"God of the gaps" is a theological concept that emerged in the 19th century, and revolves around the idea that gaps in scientific understanding are regarded as indications of the existence of God. This perspective has its origins in the observation that some individuals, often with religious
inclinations, point to areas where science falls short in explaining
natural phenomena as opportunities to insert the presence of a divine creator. The term itself was coined in response to this tendency. This theological view suggests that God fills in the gaps left by scientific knowledge, and that these gaps represent moments of divine intervention or influence.
This concept has been met with criticism and debate from various
quarters. Detractors argue that this perspective is problematic as it
seems to rely on gaps in human understanding and ignorance to make its
case for the existence of God. As scientific knowledge continues to
advance, these gaps tend to shrink, potentially weakening the argument
for God's existence. Critics contend that such an approach can undermine
religious beliefs by suggesting that God only operates in the
unexplained areas of our understanding, leaving little room for divine
involvement in a comprehensive and coherent worldview.
The "God of the gaps" perspective has been criticized for its association with logical fallacies. The "God of the gaps" perspective is also a form of confirmation bias,
since it involves interpreting ambiguous evidence (or rather no
evidence) as supporting one's existing attitudes. This type of reasoning
is seen as inherently flawed and does not provide a robust foundation
for religious faith.
In this context, some theologians and scientists have proposed that a
more satisfactory approach is to view evidence of God's actions within
the natural processes themselves, rather than relying on the gaps in
scientific understanding to validate religious beliefs.
Origins of the term
From the 1880s, Friedrich Nietzsche's Thus Spoke Zarathustra, Part Two, "On Priests", said that "into every gap they put their delusion, their stopgap, which they called God". The concept, although not the exact wording, goes back to Henry Drummond, a 19th-century evangelist lecturer, from his 1893 Lowell Lectures on The Ascent of Man. He chastises those Christians
who point to the things that Science has not explained as presence of
God – "gaps which they will fill up with God" – and urges them to
embrace all nature as God's, as the work of "an immanent
God, which is the God of Evolution, is infinitely grander than the
occasional wonder-worker, who is the God of an old theology."
Must we then postulate Divine
intervention? Are we to bring in God to create the first current of
Laplace's nebula or to let off the cosmic firework of Lemaître's
imagination? I confess an unwillingness to bring God in this way upon
the scene. The circumstances which thus seem to demand his presence are
too remote and too obscure to afford me any true satisfaction. Men have
thought to find God at the special creation of their own species, or
active when mind or life first appeared on earth. They have made him God
of the gaps in human knowledge. To me the God of the trigger is as
little satisfying as the God of the gaps. It is because throughout the
physical Universe I find thought and plan and power that behind it I see
God as the creator.
During World War II, the German theologian and martyr Dietrich Bonhoeffer expressed the concept in similar terms in letters he wrote while in a Nazi prison. Bonhoeffer wrote, for example:
how wrong it is to use God as a
stop-gap for the incompleteness of our knowledge. If in fact the
frontiers of knowledge are being pushed further and further back (and
that is bound to be the case), then God is being pushed back with them,
and is therefore continually in retreat. We are to find God in what we
know, not in what we don't know.
There is no 'God of the gaps' to
take over at those strategic places where science fails; and the reason
is that gaps of this sort have the unpreventable habit of shrinking.
and
Either God is in the whole of Nature, with no gaps, or He's not there at all.
Coulson was a mathematics professor at Oxford University as well as a Methodist church leader, often appearing in the religious programs of British Broadcasting Corporation. His book got national attention, was reissued as a paperback, and was reprinted several times, most recently in 1971.
It is claimed that the actual phrase 'God of the gaps' was invented by Coulson.
The term was then used in a 1971 book and a 1978 article, by Richard Bube. He articulated the concept in greater detail in Man come of Age: Bonhoeffer's Response to the God-of-the-Gaps
(1978). Bube attributed modern crises in religious faith in part to the
inexorable shrinking of the God-of-the-gaps as scientific knowledge
progressed. As humans progressively increased their understanding of
nature, the previous "realm" of God seemed to many persons and religions
to be getting smaller and smaller by comparison. Bube maintained that Darwin's Origin of Species
was the "death knell" of the God-of-the-gaps. Bube also maintained that
the God-of-the-gaps was not the same as the God of the Bible (that is,
he was not making an argument
against God per se, but rather asserting there was a fundamental
problem with the perception of God as existing in the gaps of
present-day knowledge).
General usage
The term "God of the gaps" is sometimes used in describing the incremental retreat of religious explanations of physical phenomena in the face of increasingly comprehensive scientific explanations for those phenomena. Dorothy Dinnerstein
includes psychological explanations for developmental distortions
leading to a person believing in a deity, particularly a male deity.
R. Laird Harris writes of the physical science aspect of this:
The expression, "God of the Gaps," contains a real truth. It is erroneous if it is taken to mean that God is not immanent in natural law
but is only to be observed in mysteries unexplained by law. No
significant Christian group has believed this view. It is true, however,
if it be taken to emphasize that God is not only immanent in natural
law but also is active in the numerous phenomena associated with the
supernatural and the spiritual. There are gaps in a physical-chemical
explanation of this world, and there always will be. Because science has
learned many marvelous secrets of nature, it cannot be concluded that
it can explain all phenomena. Meaning, soul, spirits, and life are
subjects incapable of physical-chemical explanation or formation.
Usage in referring to a type of argument
The term God-of-the-gaps fallacy can refer to a position that
assumes an act of God as the explanation for an unknown phenomenon,
which according to the users of the term, is a variant of an argument from ignorance fallacy. Such an argument is sometimes reduced to the following form:
There is a gap in understanding of some aspect of the natural world.
Therefore, the cause must be supernatural.
One example of such an argument, which uses God as an explanation of
one of the current gaps in biological science, is as follows:
"Because current science can't figure out exactly how life started, it
must be God who caused life to start." Critics of intelligent design creationism, for example, have accused proponents of using this basic type of argument.
God-of-the-gaps arguments have been discouraged by some
theologians who assert that such arguments tend to relegate God to the
leftovers of science: as scientific knowledge increases, the dominion of
God decreases.
Criticism
The term was invented as a criticism of people who perceive that God
only acts in the gaps, and who restrict God's activity to such "gaps". It has also been argued that the God-of-the-gaps view is predicated on
the assumption that any event which can be explained by science
automatically excludes God; that if God did not do something via direct
action, that he had no role in it at all.The "God of the gaps" argument, as traditionally advanced by
scholarly Christians, was intended as a criticism against weak or
tenuous faith, not as a statement against theism or belief in God.
According to John Habgood in The Westminster Dictionary of Christian Theology,
the phrase is generally derogatory, and is inherently a direct
criticism of a tendency to postulate acts of God to explain phenomena
for which science has not (at least at present) given a satisfactory
account. Habgood also states:
It is theologically more satisfactory to look for
evidence of God's actions within natural processes rather than apart
from them, in much the same way that the meaning of a book transcends,
but is not independent of, the paper and ink of which it is comprised.
It has been criticized by both theologians and scientists, who say
that it is a logical fallacy to base belief in God on gaps in scientific
knowledge. In this vein, Richard Dawkins, an atheist, dedicates a chapter of his book The God Delusion to criticism of the God-of-the-gaps argument. He noted that:
Creationists eagerly seek a gap in
present-day knowledge or understanding. If an apparent gap is found, it
is assumed that God, by default, must fill it. What worries thoughtful
theologians such as Bonhoeffer is that gaps shrink as science advances,
and God is threatened with eventually having nothing to do and nowhere
to hide.
Social anxiety disorder is distinct from the personality traits of introversion and shyness.
Social anxiety disorder (SAD), previously known as social phobia, is an anxiety disorder characterized by high levels of anxiety and self-consciousness in social situations, resulting in significant distress and an impaired ability to function in daily life.The defining feature of social anxiety disorder is a persistent fear of negative or positive evaluation by others.These fears can be triggered by perceived or actual scrutiny from
others. Recent data suggest the prevalence of social anxiety disorder is
rising, particularly among young people.
Physical symptoms often include excessive blushing, excessive sweating, trembling, palpitations, muscle tension, shortness of breath, and nausea. Panic attacks can also occur under intense fear and discomfort. Some affected individuals may use alcohol or other drugs to reduce fears and inhibitions at social events. It is common for socially anxious individuals to self-medicate in this fashion, especially if they are undiagnosed or untreated. This results in a heightened risk of alcohol use disorder, eating disorders, or other substance use disorders among sufferers. According to ICD-11
guidelines, an individual meets the criteria for social anxiety
disorder if they experience persistent symptoms for at least several
months, resulting in significant distress and impairment in personal,
family, social, educational, occupational, or other important areas of
functioning.
The first line of treatment for social anxiety disorder is cognitive behavioral therapy (CBT) with or without medication. CBT is most effective when delivered individually, though it can be offered in a group format. The cognitive and behavioral components seek to change thought patterns and physical reactions to anxiety-inducing situations. Metacognitive therapy and acceptance and commitment therapy are alternative options with efficacy at least as high as CBT.
