. From the search, information related to the isolation and collective of elderly people during the pandemic was extracted. RESULTS: a total of 32 articles were included, from which three fundamental areas of analysis emerged and three issues emerged: older people and institutionalisation during the pandemic, ageism and hospitalisation of the elderly during the pandemic, and loneliness and isolation of older people throughout the pandemic. DISCUSSION: the lack of material resources and infrastructures to be able to face the problem of isolation in institutions was evident. The importance of acquiring, on the part of the elderly, competences, knowledge and skills in new technologies in order to continue with contact with their peer group and family was also observed. CONCLUSIONS: this study identifies areas already understood, as well as knowledge gaps, that allow for determining opportunities for future research and thus the ability to improve in situations similar to the one that occurred.

Comparative effectiveness of two versions of a caring contacts intervention in healthcare providers, staff, and patients for reducing loneliness and mental distress: A randomized controlled trial.

BACKGROUND: Caring Contacts can effectively reduce suicide ideation, attempts, and death. In published clinical trials, Caring Contacts were sent by someone who knew the recipient. At scale, Caring Contacts programs rarely introduce the recipient and sender. It is not known whether receiving Caring Contacts from someone unknown is as effective as messages from someone the recipient has met. METHODS: Pragmatic randomized controlled trial comparing Caring Contacts with (CC+) versus without an introductory phone call (CC). Recruitment occurred January-July 2021, with outcomes assessed at 6 months. Participants were primary care patients or healthcare providers/staff reporting adverse mental health outcomes on a qualifying survey. Participants were sent 11 standardized caring text messages over 6 months; when participants replied, they received personalized unscripted responses. CC+ calls were semi-structured. The primary outcome was loneliness (NIH Toolkit). RESULTS: Participants included 331 patients (mean [SD] age: 45.5 [16.4], 78.9 % female) and 335 healthcare providers/staff (mean [SD] age: 40.9 [11.8], 86.6 % female). There were no significant differences in loneliness at 6 months by treatment arm in either stratum. In patients, mean (SD) loneliness was 61.9 (10.7) in CC, and 60.8 (10.3) in CC+, adjusted mean difference of -1.0 (95 % CI: -3.0, 1.0); p-value = 0.31. In providers/staff, mean (SD) loneliness was 61.2 (11) in CC, and 61.3 (11.1) in CC+, adjusted mean difference of 0.2 (95 % CI: -1.8, 2.2); p-value = 0.83. LIMITATIONS: Study population was 93 % white which may limit generalizability. CONCLUSIONS: Including an initial phone call added operational complexity without significantly improving the effectiveness of a Caring Contacts program.

Social isolation, loneliness and positive mental health among older adults in Canada during the COVID-19 pandemic. / Isolement social, solitude et santé mentale positive chez les aînés au Canada pendant la pandémie de COVID-19.

INTRODUCTION: Social isolation and loneliness are associated with poorer mental health among older adults. However, less is known about how these experiences are independently associated with positive mental health (PMH) during the COVID-19 pandemic. METHODS: We analyzed data from the 2020 and 2021 cycles of the Survey on COVID-19 and Mental Health to provide estimates of social isolation (i.e. living alone), loneliness and PMH outcomes (i.e. high self-rated mental health, high community belonging, mean life satisfaction) in the overall older adult population (i.e. 65+ years) and across sociodemographic groups. We also conducted logistic and linear regressions to separately and simultaneously examine how social isolation and loneliness are associated with PMH. RESULTS: Nearly 3 in 10 older adults reported living alone, and over a third reported feelings of loneliness due to the pandemic. When examined separately, living alone and loneliness were each associated with lower PMH. When assessed simultaneously, loneliness remained a significant independent factor associated with all three PMH outcomes (overall and across all sociodemographic groups), but living alone was only a significant factor for high community belonging in the overall population, for males and for those aged 65 to 74 years. CONCLUSION: Overall, social isolation and loneliness were associated with poorer wellbeing among older adults in Canada during the pandemic. Loneliness remained a significant factor related to all PMH outcomes after adjusting for social isolation, but not vice versa. The findings highlight the need to appropriately identify and support lonely older adults during (and beyond) the pandemic.

