Loneliness Across the Globe: A Life-Span Approach 

Did you know that loneliness is different from social isolation? Psychologists define loneliness as a subjective concept which is related to one’s own expectations.  

In this episode, Under the Cortex hosts Samia Akther Khan, PhD candidate from King’s College London, whose research examines the feeling of loneliness across lifespan. The conversation with APS’s Özge G. Fischer-Baum focuses on the difference between loneliness and social isolation and highlights six key social relationship expectations of older adults: (1) availability of social contacts, (2) receiving care and support, (3) intimacy and understanding, (4) enjoyment and shared interests, (5) generativity and contribution, and (6) being respected and valued. Along with other implications, Samia discusses the importance of global research and specific challenges that global research teams face. 

Samia Akther Khan also published on this topic in APS’s Perspectives with co-authors Matthew Prina, Gloria Hoi-Yan Wong, Rosie Mayston, and Leon Li. The article is titled, Understanding and Addressing Older Adults’ Loneliness: The Social Relationship Expectations Framework. 

Unedited Transcript

[00:00:10.010] – APS Özge G. Fischer-Baum 

Humans are social creatures. When we interact with the world, we are usually surrounded by other fellow humans. Do our social interactions change over time? Do we get lonelier as we get older? This is under the cortex. I am Ozge Gürcanlı Fisherbaum with the association for Psychological Science. To answer these questions I have with me Samia Akther Khan from King’s College, London. She is the author of an article published in Perspectives examining the loneliness of older adults. Samia, thank you for joining me today. Welcome to under the cortex. 

[00:00:52.460] – Samia Akther Khan 

Thank you for having me. 

[00:00:54.000] – APS Özge G. Fischer-Baum 

So I would like to start with a simple question. How do psychologists define loneliness? 

[00:01:02.430] – Samia Akther Khan 

Yeah, so commonly loneliness is defined as the discrepancy between your expected social relationships and your actual social relationships. So it means we have certain expectations for our social interactions. We expect somebody to call us, for example, and then we have reality, which is our actual relationships. And if the person doesn’t call us, our expectations are violated and may lead to loneliness. So it’s really a very cognitive definition. 

[00:01:29.780] – APS Özge G. Fischer-Baum 

Of loneliness, and I hear that it is very subjective as well. Right. It is about our expectations then. 

[00:01:37.280] – Samia Akther Khan 

Totally. It’s very subjective. And that’s the difference to social isolation, which is commonly used as the same term as loneliness. But social isolation really means being physically alone. So you might have many people around you and still feel lonely. On the other hand, you might be alone and not feel lonely. 

[00:01:56.470] – APS Özge G. Fischer-Baum 

So are there cultural differences in perception of loneliness? 

[00:02:01.350] – Samia Akther Khan 

Yeah, that’s a difficult question because obviously we have many different cultures in the world. And most research comes from higher income countries and cultures in Europe and the States, for example. And we’ve recently conducted a systematic review of what loneliness actually means in low middle income countries, which is not published yet. But there we see that loneliness is also seen as like a violation of expectations. So people expect certain things and then when they’re not met these expectations, then people do feel lonely. However, what we found in this review is that loneliness was very closely tied to rejection. So feeling of rejection that was specific to loneliness that we maybe don’t see as much in other cultures. But of course, expectations change depending on culture and context of people. Culture can affect our expectations that we have, but also the likelihood of them being met. So for example, if we compare socially embedded cultures, we might expect that people are around us all the time and we live in busy environments, whereas then move to a country where people live alone more or where it’s less socially embedded, then we have higher likelihood of a violated expectation for being together with other people. 

[00:03:21.090] – APS Özge G. Fischer-Baum 

Right, right. So the way we feel rejection, the way we perceive ourselves within our expectations yeah, that is remarkable. So let me ask you another question. So why is it important to define loneliness across lifespan? 

[00:03:37.820] – Samia Akther Khan 

We know from research that loneliness is something that people experience across the lifespan. Loneliness peaks, like, twice the prevalence across the lifespan. So in younger adulthood, around the age of 20, and then again in older age. So we are at a very different stage of the lifespan when we’re around 20, and maybe establishing our new identities in our lives, finding our career as opposed to being older and having lived our lives already, most of it focusing more on other things, such as generativity, so contributing meaningfully. 