In cognitive models of social anxiety disorder, those with social anxiety disorder experience dread over how they will present to others. They may feel overly self-conscious, pay excessive attention to themselves, or have high performance standards for themselves. According to the social psychology theory of self-presentation,
an affected person attempts to create a well-mannered impression
towards others but believes they are unable to do so. Many times, before
the potentially anxiety-provoking social situation, they may
deliberately review what could go wrong and how to deal with each
unexpected case. After the event, they may have the perception
that they performed unsatisfactorily. Consequently, they will perceive
anything that may have possibly been abnormal as embarrassing. These thoughts may extend for weeks or longer. Cognitive distortions
are a hallmark and are learned about in CBT (cognitive-behavioral
therapy). Thoughts are often self-defeating and inaccurate. Those with
social phobia tend to interpret neutral or ambiguous
conversations with a negative outlook and many studies suggest that
socially anxious individuals remember more negative memories than those
less distressed.
Behavioral aspects
Social anxiety disorder is a persistent fear of one or more
situations in which the person is exposed to possible scrutiny by others
and fears that they may do something or act in a way that will be
humiliating or embarrassing. It exceeds normal "shyness" as it leads to excessive social avoidance and substantial social or occupational impairment.
Those who have social anxiety disorder fear being judged by
others in society. In particular, individuals with social anxiety are
nervous in the presence of people with authority and feel uncomfortable
during physical examinations. People who have this disorder may behave a certain way or say something
and then feel embarrassed or humiliated after. As a result, they often
choose to isolate themselves from society to avoid such situations. They
may also feel uncomfortable meeting people they do not know and act
distant when they are with large groups of people. In some cases, they
may show evidence of this disorder by avoiding eye contact, or blushing when someone is talking to them.
People with SAD avoid situations that most people consider normal.
People with SAD avoid all or most social situations and hide from
others, which can affect their personal relationships. Social phobia can completely remove people from social situations due
to the irrational fear of these situations. People with SAD may be
addicted to social media networks, have sleep deprivation, and feel good when they avoid human interactions. SAD can also lead to low self-esteem, negative thoughts, major depressive disorder, sensitivity to criticism, and poor social skills that do not improve. People with SAD experience anxiety in a variety of social situations,
from important, meaningful encounters to common situations. These people
may feel more nervous in job interviews, dates, interactions with
authority, or at work and school.
Comorbidity
SAD shows a high degree of co-occurrence
with psychiatric disorders. In fact, a population-based study found
that 66% of those with SAD had one or more additional mental health
disorders. SAD often occurs alongside low self-esteem and most commonly clinical depression. Clinical depression is 1.49 to 3.5 times more likely to occur in those with SAD. Research also indicates that the presence of certain social fears
(e.g., avoidance of participating in small groups, avoidance of going to
a party) are more likely to trigger comorbid depressive symptoms than
other social fears.
To try to reduce their anxiety and alleviate depression, people
with social phobia may use alcohol or other drugs, which can lead to substance use disorders. It is estimated that one-fifth of people with social anxiety disorder also have alcohol use disorder. However, some research suggests SAD is unrelated to, or even protective against alcohol-related problems.Those who have both alcohol use disorder and social anxiety disorder
are more likely to avoid group-based treatments and to relapse compared
to people who do not have this combination.
Causes
Research into the causes of social anxiety and social phobia is wide-ranging, encompassing multiple perspectives from neuroscience to sociology. Scientists have yet to pinpoint the exact causes.
Studies suggest that genetics can play a part in combination with
environmental factors. Social phobia is not caused by other mental
disorders or substance use. Generally, social anxiety begins at a specific point in an individual's
life. This will develop over time as the person struggles to recover.
Eventually, mild social awkwardness can develop into symptoms of social
anxiety or phobia. Passive social media usage may cause social anxiety
in some people.
Genetics
It has been shown that there is a two to a threefold greater risk of
having social phobia if a first-degree relative also has the disorder.
This could be due to genetics and/or due to children acquiring social fears and avoidance through processes of observational learning or parental psychosocial education. Studies of identical twins brought up (via adoption)
in different families have indicated that, if one twin developed social
anxiety disorder, then the other was between 30 percent and 50 percent
more likely than average to also develop the disorder. To some extent, this "heritability" may not be specific – for example,
studies have found that if a parent has any kind of anxiety disorder or
clinical depression, then a child is somewhat more likely to develop an
anxiety disorder or social phobia. Studies suggest that parents of those with social anxiety disorder tend to be more socially isolated themselves, and shyness in adoptive parents is significantly correlated with shyness in adopted children.
Growing up with overprotective and hypercritical parents has also been associated with social anxiety disorder. Adolescents who were rated as having an insecure
(anxious-ambivalent) attachment with their mother as infants were twice
as likely to develop anxiety disorders by late adolescence, including
social phobia.
A related line of research has investigated 'behavioural inhibition'
in infants – early signs of an inhibited and introspective or fearful
nature. Studies have shown that around 10–15 percent of individuals show
this early temperament, which appears to be partly due to genetics.
Some continue to show this trait into adolescence and adulthood and
appear to be more likely to develop a social anxiety disorder.
Social experiences
A previous negative social experience can be a trigger to social phobia, perhaps particularly for individuals high in "interpersonal sensitivity". For around half of those diagnosed with social anxiety disorder, a specific traumatic or humiliating social event appears to be associated with the onset or worsening of the disorder; this kind of event appears to be particularly related to specific social phobia, for example, regarding public speaking. As well as direct experiences, observing or hearing about the socially
negative experiences of others (e.g. a faux pas committed by someone),
or verbal warnings of social problems and dangers, may also make the
development of a social anxiety disorder more likely. Social anxiety disorder may be caused by the longer-term effects of not fitting in, or being bullied, rejected, or ignored. Shy adolescents or avoidant adults have emphasized unpleasant experiences with peers or childhood bullying or harassment. In one study, popularity was found to be negatively correlated with
social anxiety, and children who were neglected by their peers reported
higher social anxiety and fear of negative evaluation than other categories of children. Socially phobic children appear less likely to receive positive reactions from peers, and anxious or inhibited children may isolate themselves.
Parental influences
Different parenting styles can also contribute to the development of
social anxiety disorder. The common negative parenting styles, such as
overcontrol and criticism can be detrimental for a child to be able to
overcome difficult situations. More aggressive and harsh parenting
styles that include both verbal abuse and physical punishment are linked
with an insecure attachment and risk for social anxiety disorder. On
the contrary, positive parenting that fosters a more supportive and warm
environment for the child is correlated to a decreased risk of
developing this disorder. On the biological level as well, there is strong evidence that states
how children from parents with social anxiety disorder have
significantly increased risk to the disorder.
Cultural influences
Cultural
factors that have been related to social anxiety disorder include a
society's attitude towards shyness and avoidance, affecting the ability
to form relationships or access employment or education, and shame. One study found that the effects of parenting are different depending
on the culture: American children appear more likely to develop social
anxiety disorder if their parents emphasize the importance of others'
opinions and use shame as a disciplinary strategy, but this association was not found for Chinese/Chinese-American children. In China, research has indicated that shy-inhibited children are more accepted than their peers and more likely to be considered for leadership and considered competent, in contrast to the findings in Western countries. Purely demographic variables may also play a role.
Problems in developing social skills, or 'social fluency', may be a cause of some social anxiety disorder, through either inability or lack of confidence
to interact socially and gain positive reactions and acceptance from
others. The studies have been mixed, however, with some studies not
finding significant problems in social skills while others have. What does seem clear is that the socially anxious perceive their own social skills to be low. It may be that the increasing need for sophisticated social skills in
forming relationships or careers, and an emphasis on assertiveness and
competitiveness, is making social anxiety problems more common, at least
among the 'middle classes'. An interpersonal or media emphasis on 'normal' or 'attractive' personal characteristics has also been argued to fuel perfectionism
and feelings of inferiority or insecurity regarding negative evaluation
from others. The need for social acceptance or social standing has been
elaborated in other lines of research relating to social anxiety.
Substance-induced
While alcohol
initially relieves social phobia, excessive alcohol misuse can worsen
social phobia symptoms and cause panic disorder to develop or worsen
during alcohol intoxication and especially during alcohol withdrawal syndrome.
This effect is not unique to alcohol but can also occur with long-term
use of drugs that have a similar mechanism of action to alcohol such as
the benzodiazepines which are sometimes prescribed as tranquillisers. Benzodiazepines possess anti-anxiety properties and can be useful for
the short-term treatment of severe anxiety. Like the anticonvulsants,
they tend to be mild and well-tolerated, although there is a risk of
habit-forming. Benzodiazepines are usually administered orally for the
treatment of anxiety; however, occasionally lorazepam or diazepam may be
given intravenously for the treatment of panic attacks.
The World Council of Anxiety does not recommend benzodiazepines
for the long-term treatment of anxiety due to a range of problems
associated with long-term use including tolerance, psychomotor impairment, cognitive and memory impairments, physical dependence and a benzodiazepine withdrawal syndrome upon discontinuation of benzodiazepines. Despite increasing focus on the use of antidepressants and other agents
for the treatment of anxiety, benzodiazepines have remained a mainstay
of anxiolytic pharmacotherapy due to their robust efficacy, rapid onset
of therapeutic effect, and generally favorable side effect profile. Treatment patterns for psychotropic drugs appear to have remained
stable over the past decade, with benzodiazepines being the most
commonly used medication for panic disorder.
Many people who are addicted to alcohol or prescribed
benzodiazepines when it is explained to them they have a choice between
ongoing ill mental health or quitting and recovering from their symptoms
decide on quitting alcohol or their benzodiazepines. Symptoms may temporarily worsen however, during alcohol withdrawal or benzodiazepine withdrawal.
