Loneliness and social connectedness: underlying mechanisms and treatment targets

The cognitive and behavioural processes that cause and/or maintain loneliness remain unclear and lack empirical support. This thesis examined the role of maladaptive cognition in loneliness, the specificity of these cognitions, the effectiveness of current interventions for loneliness, and whether cognitive restructuring of maladaptive lonely automatic thoughts can be used therapeutically to alleviate feelings of loneliness. Given that evidence supporting the processes hypothesised to cause and/or maintain loneliness in current models has been largely correlational, the first paper systematically reviewed causal and/or bidirectional evidence to support these processes. The second and third paper in the thesis utilised novel experimental paradigms to examine the causal role of maladaptive cognitions specific to loneliness. A novel online group chat paradigm designed to elicit feelings of loneliness and maladaptive lonely cognitions was tested in the second paper, whereas the third paper utilised a randomised controlled design to examine whether a single session of cognitive restructuring directed at correcting maladaptive lonely automatic thoughts would decrease feelings of loneliness over a control condition. Lastly, paper four systematically reviewed and meta-analysed the effectiveness of current interventions for loneliness. Overall, results from this thesis identified the important role of maladaptive cognition in causing and/or maintaining feelings of loneliness. In particular, maladaptive cognition related to negative automatic thoughts about the perceived unavailability of a supportive social network seemed to be associated with increased feelings of loneliness, with these cognitive processes being distinct from those that underlie depression and anxiety. The thesis further provided evidence that targeting maladaptive cognition related to loneliness is a promising avenue for the treatment of loneliness.