Temporal patterns of owner-pet relationship, stress, and loneliness during the COVID-19 pandemic, and the effect of pet ownership on mental health: A longitudinal survey.

The COVID-19 pandemic has affected us in numerous ways and may consequently impact our relationships with pet dogs and cats. We conducted a longitudinal survey to examine the temporal patterns of owner-pet relationship, stress, and loneliness during four phases of the pandemic: 1) pre-pandemic (February 2020), 2) lockdown (April to June 2020), 3) reopening (September to December 2020), and 4) recovery (January 2021 to December 2021). We also investigated the effect of pet ownership on stress and loneliness, by considering a set of a priori causal assumptions. In addition, we hypothesized that the differences in the levels of stress and loneliness between dog and cat ownerships were mediated by the owner-pet relationship. A total of 4,237 participants (657 non-pet owners, 1,761 dog owners, and 1,819 cat owners) completed between one and six surveys. Overall, the closeness in the relationship between owners and their pets increased with time during the study period. We also observed that dog owners consistently showed larger decreases in the levels of stress and loneliness than cat and non-pet owners. However, after adjusting for confounders, the findings did not support a mitigating effect of pet ownership. Pet ownership did not alleviate stress, social loneliness resulting from a lack of friendships or workplace relationships, or emotional loneliness due to deficiencies in family relationships. Pet owners, however, reported a lower degree of emotional loneliness caused by deficits in romantic relationships than non-pet owners. Our results also indicated that the differences in stress and loneliness levels between dog and cat ownerships were partially explained by the owner-pet relationship, and once this was accounted for, the differences between them reduced. In summary, this study highlights the dynamic effects of COVID-19 on owner-pet relationship and mental health. It also shows the complexity of the association between pet ownership and mental health, partially mediated by owner-pet relationships.

Global Trends in Social Prescribing: Web-Based Crawling Approach.

BACKGROUND: Social loneliness is a prevalent issue in industrialized countries that can lead to adverse health outcomes, including a 26% increased risk of premature mortality, coronary heart disease, stroke, depression, cognitive impairment, and Alzheimer disease. The United Kingdom has implemented a strategy to address loneliness, including social prescribing-a health care model where physicians prescribe nonpharmacological interventions to tackle social loneliness. However, there is a need for evidence-based plans for global social prescribing dissemination. OBJECTIVE: This study aims to identify global trends in social prescribing from 2018. To this end, we intend to collect and analyze words related to social prescribing worldwide and evaluate various trends of related words by classifying the core areas of social prescribing. METHODS: Google's searchable data were collected to analyze web-based data related to social prescribing. With the help of web crawling, 3796 news items were collected for the 5-year period from 2018 to 2022. Key topics were selected to identify keywords for each major topic related to social prescribing. The topics were grouped into 4 categories, namely Healthy, Program, Governance, and Target, and keywords for each topic were selected thereafter. Text mining was used to determine the importance of words collected from new data. RESULTS: Word clouds were generated for words related to social prescribing, which collected 3796 words from Google News databases, including 128 in 2018, 432 in 2019, 566 in 2020, 748 in 2021, and 1922 in 2022, increasing nearly 15-fold between 2018 and 2022 (5 years). Words such as health, prescribing, and GPs (general practitioners) were the highest in terms of frequency in the list for all the years. Between 2020 and 2021, COVID, gardening, and UK were found to be highly related words. In 2022, NHS (National Health Service) and UK ranked high. This dissertation examines social prescribing-related term frequency and classification (2018-2022) in Healthy, Program, Governance, and Target categories. Key findings include increased "Healthy" terms from 2020, "gardening" prominence in "Program," "community" growth across categories, and "Target" term spikes in 2021. CONCLUSIONS: This study's discussion highlights four key aspects: (1) the "Healthy" category trends emphasize mental health, cancer, and sleep; (2) the "Program" category prioritizes gardening, community, home-schooling, and digital initiatives; (3) "Governance" underscores the significance of community resources in social prescribing implementation; and (4) "Target" focuses on 4 main groups: individuals with long-term conditions, low-level mental health issues, social isolation, or complex social needs impacting well-being. Social prescribing is gaining global acceptance and is becoming a global national policy, as the world is witnessing a sharp rise in the aging population, noncontagious diseases, and mental health problems. A successful and sustainable model of social prescribing can be achieved by introducing social prescribing schemes based on the understanding of roles and the impact of multisectoral partnerships.