Psychological factors
Research has indicated the role of 'core' or 'unconditional' negative beliefs
(e.g. "I am inept") and 'conditional' beliefs nearer to the surface
(e.g. "If I show myself, I will be rejected"). They are thought to
develop based on personality and adverse experiences and to be activated when the person feels under threat. Recent research has also highlighted that conditional beliefs may also
be at play (e.g., "If people see I'm anxious, they'll think that I'm
weak").
A secondary factor is self-concealment which involves concealing the expression of one's anxiety or its underlying beliefs. One line of work has focused more specifically on the key role of self-presentational concerns. The resulting anxiety states are seen as interfering with social
performance and the ability to concentrate on interaction, which in turn
creates more social problems, which strengthens the negative schema. Also highlighted has been a high focus on and worry about anxiety symptoms themselves and how they might appear to others. A similar model emphasizes the development of a distorted mental representation of the
self and overestimates of the likelihood and consequences of negative
evaluation, and of the performance standards that others have. Such
cognitive-behavioral models consider the role of negatively biased
memories of the past and the processes of rumination after an event (also known as post-event processing), and fearful anticipation before it.
Studies have also highlighted the role of subtle avoidance and defensive factors, and shown how attempts to avoid feared negative evaluations or use of "safety behaviors" can make social interaction more difficult and the anxiety worse in the long run. This work has been influential in the development of cognitive
behavioral therapy for social anxiety disorder, which has been shown to
have efficacy.
Diagnosis
ICD-10
defines social phobia as fear of scrutiny by other people leading to
avoidance of social situations. The anxiety symptoms may present as a
complaint of blushing, hand tremor, nausea, or urgency of urination.
Symptoms may progress to panic attacks.
Generalized Social Anxiety Disorder: Affects nearly all aspects of a person's social life, making everyday interactions extremely stressful.
Specific (Performance-Based) Social Anxiety Disorder: Individuals feel extreme nervousness in specific situations, like giving a speech or performing on stage.
DSM-5 diagnostic criteria
Although the DSM defines social anxiety disorder as an intense fear
or anxiety of social situations, it makes clear a distinction to
separate social anxiety disorder from simply social anxiety or social
fear.
Social situations
The anxiety must occur in a social setting under circumstances that are conducive to the possible scrutiny of others.
For children, the DSM-5 notes that the anxiety must be in a setting with other children and not with adults.
Social situations induce and are avoided due to the intense feelings of anxiety or fear.
Social situations must be the cause of anxiety or fear.
The DSM-5 notes that for social anxiety disorder, the fear must be
attributed or correlated to social situations and not another condition.
Anxiety
The fear or anxiety is out of reasonable proportion to the context of the situation.
The fear or anxiety affects an individual for an abnormally long time – 6 months or more.
There is a significant negative impact on an individual's life due
to fear or anxiety in a social, professional, or other life event.
To determine a reasonable proportion, an individual's sociocultural
situation is assessed. Different cultures have individual criteria for
determining a reasonable fear to a learned behavior for a particular
social situation. Criteria for anxiety assess whether a fear has a
significant impact on social, professional, or other life function.
Other causes
Condition is not a psychological effect induced by a substance (e.g., drugs, alcohol or other medication).
Condition is not a psychological effect induced by another medical condition.
Condition is not a psychological effect induced by another mental disorder.
Performance
Fear is limited to only public speaking or public performing
The DSM-5 notes that performance only type of social anxiety disorder
(a subset specific version of this disorder) often affects individual's
professional lives of those involved with public speaking or public
performing. These fears can arise in settings other than just an
individual's professional life but are limited to only public social
performance situations.
Differential diagnosis
The DSM-IV criteria stated that an individual cannot receive a
diagnosis of social anxiety disorder if existing symptoms are better
diagnosed by one of the autism spectrum disorders, such as autism or Asperger syndrome.
The first-line treatment for social anxiety disorder is cognitive behavioral therapy (CBT), with medications such as selective serotonin reuptake inhibitors (SSRIs) sometimes used in combination with CBT. The purpose of CBT is to help individuals address unhelpful thinking
patterns and behaviors that contribute to emotional distress. Self-help based on principles of CBT is an alternative option for those unable to access in-person mental health services.
Another treatment with a growing evidence base for social anxiety disorder is metacognitive therapy (MCT), which targets the underlying processes that maintain the disorder. More specifically, the aim of MCT is to identify and modify
dysfunctional metacognitive beliefs that contribute to and sustain a
perseverative style of thinking known as the cognitive attentional
syndrome (CAS), which comprises worry and rumination, threat monitoring,
self-focused attention, and maladaptive coping behaviors. Some studies have suggested that MCT may be superior to CBT for social anxiety disorder.
There is emerging evidence for the use of acceptance and commitment therapy
(ACT) in the treatment of social anxiety disorder. ACT is considered an
offshoot of traditional CBT and emphasizes accepting unpleasant
symptoms rather than fighting against them, as well as psychological flexibility – the ability to adapt to changing situational demands, to shift one's perspective, and to balance competing desires. ACT may be useful as an alternative treatment for the disorder in situations where CBT is ineffective or refused.
Some studies have suggested social skills training can help with social anxiety. Examples of social skills that may be modified for social anxiety
disorder include initiating conversations, establishing friendships,
interacting with members of the preferred sex, constructing a speech,
and assertiveness skills. However, it is not clear whether specific social skills techniques and
training are required, rather than just support with general social
functioning and exposure to social situations.
Social anxiety disorder may predict subsequent development of other psychiatric disorders, such as depression. Social anxiety disorder remains under-recognized in primary care practice, with people presenting for treatment only after the onset of complications, such as clinical depression or substance use disorders.
A comparison of the treatment effects on social anxiety disorder
showed that using a medication is faster, while CBT is longer-lasting. Using antidepressants for treating social anxiety disorder is typically not as effective as using CBT.
SSRIs & SNRIs
Selective serotonin reuptake inhibitors (SSRIs), a class of
antidepressants, are the first choice of medication for generalized
social phobia but a second-line treatment. Compared to older forms of medication, there is less risk of tolerability and drug dependency associated with SSRIs. Paroxetine and paroxetine CR, sertraline, venlafaxine XR and fluvoxamine CR (Luvox CR) are all approved and effective for treating social anxiety disorder. The effectiveness of medications other than paroxetine is small.
General side effects are common during the first weeks while the body adjusts to SSRI drugs. Symptoms may include headaches, nausea, insomnia and changes in sexual behavior.[112]
Other drugs
Other prescription drugs are also used, if other methods are not effective. Before the introduction of SSRIs, monoamine oxidase inhibitors (MAOIs) such as phenelzine were frequently used in the treatment of social anxiety.Evidence continues to indicate that MAOIs are effective in the
treatment and management of social anxiety disorder and they are still
used, but generally only as a last resort medication, owing to concerns
about dietary restrictions, possible adverse drug interactions and a
recommendation of multiple doses per day. RIMAs have been found to be less efficacious for social anxiety disorder than irreversible MAOIs like phenelzine. Serotonergic anxiolytic buspirone may also be used.
Propranolol, a beta blocker commonly used to control high blood pressure, is used for performance anxiety specifically.
Pregablin at high doses appears to have modest efficacy. Gabapetin has been investigated for social anxiety disorder in preliminary long-term studies.
Social anxiety disorder is known to appear at an early age in most
cases. Fifty percent of those who develop this disorder have developed
it by the age of 11, and 80% have developed it by age 20. This early age of onset may lead to people with social anxiety disorder
being particularly vulnerable to depressive illnesses, substance use,
and other psychological conflicts.
The National Comorbidity Survey
of over 8,000 American correspondents in 1994 revealed 12-month and
lifetime prevalence rates of 7.9 percent and 13.3 percent, respectively;
this makes it the third most prevalent psychiatric disorder after
depression and alcohol use disorder, and the most common of the anxiety
disorders. According to US epidemiological data from the National Institute of Mental Health, social phobia affects 15 million adult Americans in any given year. Estimates vary within 2 percent and 7 percent of the US adult population.
The mean onset of social phobia is 10 to 13 years. Onset after age 25 is rare and is typically preceded by panic disorder or major depression. Social anxiety disorder occurs more often in females than males. The prevalence of social phobia appears to be increasing among white,
married, and well-educated individuals. As a group, those with
generalized social phobia are less likely to graduate from high school
and are more likely to rely on government financial assistance or have
poverty-level salaries. Surveys carried out in 2002 show the youth of England, Scotland, and Wales have a prevalence rate of 0.4 percent, 1.8 percent, and 0.6 percent, respectively. In Canada, the prevalence of self-reported social anxiety for Nova Scotians older than 14 years was 4.2 percent in June 2004 with women (4.6 percent) reporting more than men (3.8 percent). In Australia, social phobia is the 8th and 5th leading disease or illness for males and females between 15 and 24 years of age as of 2003. Because of the difficulty in separating social phobia from poor social
skills or shyness, some studies have a large range of prevalence. The table also shows higher prevalence in Sweden.
History
Literary descriptions of shyness can be traced back to the days of Hippocrates
around 400 BC. Hippocrates described someone who "through bashfulness,
suspicion, and timorousness, will not be seen abroad; loves darkness as
life and cannot endure the light or to sit in lightsome places; his hat
still in his eyes, he will neither see, nor be seen by his good will. He
dare not come in company for fear he should be misused, disgraced,
overshoot himself in gesture or speeches, or be sick; he thinks every
man observes him".