[00:04:11.810] – APS Özge G. Fischer-Baum 

Yeah. So in your article, you define six key social relationship expectations about loneliness. Right. So you have used definitions from different scientific disciplines. Could you tell our listeners what these six expectations are and why you wanted to incorporate multiple disciplines in your research? 

[00:04:32.790] – Samia Akther Khan 

Of course. Yeah. So the Social Relationship Expectations Framework, or SRE, is something we developed because we knew this definition of loneliness is a violation of expectations, but there wasn’t really a defined framework or theory about what we expect from our relationships. So we identified six different expectations, which are proximity, so having social contacts available and close by, support, feeling cared for and able to rely on others. We have intimacy, which means feeling close to a person, understood and listened to, and fun, so sharing interests and enjoyable experiences. And these first four expectations are really incorporated into loneliness literature, into the scales, and are really considered in interventions as well. But then we have two expectations that we define as maybe more relevant in older age and also not so regarded yet in learningness, research or interventions. And one of them is generativity, which is a common psychological concept defined by Erickson, where we have or expect having opportunities to contribute meaningfully, so leaving a legacy, helping somebody in a meaningful way. And the other one is respect. And what we mean by respect is more so feeling valued and appreciated, but also actively included. So these are the six expectations that we define in the SRE framework. 

[00:06:00.690] – APS Özge G. Fischer-Baum 

And I noticed that you are primarily working with global samples. Can you tell us why you had this choice in your research program? 

[00:06:10.410] – Samia Akther Khan 

Sure, yeah. I mean, as I said earlier, I think most research comes from weird countries like Henrik defined. And we’ve known this for a long. 

[00:06:17.550] – APS Özge G. Fischer-Baum 

Time, and I just want to clarify something. So in psychology, we talk a lot about Weird sampling issue that you mentioned. So, Weird stands for Western educated, industrialized rich, and democratic. And majority of psychological research comes from this category. 

[00:06:38.130] – Samia Akther Khan 

Yeah, approximately 96% of psychological research is done with samples from higher income countries, which leaves, like, a really large population from our world out of psychological research and our knowledge about how humans think and behave, including loneliness. My research focus on focusing more globally really started when I moved to Myanmar in 2018, where I did research on loneliness in older adults. And that really sparked my interest for doing more research in an area of global mental health, which is a relatively new field and interdisciplinary field. And so now I’m at the Centre for Global Mental Health at King’s College London, which really focuses on mental health interventions, mental health research globally and specifically in low middle income settings. I mean, I think personally you think that’s really important to include different cultures, especially where there’s a lack of mental health research and interventions, but also funding and structural barriers to doing that research. 

[00:07:43.430] – APS Özge G. Fischer-Baum 

Yeah, definitely. So diversifying our samples in psychological research is very important. It is fascinating that you are doing something about that and you are using more global samples. So what are your suggestions to our senior listeners? What is the best way for them to cope with their loneliness? 

[00:08:09.630] – Samia Akther Khan 

Yeah, again, talking about cultural differences, I think there are different coping strategies that people use in different occasions or countries or contexts they’re in. And then it’s just really hard to suggest something that wouldn’t be possible in a different context. But I can maybe share some work of mine from Myanmar where we interviewed people about how they, older people, about how they coped with loneliness. And there was basically a two step process to simplify it, one of which was first accepting that one is lonely. So really realizing I am lonely at this moment, it may be a transient state, it might not last forever, but at this very moment I am lonely because some people are in denial of loneliness or maybe because it’s stigmatized as well. Don’t feel comfortable in actually seeing themselves as a lonely person. And acceptance can really be facilitated by meditation, it can be facilitated by praying. And then the next step would be not to stay in that state of acceptance and just being lonely and maybe also in self pity in some cases. This is what older people taught me. But then to fight against loneliness. So there are obviously many different ways people can fight, actively cope with loneliness and change that state once they’re aware that they are lonely. 

[00:09:27.440] – Samia Akther Khan 

And one of the things could be using the SRE framework. So these six different expectations and identifying which expectations are actually met and which ones are not met. So we might be in a situation where we find okay, I have people around me, proximity is met, I have very close relationships. Intimacy is met, I do provide a lot of care, generativity is met, but I don’t feel respected because, for example, I do provide a lot of care work, but nobody appreciates me for it. Right? I might have been working at home my whole life as doing housework and care work. I’ve never gotten money for it. So no economic value, no economic appreciation, but also no appreciation from my partner or from my family. So in this instance, one opportunity to talk to people about this issue and actually asking them to maybe see that value of care provided, as one example. So I think it would really help to identify first which expectations aren’t met, and then try and find out what you could do about these different expectations not being met. 

