文献：Lieberz, Jana, et al. "Behavioral and neural dissociation of social anxiety and loneliness." Journal of Neuroscience 42.12 (2022): 2570-2583.
DOI:10.1523/JNEUROSCI.2029-21.2022
Author: Dog Tail Flower | Cover: Render Mix
"Loneliness" is a phenomenon that cannot be underestimated in modern society. Since the outbreak of COVID-19, the mental health risks associated with loneliness have increasingly caught the attention of scientists. As a risk factor for premature mortality, loneliness can be compared to smoking and obesity. Currently, cognitive behavioral therapy (CBT) to reduce loneliness is often adapted from therapies associated with the treatment of social anxiety. The logic behind this is also simple: Social phobia is often associated with social isolation, subjective low social support, and low-quality friendships, which can lead to lower satisfaction with relationships in people with social phobia — and low relationship satisfaction is a key feature of loneliness.
In addition, one of the core mechanisms of social phobia is "avoidance of social situations", which is also what people with higher loneliness tend to do in some scholars' assumptions. With the intersection of "low relationship satisfaction" and "avoidance of social situations," it seems reasonable to associate loneliness with social phobia. But is this really the case?
In this study, 42 participants with high loneliness and 40 participants with low loneliness (none of whom were clinically diagnosed and belonged to the general population) participated in social gambling games. In the game, participants can choose the conservative option of keeping the money allocated in this round, or the risk option of either winning double the money or losing the allocated money. When a bet is won, participants receive positive feedback, and if they lose, they receive negative feedback. There are two forms of feedback: social feedback and machine feedback. For various scenarios, refer to Figures A and B below. In games played on fMRI machines, all images are replaced by text.
- Lieberz et al.,J. Neurosci.-
The findings suggest that the social anxiety scores of the high loneliness group were indeed higher than those in the low loneliness group (figure A below), but the decisions made by the two groups in the game were not distinguished (the more money was initially allocated, the less willing to gamble, figure B below), but there was a slight difference in their feelings about feedback. Specifically, highly lonely people are more likely to receive negative feedback from "humans" than negative feedback from computers (giving a higher score of "pleasantness"); low lonely people are the opposite, and negative feedback in the social sense is more unpleasant (Figure C below). Both groups felt similar about positive feedback from different sources. This part of the behavioral results show that the cognitive pattern of social feedback in highly lonely people is not the same as that of low lonely people.
- Lieberz et al.,J. Neurosci.-
The fMRI results were consistent with the behavioral results, and instead of finding significant differences in amygdala activity between the two groups (Figure A below), the researchers found the opposite pattern of nucleus accumbens activity during the receiving feedback phase (Figure B below). The nucleus accumbens is part of the ventral striatum and is thought to be associated with a motivation-behavioral link. Compared with machine negative feedback, high solitarizers have lower nucleus accumbene activity in social negative feedback, while low solitude people have the opposite - brain imaging results confirm the behavioral results, and in the cognitive pattern of negative social feedback, high lonely people have different levels of neural activity than low lonely people.
- Lieberz et al.,J. Neurosci.-
When the researchers associated loneliness with symptoms of social phobia, they could find that low solitude had the opposite pattern of amygdala activity to those with high loneliness (Figures A, B below). The most interesting is the result of Figure C below, for high solitarants, the more social phobia symptoms, the higher the subjective value of participation in social situations, once again as opposed to low solitarators.
- Lieberz et al.,J. Neurosci.-
This study shows that loneliness and social phobia have different cognitive-behavioral and neurological patterns. Unlike social avoidance, which is common in people with social phobia, the difference between people with high loneliness and people with low loneliness is the response to negative feedback – people with high loneliness are more affected by negative feedback, but the addition of social factors weakens this effect. Therefore, behavioral cognitive therapy for high loneliness should be distinguished from therapy for social phobia, and its treatment goal is not social avoidance.
We might be able to summarize these findings in general terms: "The lonelier the more socially the more social." Although not very good at socializing (social anxiety scores are high), other humans are both a cherished presence for highly lonely people (the subjective value of social interaction increases with social anxiety scores) and a protective mechanism against negative feedback (both cognitive-behavioral and brain imaging results support this hypothesis).