The first mention of the psychiatric term "social phobia" (phobie des situations sociales) was made in the early 1900s. Psychologists used the term "social neurosis" to describe extremely shy patients in the 1930s. After extensive work by Joseph Wolpe on systematic desensitization,
research on phobias and their treatment grew. The idea that social
phobia was a separate entity from other phobias came from the British
psychiatrist Isaac Marks in the 1960s. This was accepted by the American Psychiatric Association and was first officially included in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).
Research
Although social anxiety disorder has been under study for decades, the underlying neurobiology is not well understood. Neurotransmitters under research include serotonin, dopamine, and glutamate. Neuroimaging technologies are in use to clarify brain regions involved. The amygdala is a primary brain structure involved in SAD, as explored in imaging studies.
Parenting that is intrusive or controlling and stressful life
events may increase the risk for SAD development during childhood,
extending into adult years. Genetic factors may have a role, although genetic biomarkers are not specifically identified.
Open-source artificial intelligence, as defined by the Open Source Initiative, is an AI system that is freely available to use, study, modify, and share. This includes datasets used to train the model, its code, and model parameters, promoting a collaborative and transparent approach to AI development so someone could create a substantially similar result.
The debate over what should count as ‘open-source’ given a range
of openness among AI projects has been significant. Some large language
models touted as open-sourced that only release model-weights (but not
training data and code) have been criticized as "openwashing" systems that are mostly closed.
Popular open-source artificial intelligence project categories include large language models, machine translation tools, and chatbots. Debate over the benefits and risks of open-sourced AI involve a range
of factors like security, privacy and technological advancement.
The history of open-source artificial intelligence is intertwined
with both the development of AI technologies and the growth of the open-source software movement.
1990s: Early development of AI and open-source software
The concept of AI dates back to the mid-20th century, when computer scientists like Alan Turing and John McCarthy laid the groundwork for modern AI theories and algorithms An early form of AI, the natural language processing "doctor" ELIZA,
was re-implemented and shared in 1977 by Jeff Shrager as a BASIC
program, and soon translated to many other languages. Early AI research
focused on developing symbolic reasoning systems and rule-based expert systems.
During this period, the idea of open-source software was beginning to take shape, with pioneers like Richard Stallman advocating for free software as a means to promote collaboration and innovation in programming. The Free Software Foundation,
founded in 1985 by Stallman, was one of the first major organizations
to promote the idea of software that could be freely used, modified, and
distributed. The ideas from this movement eventually influenced the
development of open-source AI, as more developers began to see the
potential benefits of open collaboration in software creation, including
AI models and algorithms.
In the 1990s, open-source software began to gain more traction, the rise of machine learning and statistical methods also led to the
development of more practical AI tools. In 1993, the CMU Artificial
Intelligence Repository was initiated, with a variety of openly shared
software.
2000s: Emergence of open-source AI
In the early 2000s open-source AI began to take off, with the release
of more user-friendly foundational libraries and frameworks that were
available for anyone to use and contribute to.
Open-source deep learning framework as Torch was released in 2002 and made open-source with Torch7 in 2011, and was later augmented by PyTorch, and TensorFlow.
OpenAI
was founded in 2015 with a mission to create open-source artificial
intelligence that benefited humanity, at least in part to help with
recruitment in the early phases of the organization. GPT-1 was released in 2018.
2020s: Open-weight and open-source generative AI
With the announcement of GPT-2
in 2019, OpenAI originally planned to keep the source code of their
models private citing concerns about malicious applications. After OpenAI faced public backlash, however, it released the source code for GPT-2 to GitHub three months after its release. OpenAI did not publicly release the source code or pretrained weights for the GPT-3 model. At the time of GPT-3's release GPT-2 was still the most powerful open
source language model in the world. 2022 also saw the rise of larger and
more powerful models under licenses of varying openness including
Meta's OPT.
The Open Source Initiative
consulted experts over two years to create a definition of
"open-source" that would fit the needs of AI software and models. The
most controversial aspect relates to data access, since some models are
trained on sensitive data which can't be released. In 2024, they
published the Open Source AI Definition 1.0 (OSAID 1.0). It requires full release of the software for processing the data,
training the model and making inferences from the model. For the data,
it only requires access to details about the data used to train the AI
so others can understand and re-create it.
In 2023, Meta's weights-available Llama 1 and 2, and Mistral AI's open-weight Mistral and Mixtral models were first released,along with MosaicML's smaller open-source models. The release of the Llama models was a milestone in generating interest in open-weight and open-source models. In 2024, Meta released a collection of large AI models, including Llama 3.1 405B, which was competitive with less open models. Meta's description of Llama as open-source has been disputed due to
Llama's software license, which prohibits it from being used for some
purposes, and due to Meta not disclosing the origin of the data used to
train the models.
DeepSeek released their V3 LLM in December 2024, and their R1 reasoning model on 20 January 2025, both as open-weights models under the MIT license. This release made widely known how China had been embracing using and
building more open AI systems as a way to reduce reliance on western
software and gatekeeping as well as to help give its industries access
to higher-powered AI more quickly. Projects based in China have since become more widely used around the
world as well as they have closed at least some of the gap with leading
proprietary American models.
Since the release of OpenAI's proprietary ChatGPT model in late
2022, there have been only a few fully open (weights, data, code, etc.)
large language models released. In September 2025, a Swiss consortium
added to this short list by releasing a fully open model named Apertus.
Starting in November 2024, Lightricks began releasing the LTX video models as open weights.
Significance
The label ‘open-source’ can provide real benefits to companies looking to hire top talent or attract customers.[4] The debate around "openwashing”
(or calling a project open-source when it is mostly closed) has big
implications for the success of various projects within the industry.
Open-source artificial intelligence tends to get more support and
adoption in countries and companies that do not have their own leading
AI model. These open-source projects can help to undercut the position of
business and geopolitical rivals with the strongest proprietary models. Europe is a region pursuing openness as a digital sovereignty strategy
to try and reduce the leverage that countries like the United States can
use in negotiations on various topics like trade.
Licenses
As of 2025, a plurality (39%) of models released on Hugging Face used the permissive Apache 2.0 License.
Some models, such as the source-available Llama 3, have licenses that grant some of the benefits of open-source licenses, but also contain legal restrictions that deter some companies from using those models, as the companies fear a future lawsuit or a change in the terms and conditions. Some of the same fears also exist in the large number of smaller models that do not specify a license.
In the healthcare industry, open-source AI has been used in diagnostics, patient care, and personalized treatment options. Open-source libraries have been used for medical imaging for tasks such as tumor detection, improving the speed and accuracy of diagnostic processes. Additionally, OpenChem, an open-source library specifically geared
toward chemistry and biology applications, enables the development of
predictive models for drug discovery, helping researchers identify potential compounds for treatment.
Meta's Llama models, which have been described as open-source by Meta, were adopted by U.S. defense contractors like Lockheed Martin and Oracle after unauthorized adaptations by Chinese researchers affiliated with the People's Liberation Army (PLA) came to light. The Open Source Initiative and others have contested Meta's use of the term open-source to describe Llama, due to Llama's license containing an acceptable use policy that prohibits use cases including non-U.S. military use. Chinese researchers used an earlier version of Llama to develop tools
like ChatBIT, optimized for military intelligence and decision-making,
prompting Meta to expand its partnerships with U.S. contractors to
ensure the technology could be used strategically for national security. These applications now include logistics, maintenance, and cybersecurity enhancements.
Benefits
Privacy and independence
A Nature
editorial suggests medical care could become dependent on AI models
that could be taken down at any time, are difficult to evaluate, and may
threaten patient privacy. Its authors propose that health-care institutions, academic
researchers, clinicians, patients and technology companies worldwide
should collaborate to build open-source models for health care of which
the underlying code and base models are easily accessible and can be
fine-tuned freely with own data sets.
Free speech
Open-source models are harder to censor than close-sourced ones.
Collaboration and faster advancements
Large-scale collaborations, such as those seen in the development of
open-source frameworks like TensorFlow and PyTorch, have accelerated
advancements in machine learning (ML) and deep learning. The open-source nature of these platforms also facilitates rapid
iteration and improvement, as contributors from across the globe can
propose modifications and enhancements to existing tools.
Democratizing access
Open-source allows countries and organizations that otherwise do not
have access to proprietary models a way to use and invest in AI more
cheaply. This can help to create an ecosystem for other businesses to sell services on top of.
Transparency
One benefit of open-source AI is the increased transparency it offers compared to closed-source alternatives. The open-sourced aspects of models allow those algorithms and code to
be inspected, which promotes accountability and helps developers
understand how a model reaches its conclusions. Additionally, open-weight models, such as Llama and Stable Diffusion,
allow developers to directly access model parameters, potentially
facilitating the reduced bias and increased fairness in their
applications. This transparency can help create systems with human-readable outputs, or "explainable AI",
which is a growingly key concern, especially in high-stakes
applications such as healthcare, criminal justice, and finance, where
the consequences of decisions made by AI systems can be significant.
Concerns
Quality and security
Open sourced models have fewer ways to prevent them from being used for malicious activities. Open-source AI may allow bioterrorism groups to remove fine-tuning and other safeguards of AI models. One proposed step towards reducing these kinds of harms could be to
require models to have their risks evaluated and pass a certain standard
before being released. A July 2024 report by the White House found it did not yet find sufficient evidence to restrict revealing model weights, though a number of experts in 2024 seemed more concerned about future advances than present-day capabilities.
Executives that preferred proprietary models in 2025 cited security concerns and performance as major factors why.
Training costs
The cost of training datasets for fully open-sourced models can be prohibitively expensive for many projects.