[00:10:34.250] – APS Özge G. Fischer-Baum 

Yeah, and I want to ask you for our final question, how the younger generations can help with minimizing the challenges of loneliness in the older generation. And what are the barriers to that? What are cross cultural differences? 

[00:10:51.190] – Samia Akther Khan 

Yeah, that’s a good question, and a really important one, because I feel that intergenerational contact is really something, at least in our culture. So I’m talking about Germany here. The UK and the US is really not very common anymore. So we don’t really share spaces with older people as younger adults, and vice versa, as much as this happens maybe in Myanmar or in different Southeast Asian countries. So the contact itself is so important for older people and also for younger people. It’s really like a reciprocal learning experience where both people can benefit. So older people giving advice and sharing life advice and stories, but also learning from younger people, for example, about technology, about current issues that are relevant, that keep them young and fit and involved. So sharing spaces or having that ability to create intergenerational contact where you can is, I think, an amazing opportunity to realize many of these expectations. So that could be one thing, just to engage in spaces or create spaces where you can have more intergenerational contact. 

[00:12:02.790] – APS Özge G. Fischer-Baum 

Yeah, I definitely agree. And there are definitely cross cultural differences there too. Right, so the way we take care of our elderly is very different in a Western setting compared to an Eastern setting. Yeah. Samia, anything else that you would like to add? 

[00:12:21.230] – Samia Akther Khan 

Yeah, so maybe I would like to touch upon talking about global research and global engagement. I think it’s really important for listeners from the US or researchers to hear about the barriers that we have to doing research in global settings. And I would just like to highlight two of them, which is, one, the problems of ethical approval in research. So journals, academic journals, expect to have ethical approvals from international review boards and from institutions to publish their work. And many times there is a lot of meaningful research done in low middle income countries. But then, as we have over 30 countries in conflict, we can’t always get ethical approval from these institutions. So researchers there really rely on ethical approval from higher income countries and collaborating with higher income scholars who are then also PiS, usually of the project, even though the work is really conducted by local researchers. So that’s one huge barrier to actually accessibility to that kind of research. And then, on the other hand, it’s the grant and funding problem for actually directing grant funding to lower middle income countries in conflict settings such as Myanmar. So colleagues of mine have received a grant and then they couldn’t actually access the money for the grant and conducting the research because the money couldn’t be sent to a conflict setting which is governed by a military regime. 

[00:13:51.680] – Samia Akther Khan 

So it’s really huge obstacle to conducting research and meaningful psychological research or mental health research in lower middle income countries, specifically in context settings. And they’re like really important barriers. I think that we as psychologists, but also associations or publishers need to maybe find solutions to of how people can actually publish their work or receive funding. It continues to be an inequal power balance because scholars from low middle income countries just have these huge barriers to publishing their work. And that obviously is sad for the world of research and psychology because we just keep continuing to publish the easy stuff. So meaning where it’s easy to conduct research, where it’s easy to get funding and where it’s also easy to publish because we have IIBs at our institutions. 

[00:14:49.550] – APS Özge G. Fischer-Baum 

Remarkable points. Thank you very much. So what we are saying is the field of psychology, we are philosophically against the weird sampling issue. But are we doing everything we can to support the researchers who want to go against it and try to diversify the population samples? Yes. The barriers you counted are very important ones and hopefully we are going to see adjustments in grants, in journals and the standards for accepting people’s work to be published. 

[00:15:30.390] – Samia Akther Khan 

Yeah, I hope so. 

[00:15:32.970] – APS Özge G. Fischer-Baum 

Samia, thank you very much for joining us today. It was a lovely conversation. I personally learned a lot. I wish you best of luck with your research and I hope we stay in touch. 

[00:15:48.260] – Samia Akther Khan 

Thank you very much. Yeah, it was a pleasure to talk to you. 

[00:15:56.750] – APS Özge G. Fischer-Baum 

This is Ozge Gürcanlı Fisherbaum with APS and I have been speaking to PhD candidate Samir Akhter Khan from King’s College London. If you want to know more about this research, visit psychologicalscience.org, our channel.