Experience of loneliness during the COVID-19 pandemic: a cross-sectional study of 50 968 adult Danes.

OBJECTIVES: To examine the level of loneliness experienced during the COVID-19 pandemic in Denmark and to identify associated behavioural patterns and demographic factors. DESIGN: Cross-sectional cohort study. SETTING: Includes Danish active and former blood donors. PARTICIPANTS: A questionnaire was sent to 124 307 active and former blood donors, of these a total of 50 968 participants completed the study questionnaire (response rate=41%). PRIMARY AND SECONDARY OUTCOME MEASURES: Subjective experience of loneliness was measured using the 3-item University of California, Los Angeles Loneliness Scale (UCLA-3). Besides the UCLA-3, the respondents answered items on sociodemographic and economic characteristics, items on precautionary measures taken to avoid COVID-19 infection as well as on COVID-19 anxiety. RESULTS: The participants indicated their experienced level of loneliness both before and during the pandemic. Comparing the two reports yielded a mean increase in loneliness scores of 14.1% (p<0.001). Exploratory factor analysis identified the factor well-being, which comprised three questionnaire items related to emotional heath, physical health and happiness. A high score on the factor well-being was associated with reduced levels of loneliness (coefficient=-0.47, 95% CI -0.49 to -0.46)). Furthermore, women were more likely than men to have experienced increased levels of loneliness during the pandemic (coefficient=0.27, 95% CI 0.25 to 0.29). Furthermore, a negative correlation between higher age and change in loneliness score was observed. CONCLUSIONS: The findings document an increase in the level of experienced loneliness during the COVID-19 pandemic, particularly affecting individuals with low well-being, women and younger individuals.

Genetic and environmental contributions to the subjective burden of social isolation during the COVID-19 pandemic.

BACKGROUND: Feelings of loneliness and the burden of social isolation were among the most striking consequences of widespread containment measures, such as "social distancing", during the COVID-19 pandemic. Because of the potential impact on people's health, there has been increased interest in understanding the mechanisms and factors that contributed to feelings of loneliness and the burdens of social isolation. However, in this context, genetic predisposition has been largely ignored as an important factor. This is problematic because some of the phenotypic associations observed to date may in fact be genetic. The aim of this study is, therefore, to examine the genetic and environmental contributions to the burden of social isolation at two time points during the pandemic. In addition, we examine whether risk factors identified in previous studies explain genetic or environmental contributions to the burden of social isolation. METHODS: The present study is based on a genetically sensitive design using data from the TwinLife panel study, which surveyed a large sample of adolescent and young adult twins during the first (N = 798) and the second (N = 2520) lockdown in Germany. RESULTS: We find no substantive differences in genetic and environmental contributions to social isolation burden over the course of the pandemic. However, we find the determinants highlighted as important in previous studies can explain only a small proportion of the observed variance in the burden of social isolation and mainly explained genetic contributions. CONCLUSIONS: While some of the observed associations appear to be genetic, our findings underscore the need for further research, as the causes of individual differences in burden of social isolation remain unclear.