Loneliness is an unpleasant emotional response to perceived or actual isolation. Loneliness has been described as social pain, a psychological mechanism that motivates individuals to seek social connections.
This condition is frequently associated to a perceived lack of
emotional connection and intimacy. Loneliness overlaps and yet is
distinct from solitude.
Solitude is simply the state of being apart from others; however, not
all individuals who experience solitude feel lonely. Loneliness, as a
subjective emotion, can be experienced even in the presence of others.
The causes of loneliness are varied. Loneliness can be a result of systemic issues, genetic inheritance, cultural factors, a lack of meaningful relationships, a significant loss, an excessive reliance on passive technologies (particularly the Internet in the 21st century), and a self-perpetuating mindset. Research has demonstrated that loneliness is ubiquitous in society,
including among people in marriages along with other strong
relationships and those with successful careers. Most people experience
loneliness at some points in their lives, and some feel it often.
Loneliness is found to be the highest among younger people as,
according to the BBC Loneliness Experiment, 40% of people within the age
group 16–24 admit to feeling lonely while the percentage of people who
feel lonely above age 75 is around 27%.
The effects of loneliness are also varied. Transient loneliness
(loneliness that exists for a short period of time) is related to
positive effects, including an increased focus on the strength of one's
relationships. Chronic loneliness (loneliness that exists for a significant amount of
time in one's life) is generally correlated with negative effects,
including increased obesity, substance use disorder, risk of depression, cardiovascular disease, risk of high blood pressure, and high cholesterol.Chronic loneliness is also correlated with an increased risk of death and suicidal thoughts.
Medical treatments for loneliness include beginning therapy and taking antidepressants. Social treatments for loneliness generally include an increase in interaction with others, such as group activities (such as exercise or religious activities), re-engaging with old friends or colleagues, owning pets, and becoming more connected with one's community.
Thomas Wolfe
who, in an often quoted passage, stated "The whole conviction of my
life now rests upon the belief that loneliness, far from being a rare
and curious phenomenon, is the central and inevitable fact of human
existence."
Existential
Loneliness has long been viewed as a universal
condition which, at least to a moderate extent, is felt by everyone.
From this perspective, some degree of loneliness is inevitable as the
limitations of human life mean it is impossible for anyone to
continually satisfy their inherent need for connection. Professors including Michele A. Carter and Ben Lazare Mijuskovic
have written books and essays tracking the existential perspective and
the many writers who have talked about it throughout history. Thomas Wolfe's 1930s essay God's Lonely Man
is frequently discussed in this regard; Wolfe makes the case that
everyone imagines they are lonely in a special way unique to themselves,
whereas really every single person sometimes experiences loneliness.
While agreeing that loneliness alleviation can be a good thing, those
who take the existential view
tend to doubt such efforts can ever be fully successful, seeing some
level of loneliness as both unavoidable and even beneficial, as it can
help people appreciate the joy of living.
Cultural
Culture is discussed as a cause of loneliness in two senses. Migrants can experience loneliness due to missing their home culture. Studies have found this effect can be especially strong for students from countries in Asia with a collectivist culture, when they go to study at universities in more individualist English-speaking countries. Culture is also seen as a cause of loneliness in the sense that Western culture may have been contributing to loneliness, ever since the Enlightenment began to favour individualism over older communal values.
For many people, their family of origin did not offer the
trust-building relationships needed to build a reference that lasts a
lifetime, even in memory after the passing of a loved one. This can be
due to parenting style, traditions, and mental health issues including
personality disorders and abusive family environments. Sometimes religious shunning is also present. This impacts the ability
of individuals to know themselves, to value themselves, and to relate to
others (or to do so with great difficulty).
All these factors and many others are often overlooked by the standard medical or psychological advice
that recommends to go meet friends or family and to socialise. This is
not always possible when there is no one available to relate to and an
inability to connect without the skills and knowledge on how to proceed.
With time, a person might become discouraged or develop apathy from
numerous trials, failures or rejections brought on by the lack of
interpersonal skills.
As the rate of loneliness increases yearly among people of every age group and more so in the elderly,with known detrimental physical and psychological effects, there is a
need to find new ways to connect people with each other. Addressing
loneliness is especially challenging and needed at a time when much of human attention is focused on electronic devices.
Relationship loss
Loneliness is a very common, though often temporary, consequence of a relationship breakup or bereavement. The loss of a significant person in one's life will typically initiate a grief response;
in this situation, one might feel lonely, even while in the company of
others. Loneliness can occur due to the disruption to one's social circle, sometimes combined with homesickness, which results from people moving away for work or education.
All sorts of situations and events can cause loneliness, especially
in combination with certain personality traits for susceptible
individuals. For example, an extroverted person who is highly social is more likely to feel lonely if they are living somewhere with a low population density,
with fewer people for them to interact with. Loneliness can sometimes
even be caused by events that might normally be expected to alleviate
it: for example the birth of a child (if there is significant postpartum depression)
or after getting married (especially if the marriage turns out to be
unstable, overly disruptive to previous relationships, or emotionally
cold). In addition to being impacted by external events, loneliness can
be aggravated by pre-existing mental health conditions like chronic depression and anxiety.
Self-perpetuating
Long-term loneliness can cause various types of maladaptive social cognition, such as hypervigilance and social awkwardness,
which can make it harder for an individual to maintain existing
relationships or establish new ones. Various studies have found that
therapy targeted at addressing this maladaptive cognition is the single
most effective way of intervening to reduce loneliness, though it does
not always work for everyone.
Social contagion
Loneliness can spread through social groups
like a disease. If a person loses a friend, this may increase their
loneliness, resulting in development of maladaptive cognition such as
excessive neediness or suspicion of other friends, possibly leading to a
further loss of human connection among their remaining friends. Those
other friends can become lonelier too, leading to a ripple effect of
loneliness. Studies have however found that this contagion effect is not
consistent – a small increase in loneliness does not always cause the
maladaptive cognition. Also, when someone loses a friend, they will
sometimes form new friendships or deepen other existing relationships.
Studies have tended to find a moderate correlation between extensive internet use and loneliness, especially ones that draw on data from the 1990s, before internet use became widespread. Contradictory results have been found by studies investigating whether
the association is simply a result of lonely people being more attracted
to the internet or if the internet can actually cause loneliness. The displacement hypothesis holds that some people choose to withdraw from real world social interactions so they can have more time for the internet. Excessive internet use can directly cause anxiety and depression,
conditions which can contribute to loneliness – yet these factors may be
offset by the internet's ability to facilitate interaction and to
empower people. Some studies found that internet use is a cause of
loneliness for somewhile others have found internet use can have a significant positive effect on reducing loneliness. The authors of meta-studies and reviews around 2015 and later have
tended to argue that there is a bidirectional causal relationship
between loneliness and internet use. Moderate use, especially by users
who actively engage with others rather than passively consume content,
can increase social connection and reduce loneliness.
Genetics
Smaller early studies had estimated that loneliness may be between 37–55% hereditable. However, in 2016, the first Genome-wide association study of loneliness found that the heredity of loneliness is much lower, at about 14–27%. This suggests that while genes play a role in determining how much
loneliness a person may feel, they are less of a factor than individual
experiences and the environment.
Loneliness peaks in adolescence and late adulthood, while being less common in middle adulthood.
Other
People making long driving commutes have reported dramatically higher
feelings of loneliness (as well as other negative health impacts).
Typology
Two principal types of loneliness are social and emotional
loneliness. This delineation was made in 1973 by Robert S. Weiss, in his
seminal work: Loneliness: The Experience of Emotional and Social Isolation. Based on Weiss's view that "both types of loneliness have to be
examined independently, because the satisfaction for the need of
emotional loneliness cannot act as a counterbalance for social
loneliness, and vice versa", people working to treat or better
understand loneliness have tended to treat these two types of loneliness
separately, though this is far from always the case.
Social loneliness
Social loneliness is the loneliness people experience because of the lack of a wider social network. They may not feel they are members of a community, or that they have friends or allies whom they can rely on in times of distress.
Emotional loneliness
Emotional loneliness results from the lack of deep, nurturing
relationships with other people. Weiss tied his concept of emotional
loneliness to attachment theory.
People have a need for deep attachments, which can be fulfilled by
close friends, though more often by close family members such as
parents, and later in life by romantic partners. In 1997, Enrico
DiTommaso and Barry Spinner separated emotional loneliness into Romantic
and Family loneliness. A 2019 study found that emotional loneliness significantly increased the
likelihood of death for older adults living alone (whereas there was no
increase in mortality found with social loneliness).
Family loneliness
Family loneliness results when individuals feel they lack close ties
with family members. A 2010 study of 1,009 students found that only
family loneliness was associated with increased frequency of self-harm,
not romantic or social loneliness.
Romantic loneliness can be experienced by adolescents and adults who
lack a close bond with a romantic partner. Psychologists have asserted
that the formation of a committed romantic relationship is a critical
development task for young adults, but is also one that many are
delaying into their late 20s or beyond. People in romantic relationships
tend to report less loneliness than single people, provided their
relationship provides them with emotional intimacy. People in unstable
or emotionally cold romantic partnerships can still feel romantic
loneliness.
Other
Several other typologies and types of loneliness exist. Further types of loneliness include existential loneliness, cosmic loneliness – feeling alone in a hostile universe, and cultural loneliness – typically found among immigrants who miss their home culture. These types are less well studied than the threefold separation into
social, romantic and family loneliness, yet can be valuable in
understanding the experience of certain subgroups with loneliness.
Lockdown loneliness refers to "loneliness resulting because of
social disconnection due to enforced social distancing and lockdowns
during the COVID-19 pandemic and similar emergency situations."
Demarcation
Differences between feeling lonely and being socially isolated
There is a clear distinction between feeling lonely and being socially isolated (for example, a loner). In particular, one way of thinking about loneliness is as a discrepancy between one's necessary and achieved levels of social interaction, while solitude
is simply the lack of contact with people. Loneliness is therefore a
subjective yet multidimensional experience; if a person thinks they are
lonely, then they are lonely. People can be lonely while in solitude or
in the middle of a crowd; what makes a person lonely is their perceived
need for more social interaction or a certain type or quality of social
interaction that is not currently available. A person can be in the
middle of a party and feel lonely due to not talking to enough people.
Conversely, one can be alone and not feel lonely; even though there is
no one around, that person is not lonely because there is no desire for social interaction.
There have also been suggestions that each person has their own optimal
level of social interaction. If a person gets too little or too much
social interaction, this could lead to feelings of loneliness or over-stimulation.
Solitude can have positive effects on individuals. One study
found that, although time spent alone tended to depress a person's mood
and increase feelings of loneliness, it also helped to improve their cognitive state, such as improving concentration. It can be argued some individuals seek solitude for discovering a more meaningful and vital existence. Furthermore, once the alone time was over, people's moods tended to increase significantly. Solitude is also associated with other positive growth experiences, religious experiences, and identity building such as solitary quests used in rites of passages for adolescents.
Transient vs. chronic loneliness
Another important typology of loneliness focuses on the time perspective. In this respect, loneliness can be viewed as either transient or chronic.
Transient loneliness is temporary in nature; generally it is easily
relieved. Chronic loneliness is more permanent and not easily relieved. For example, when a person is sick and cannot socialize with friends,
this would be a case of transient loneliness, as it would be easy for
them to alleviate their loneliness once they got better. A person with
long-term feelings of loneliness, regardless of whether they are with
friends or at a family gathering, is experiencing chronic loneliness.
Loneliness as a human condition
The existentialist
school of thought views individuality as the essence of being human.
Each human being comes into the world alone, travels through life as a
separate person, and ultimately dies alone. Coping with this, accepting
it, and learning how to direct our own lives with some degree of grace
and satisfaction is the human condition.
Some philosophers, such as Sartre,
believe in an epistemic loneliness in which loneliness is a fundamental
part of the human condition because of the paradox between people's
consciousness desiring meaning in life and the isolation and nothingness of the universe. Conversely, other existentialist thinkers argue that human beings might
be said to actively engage each other and the universe as they
communicate and create, and loneliness is merely the feeling of being
cut off from this process.
In his 2019 text, Evidence of Being: The Black Gay Cultural Renaissance and the Politics of Violence, Darius Bost draws from Heather Love's theorization of loneliness to delineate the ways in which loneliness structures black gay feeling
and literary, cultural productions. Bost writes, "As a form of negative
affect, loneliness shores up the alienation, isolation, and
pathologization of black gay men during the 1980s and early 1990s. But
loneliness is also a form of bodily desire, a yearning for an attachment
to the social and for a future beyond the forces that create someone's
alienation and isolation."
Possibly over 5% of the population of the industrial countries
experience loneliness at levels which are harmful to physical and mental
health, though scientists have expressed caution over making such
claims with high confidence. Thousands of studies and surveys have been
undertaken to assess the prevalence of loneliness, yet it remains
challenging for scientists to make accurate generalizations and
comparisons. Reasons for this include various loneliness measurement
scales being used by different studies, differences in how even the same
scale is implemented from study to study, and cultural variations
across time and space, which may impact how people report the largely
subjective phenomenon of loneliness.The most widely used self-report measures for loneliness are the University of California, Los Angeles Loneliness Scale (UCLA) and the De Jong Gierveld Loneliness Scale (DJGLS).
One consistent finding has been that loneliness is not evenly
distributed across a nation's population. Rather, it tends to be
concentrated among vulnerable sub groups; for example the poor, the
unemployed, immigrants, and mothers. Some of the most severe loneliness
tends to be found among international students from countries in Asia
with a collective culture, when they come to study in countries with a
more individualist culture, such as Australia. In New Zealand, the fourteen surveyed groups with the highest
prevalence of loneliness most or all of the time in descending order
are: disabled people, recent migrants, low-income households,
unemployed, single parents, rural (rest of South Island), seniors aged
75+, not in the labor force, youth aged 15–24, no qualifications, not
housing owner-occupier, not in a family nucleus, Māori, and low personal
income.
Studies have found inconsistent results concerning the effect of age, gender and culture on loneliness. Much of 20th century and early 21st century writing on loneliness
assumed it typically increases with age. In high-income countries, on
average, one in four people over 60 and one in three over 75 feels
lonely. Yet as of 2020, with some exceptions, recent studies have tended to
find that it is young people who report the most loneliness. There have been contradictory results concerning how the prevalence of
loneliness varies with gender. A 2020 analysis based on a worldwide
dataset gathered by the BBC found greater loneliness among men, though
some earlier work had found the opposite, or that gender made no
difference.
While cross-cultural comparisons are difficult to interpret with
high confidence, the 2020 analyses based on the BBC dataset found the
more individualist countries like the UK tended to have higher levels of
loneliness. However, previous empirical work had often found that
people living in more collectivist cultures tended to report greater
loneliness, possibly due to less freedom to choose the sort of
relationships that suit them best.
In the 21st century, loneliness has been widely reported as an
increasing worldwide problem. A 2010 systematic review and meta analyses
had stated that the "modern way of life in industrialized countries" is
greatly reducing the quality of social relationships, partly due to
people no longer living in close proximity with their extended families.
The review notes that from 1990 to 2010, the number of Americans
reporting no close confidants has tripled.
In 2017, Vivek Murthy, the Surgeon General of the United States, argued that there was a loneliness epidemic. It has since been described as an epidemic thousands of times, by reporters, academics and other public officials.
Professors such as Claude S. Fischer and Eric Klinenberg
opined in 2018 that while the data doesn't support describing
loneliness as an "epidemic" or even as a clearly growing problem,
loneliness is indeed a serious issue, having a severe health impact on
millions of people. However, a 2021 study found that adolescent loneliness in contemporary schools and depression increased substantially and consistently worldwide after 2012.
A comparative overview of the prevalence and determinants of
loneliness and social isolation in Europe in the pre-COVID period was
conducted by Joint Research Centre of the European Commission within the
project Loneliness in Europe. The empirical results indicate that 8.6% of the adult population in
Europe experience frequent loneliness and 20.8% experience social
isolation, with eastern Europe recording the highest prevalence of both
phenomena.
In Australia, the annual national Household, Income and Labour
Dynamics in Australia (HILDA) Survey has reported a steady 8% rise in
agreement with the statement "I often feel very lonely" between 2009 and
2021, responses indicating "strongly agree" rose steadily by over 20%
in that same time period. This is a reversal of the trend seen from the
start of the survey in 2001 until 2009 where these figures had both been
steadily decreasing.
In May 2023, Murthy published a United States Department of Health and Human Services advisory on the impact of the epidemic of loneliness and isolation in the United States. The report likened the dangers of loneliness to other public health threats such as smoking and obesity. In November 2023, the World Health Organization declared loneliness a "global public health concern" and launched an international commission to study the problem.
Effects
Transient
While unpleasant, temporary feelings of loneliness are sometimes
experienced by almost everyone and are not thought to cause long term
harm. Early 20th century work sometimes treated loneliness as a wholly
negative phenomenon, but transient loneliness is now generally
considered beneficial. The capacity to feel it may have been
evolutionarily selected for, a healthy aversive emotion that motivates individuals to strengthen social connections. Transient loneliness is sometimes compared to short-term hunger, which is unpleasant but ultimately useful as it motivates us to eat.
Chronic
Long-term loneliness is widely considered a close to entirely harmful
condition. Whereas transient loneliness typically increases motivation
to improve relationships with others, chronic loneliness can have the
opposite effect. This is as long-term social isolation can cause hypervigilance.
While enhanced vigilance may have been evolutionary adaptive for
individuals who went long periods without others watching their backs,
it can lead to excessive cynicism and suspicion of other people, which
in turn can be detrimental to interpersonal relationships. So without
intervention, chronic loneliness can be self-reinforcing.
Benefits
Some assert that even long-term involuntary loneliness can have beneficial effects.
Chronic loneliness is often seen as a purely negative phenomenon
from the lens of social and medical science. Yet in spiritual and
artistic traditions, it has been viewed as having mixed effects. Though
even within these traditions, there can be warnings not to intentionally
seek out chronic loneliness or other conditions – just advise that if
one falls into them, there can be benefits. In western arts, there is a
long belief that psychological hardship, including loneliness, can be a
source of creativity. In spiritual traditions, perhaps the most obvious benefit of loneliness
is that it can increase the desire for a union with the divine. More
esoterically, the psychic wound opened up by loneliness or other
conditions has been said, e.g. by Simone Weil, to open up space for God to manifest within the soul. In Christianity, spiritual dryness has been seen as advantageous as part of the "dark night of the soul", an ordeal that while painful, can result in spiritual transformation. From a secular perspective, while the vast majority of empirical
studies focus on the negative effects of long term loneliness, a few
studies have found there can also be benefits, such as enhanced
perceptiveness of social situations.
Brain
Studies have found mostly negative effects from chronic loneliness on brain functioning and structure. However, certain parts of the brain and specific functions, like the
ability to detect social threat, appear to be strengthened. A 2020
population-genetics study looked for signatures of loneliness in grey
matter morphology, intrinsic functional coupling, and fiber tract
microstructure. The loneliness-linked neurobiological profiles converged
on a collection of brain regions known as the default mode network.
This higher associative network shows more consistent loneliness
associations in grey matter volume than other cortical brain networks.
Lonely individuals display stronger functional communication in the
default network, and greater microstructural integrity of its fornix pathway. The findings fit with the possibility that the up-regulation of these neural circuits supports mentalizing, reminiscence and imagination to fill the social void.
Physical health
Chronic loneliness can be a serious, life-threatening health
condition. It has been found to be strongly associated with an increased
risk of cardiovascular disease, though direct causal links have yet to be firmly identified. People experiencing loneliness tend to have an increased incidence of high blood pressure, high cholesterol, and obesity. Loneliness has been shown to increase the concentration of cortisol levels in the body and weaken the effects of dopamine. Prolonged, high cortisol levels can cause anxiety, depression,
digestive problems, heart disease, sleep problems, and weight gain.
Associational studies on loneliness and the immune system have found mixed results, with lower natural killer (NK) cell activity or dampened antibody response to viruses such Epstein Barr, herpes, and influenza, but either slower or no change to the progression of AIDS. Based on the English Longitudinal Study of Ageing (ELSA), a study found that loneliness increased the risk of dementia
by one-third. Not having a partner (being single, divorced, or widowed)
doubled the risk of dementia. However, having two or three closer
relationships reduced the risk by three-fifths.And based on the large UK Biobank cohort, a study found that
individuals who reported feeling lonely had a higher risk of developing Parkinson's disease.
Death
A 2010 systematic review and meta-analysis found a significant
association between loneliness and increased mortality. People with good
social relationships were found to have a 50% greater chance of
survival compared to lonely people (odds ratio
= 1.5). In other words, chronic loneliness seems to be a risk factor
for death comparable to smoking, and greater than obesity or lack of exercise. A 2017 overview of systematic reviews found other meta-studies with
similar findings. However, clear causative links between loneliness and
early death have not been firmly established.
Mental health
Loneliness has been linked with depression, and is thus a risk factor for suicide. A study based on more than 4,000 adults aged over 50 in the ELSA found
that nearly one in five of those who reported being lonely had developed
signs of depression within a year. Émile Durkheim
has described loneliness, specifically the inability or unwillingness
to live for others, i.e. for friendships or altruistic ideas, as the
main reason for what he called egoistic suicide. In adults, loneliness is a major precipitant of depression and alcoholism. People who are socially isolated may report poor sleep quality, and thus have diminished restorative processes. Loneliness has also been linked with a schizoid character type in which one may see the world differently and experience social alienation, described as the self in exile. Loneliness has been linked to eating disorders.
While the long-term effects of extended periods of loneliness are
little understood, it has been noted that people who are isolated or
experience loneliness for a long period of time fall into a "ontological
crisis" or "ontological insecurity," where they are not sure if they or
their surroundings exist, and if they do, exactly who or what they are,
creating torment, suffering, and despair to the point of palpability
within the thoughts of the person.
In children, a lack of social connections is directly linked to several forms of antisocial and self-destructive behavior, most notably hostile and delinquent behavior. In both children and adults, loneliness often has a negative impact on learning and memory. Its disruption of sleep patterns can have a significant impact on the ability to function in everyday life.
Research from a large-scale study published in the journal Psychological Medicine, showed that "lonely millennials
are more likely to have mental health problems, be out of work, and
feel pessimistic about their ability to succeed in life than their peers
who feel connected to others, regardless of gender or wealth".
In 2004, the United States Department of Justice
published a study indicating that loneliness increases suicide rates
profoundly among juveniles, with 62% of all suicides that occurred
within juvenile facilities being among those who either were, at the
time of the suicide, in solitary confinement or among those with a
history of being housed thereof.
Pain, depression, and fatigue function as a symptom cluster and
thus may share common risk factors. Two longitudinal studies with
different populations demonstrated that loneliness was a risk factor for
the development of that symptom cluster over time.
Loneliness can cause suicidal thoughts, attempts at suicide, and actual suicide.
The extent to which suicides result from loneliness are difficult to
determine however, as there are typically several potential causes
involved. In an article written for the American Foundation for Suicide Prevention, Dr. Jeremy Noble writes, "You don't have to be a doctor to recognize the connection between loneliness and suicide." As feelings of loneliness intensify, so do thoughts of suicide and attempts at suicide.
The Samaritans,
a nonprofit charity in England which works with people going through
crisis, says there is a definite correlation between feelings of
loneliness and suicide for juveniles and those in their young adult
years. The English Office of National Statistics found one of the top ten reasons young people have suicidal idealizations and attempt suicide is because they are lonely. College students who are lonely, away from home, living in new
unfamiliar surroundings, or away from friends feel isolated and, without
proper coping skills, will turn to suicide as a way to fix the pain of
loneliness. A common theme, among children and young adults dealing with feelings
of loneliness, is they didn't know help was available or where to get
help. Loneliness, to them, is a source of shame.
In some countries, senior citizens appear to commit a high
proportion of suicides, though in other countries the rate is
significantly higher for middle-aged men. Retirement, poor health, loss
of a significant other or other family or friends are all factors which
contribute to loneliness. Suicides caused by loneliness in older people
can be difficult to identify. Often they don't have anyone to disclose
their feelings of loneliness and the despair it brings. They may stop
eating, alter the doses of medications, or choose not to treat an
illness as a way to help expedite death so they don't have to deal with
feeling lonely.
Cultural influences can also cause loneliness leading to suicidal
thoughts or actions. For example, Hispanic and Japanese cultures value
interdependence. When a person from one of these cultures feels removed
or feels like they can't sustain relationships in their families or
society, they start to have negative behaviors, including negative
thoughts or acting self-destructively. Other cultures, such as in Europe, are more independent.
Society level
High levels of chronic loneliness can also have society-wide effects. Economist Noreena Hertz writes that Hannah Arendt was the first to discuss the link between loneliness and the politics of intolerance. In her book, The Origins of Totalitarianism, Arendt argues that loneliness is an essential prerequisite for a totalitarian
movement to gain power. Hertz states that the link between an
individual's loneliness and their likelihood to vote for a populist
political party or candidate has since been supported by several
empirical studies. In addition to increasing support for populist
policies, Hertz argues that a society with high levels of loneliness
risks eroding its ability to have effective mutually beneficial
politics. Some of the ways individuals alleviate loneliness, such as
technological or transactional substitutes for human companionship, can
reduce people's political and social skills, such as their ability to
compromise and to see other points of view.
Studies investigating the relationship between loneliness and
voter orientation directly found that lonely individuals can abstain
from elections rather than support authoritarian parties. Other studies found romantic loneliness increased support for authoritarianism. This inconsistency might stem from differences in the definition and operationalization of loneliness.
Physiological mechanisms linked to poor health
There are a number of potential physiological mechanisms linking
loneliness to poor health outcomes. In 2005, results from the American Framingham Heart Study demonstrated that lonely men had raised levels of Interleukin 6 (IL-6), a blood chemical linked to heart disease. A 2006 study conducted by the Center for Cognitive and Social Neuroscience at the University of Chicago
found loneliness can add thirty points to a blood pressure reading for
adults over the age of 50. Another finding, from a survey conducted by John Cacioppo from the same university, is that doctors report providing better medical care
to patients who have a strong network of family and friends than they
do to patients who are alone. Cacioppo states that loneliness impairs cognition and willpower, alters DNAtranscription in immune cells, and leads over time to high blood pressure. Lonelier people are more likely to show evidence of viral reactivation and have stronger inflammatory responses to acute stress compared to
less lonely people; inflammation is a well-known risk factor for
age-related diseases.
When someone feels left out of a situation, they feel excluded
and one possible side effect is for their body temperature to decrease.
When people feel excluded blood vessels at the periphery of the body may
narrow, preserving core body heat. This class protective mechanism is
known as vasoconstriction.
Relief
The reduction of loneliness in oneself and others has long been a
motive for human activity and social organization. For some
commentators, such as professor Ben Lazare Mijuskovic, loneliness has
been the single strongest motivator for human activity after essential
physical needs are satisfied, ever since the dawn of civilization.
Nevertheless, there is relatively little direct record of explicit
loneliness relief efforts prior to the 20th century. Some commentators,
including professor Rubin Gotesky, have argued the sense of aloneness
was rarely felt until older communal ways of living began to be
disrupted by the Enlightenment.
Starting in the 1900s, and especially in the 21st century,
efforts explicitly aiming to alleviate loneliness became much more
common. Loneliness reduction efforts occur across multiple disciplines,
often by actors for whom loneliness relief is not their primary concern.
For example, by commercial firms, civic planners, designers of new
housing developments, and university administration. Across the world,
many departments, NGOs and even umbrella groups entirely dedicated to loneliness relief have been established. For example, in the UK, the Campaign to End Loneliness.
With loneliness being a complex condition, there is no single method
that can consistently alleviate it for different individuals; many
different approaches are used.
Medical treatment
Therapy is a common way of treating loneliness. For individuals whose
loneliness is caused by factors that respond well to medical
intervention, it is often successful. Short-term therapy, the most
common form for lonely or depressed patients, typically occurs over a
period of ten to twenty weeks. During therapy, emphasis is put on
understanding the cause of the problem, reversing the negative thoughts,
feelings, and attitudes resulting from the problem, and exploring ways
to help the patient feel connected. Some doctors also recommend group therapy as a means to connect with other patients and establish a support system. Doctors also frequently prescribe anti-depressants
to patients as a stand-alone treatment, or in conjunction with therapy.
It may take several attempts before a suitable anti-depressant
medication is found.
Doctors often see a high proportion of patients with loneliness; a
UK survey found that three-quarters of doctors believed that between
1–5 patients visited them each day mainly out of loneliness. There isn't
always sufficient funds to pay for therapy, leading to the rise of
"social prescription", where doctors can refer patients to NGO and
community-led solutions such as group activities. While preliminary
findings suggest social prescription has good results for some people,
early evidence to support its effectiveness was not strong, with
commentators advising that for some people it is not a good alternative
to medical therapy. As of 2024,
formal social prescribing programmes have been launched in 17 different
countries around the world, with improved evidence for its
effectiveness when the prescriptions are carefully targeted, such as
helping the lonely person get closer to nature, or participate in group
activities they enjoy.
NGO and community led
Along with growing awareness of the problem of loneliness,
community-led projects explicitly aiming for its relief became more
common in the latter half of the 20th century, with still more starting
up in the 21st. There have been many thousands of such projects across
North and South America, Europe, Asia, and Africa. Some campaigns are
run nationally, under the control of charities dedicated to loneliness
relief, while other efforts may be local projects, sometimes run by a
group for which loneliness relief is not their primary objective. For
example, housing associations that aim to ensure multi generational
living, with social interaction between younger and older people
encouraged, in some cases even contractually required. Projects range
from befriending schemes that facilitate just two people meeting up, to
large group activities, which will often have other objectives in
addition to loneliness relief: as having fun, improving physical health
with exercise, or participating in conservation efforts. For example, in New Zealand the NGO Age Concern began an Accredited
Visiting Service which was found to be an effective counter to this
loneliness and isolation.
Government
In 2010, François Fillon announced the fight against loneliness would be France's great national cause for 2011. In the UK, the Jo Cox Commission on Loneliness began pushing to make tackling loneliness a government priority from 2016. In 2018, this led to Great Britain becoming the first country in the
world to appoint a ministerial lead for loneliness, and to publish an
official loneliness reduction strategy. There have since been calls for other countries to appoint their own minister for loneliness, for example in Sweden and Germany. Various other countries had seen government led anti loneliness efforts
even before 2018 however. For example, in 2017 the government of
Singapore started a scheme to provide allotments to its citizens so they could socialise while working together on them, while the Netherlands government set up a telephone line for lonely
older people. While governments sometimes directly control loneliness
relief efforts, they can work in partnership with educational
institutions and organisations. Social policy can reduce loneliness across all age groups by reducing the barriers for formation of new friendships.
Pets
Paro, a robot pet seal classified as a medical device by U.S. regulators
Pet therapy, or animal-assisted therapy, can be used to treat both loneliness and depression. The presence of animal companions, especially dogs, but also others like cats, rabbits, and guinea pigs,
can ease feelings of depression and loneliness among some patients.
Beyond the companionship the animal itself provides there may also be
increased opportunities for socializing with other pet owners. According
to the Centers for Disease Control and Prevention there are a number of other health benefits associated with pet ownership, including lowered blood pressure and decreased levels of cholesterol and triglycerides.
Technology
Technology companies have been advertising their products as helpful
for reducing loneliness at least as far back as 1905; records exist of
early telephones being presented as a way for isolated farmers to reduce
loneliness. Technological solutions for loneliness have been suggested
much more frequently since the development of the internet, and
especially since loneliness became a more prominent public health issue
at around 2017. Solutions have been proposed by existing tech companies,
and by start-ups dedicated to loneliness reduction.
Solutions that have become available since 2017 tend to fall under 4 different approaches.
Mindfulness
apps aim to change an individual's attitude towards loneliness,
emphasising possible benefits, and trying to shift towards an experience
more similar to voluntary solitude.
Apps that warn users when they're starting to spend too much time online, which is based on research findings that moderate use of digital technology can be beneficial, but that excessive time online can increase loneliness.
Apps that help people connect with others, including to arrange real life meetups.
AI-related technologies that provide digital companionship.
Such AI companions can be conventionally virtual (having existence
only when their application is switched on), can have an independent
digital life (their program may run all the time in the cloud,
allowing them to interact with the user across different platforms like
Instagram & Twitter in similar ways to how a real human friend
might behave), or can have a physical presence like a Pepper robot. As far back as the 1960s, some individuals had stated they prefer communicating with the ELIZA
computer program rather than regular human beings. AI-driven
applications available in the 2020s are considerably more advanced, able
to remember previous conversations, with some ability to sense
emotional states, and to tailor their interaction accordingly. An
example of a start-up working on such technology is Edward Saatchis's Fable studio.
As they'll be in some senses beyond human, untainted by negative
motivators like greed or envy, and with enhanced powers of attention,
they may be able to help people be kinder and gentler to others. And so
assist with loneliness relief on a society wide level, as well as
directly with individuals.
Effectiveness of digital technology interventions
A 2021 systematic review and meta-analysis on the effectiveness of
digital technology interventions (DTIs) in reducing loneliness in older
adults found no evidence supporting that DTIs reduce loneliness in older
adults with an average age from 73 to 78 years (SD 6–11). DTIs studied included social internet-based activities, that is, social
activities via social websites, videoconferencing, customized computer
platforms with simplified touch-screen interfaces, personal reminder
information and social management systems, WhatsApp groups, and video or
voice networks.
Religion
Studies have found an association with religion and the reduction of
loneliness, especially among the elderly. The studies sometimes include
caveats, such as that religions with strong behavioural prescriptions
can have isolating effects. In the 21st century, numerous religious
organisations have begun to undertake efforts explicitly focusing on
loneliness reduction. Religious figures have also played a role in
raising awareness of the problem of loneliness; for example, Pope Francis said in 2013 that loneliness of the old (along with youth unemployment) were the most serious evils of the age.
Others
Nostalgia has also been found to have a restorative effect, counteracting loneliness by increasing perceived social support. Similar media-based practices such as Comfort television involve engaging with familiar content to provide emotional comfort and alleviate feelings of loneliness.Vivek Murthy has stated that the most generally available cure for loneliness is human connection.
Murthy argues that regular people have a vital role to play as
individuals in reducing loneliness for themselves and others, in part by
greater emphases on kindness and on nurturing relationships with
others.
Effectiveness
Professor Stella Mills has suggested that, while social loneliness
can be relatively easy to address with group activities and other
measures that help build connections between people, effective
intervention against emotional loneliness can be more challenging. Mills
argues that such intervention is more likely to succeed for individuals
who are in the early stages of loneliness, before the effects caused by
chronic loneliness are deeply engrained.
A 2010 meta-study compared the effectiveness of four
interventions: improving social skills, enhancing social support,
increasing opportunities for social interaction, and addressing faulty
patterns of thoughts (such as the hyper-vigilance). The results of the
study indicated that all interventions were effective in reducing
loneliness, possibly with the exception of social skill training.
Results of the meta-analysis suggest that correcting the faulty patterns
of thoughts offers the best chance of reducing loneliness. A 2019 umbrella review of systematic reviews on the effectiveness of
loneliness relief efforts aimed at older people also found that it was
the most effective method.
A 2018 overview of systematic reviews concerning the
effectiveness of loneliness interventions found that, generally, there
is little solid evidence that intervention are effective. However, they
also found no reason to believe the various types of intervention did
any harm, except they cautioned against the excessive use of digital
technology. The authors called for more rigorous, best
practice–compliant research in future studies, and for more attention to
the cost of interventions.
Historical emergence of loneliness as a social problem
Loneliness has been a theme in literature throughout the ages, as far back as Epic of Gilgamesh. Yet according to Fay Bound Alberti, it was only around the year 1800 that the word began to widely denote a negative condition. With some exceptions, earlier writings and dictionary definitions of loneliness tended to
equate it with solitude – a state that was often seen as positive,
unless taken to excess.
From about 1800, the word loneliness began to acquire its modern
definition as a painful subjective condition. This may be due to the
economic and social changes arising out of the enlightenment.
Such as alienation and increased interpersonal competition, along with a
reduction in the proportion of people enjoying close and enduring
connections with others living in close proximity, may have been the
case for modernising pastoral villages. Despite growing awareness of the problem of loneliness, widespread
social recognition of the problem remained limited, and scientific study
was sparse, until the last quarter of the twentieth century. One of the
earliest studies of loneliness was published by Joseph Harold Sheldon in 1948. The 1950 book The Lonely Crowd
helped further raise the profile of loneliness among academics. For the
general public, awareness was raised by the 1966 Beatles song "Eleanor Rigby".According to Eugene Garfield, it was Robert S. Weiss who brought the attention of scientists to the topic of loneliness, with his 1973 publication of Loneliness: The experience of emotional and social isolation. Before Weiss's publication, what few studies of loneliness existed were
mostly focussed on older adults. Following Weis's work, and especially
after the 1978 publication of the UCLA Loneliness Scale,
scientific interest in the topic has broadened and deepened
considerably, with tens of thousands of academic studies having been
carried to investigate loneliness just among students, with many more
focussed on other subgroups, and on whole populations.
Concern among the general public over loneliness increased in the decades since "Eleanor Rigby"'s
release; by 2018, government-backed anti-loneliness campaigns had been
launched in countries including the UK, Denmark and Australia.
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