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Sociality, Spirituality, and Meaning Making: Chicago Health, Aging,
and Social Relations Study
John T. Cacioppo, Louise C. Hawkley, Edith M. Rickett, and Christopher M. Masi
University of Chicago
Scientific theories in the natural sciences posit invisible forces operating with measur-
able effects on physical bodies, but the scientific study of invisible forces acting on
human bodies has made limited progress. The topics of sociality, spirituality, and
meaning making are cases in point. The authors discuss some of the possible reasons
for this as well as contemporary developments in the social sciences and neurosciences
that may make such study possible and productive.
In approximately 600 BCE, the Greek philos-
opher Heraclitus referred to the mind as an
overwhelming space whose boundaries could
never be fully comprehended. For the
next 2,300 years, little changed in this regard.
Indeed, before the enlightenment of the 18th
century, scholars generally believed that
thought was instantaneous and that action was
governed by an indivisible mind separate from
the body. As a result of the belief that the mind
was infinitely fast and essentially unanalyzable,
there was no point in trying to understand it
using scientific means. The human spirit—en-
compassing the qualities of kindness, mercy,
empathy, trust, compassion, justice, love,
friendship, devotion, and hope—was champi-
oned in art, literature, and religion but was at
best ignored by the scientific community.
The past three centuries have been a period of
unparalleled advance in science. Scientific the-
ories of magnetism, gravity, and dark matter
have emerged to posit invisible forces operating
with measurable effects on physical bodies.
During this same period, the scientific study of
invisible forces acting on human bodies has
made limited progress. Research on the dimen-
sions of sociality, spirituality, and meaning
making for instance, has been blunted by biases
against what were regarded as soft or religious
topics, misguided by metaphors such as the
human brain as a solitary computer, and over-
looked in a funding climate that demands time
and attention be given to societal, psychologi-
cal, and physiological deficits rather than capac-
ities. Although the history and causes of such
biases are complex, little is achieved to mitigate
these biases when the constructs of sociality,
spirituality, and meaning making are defined
imprecisely, their predicted effects are not fal-
sifiable or are difficult to replicate, or the un-
derlying mechanisms for such effects are not
delineated within a framework that is recog-
nized by the scientific community.
The dawn of the 21st century may herald a
paradigm shift in constructs deemed amenable
to scientific inquiry. With new developments
and instruments in genetics, neuroscience, brain
science, and behavioral science, long-standing
scientific biases are being challenged by rigor-
ous quantitative analysis. Fueling these chal-
lenges is the recognition that the traditional
focus by founding and federal funding agencies
on maladies and disease misses the mark on
some of the most complex yet pressing and
enduring questions of humankind.
The guiding metaphors are also undergoing
dramatic transformations. Now that the human
genome has been sequenced and has been found
to involve fewer genes than anticipated, it has
become apparent that humans are not inextrica-
bly determined by their genotype irrespective of
their social environment. In addition, the ex-
John T. Cacioppo and Louise C. Hawkley, Department of
Psychology and Center for Cognitive and Social Neuro-
science, University of Chicago; Edith M. Rickett, Depart-
ment of Psychology, University of Chicago; Christopher M.
Masi, Department of Medicine and Center for Cognitive and
Social Sciences, University of Chicago.
This research was supported by National Institute on
Aging Grant PO1 AG18911.
Correspondence concerning this article should be ad-
dressed to John T. Cacioppo, Department of Psychology,
University of Chicago, 5848 South University Avenue, Chi-
cago, IL 60637. E-mail: cacioppo@uchicago.edu
Review of General Psychology Copyright 2005 by the Educational Publishing Foundation
2005, Vol. 9, No. 2, 143–155 1089-2680/05/$12.00 DOI: 10.1037/1089-2680.9.2.143
143
tended period of utter dependency of the human
infant has led to the recognition that human
genetic transmission is based not on an individ-
ual’s selfish ability to reproduce but on the
success of offspring to reproduce (Dawkins,
1976). Accordingly, we have a better apprecia-
tion of how humans have evolved to be an
inherently social, meaning-making species.
Moreover, the notion of the solitary com-
puter—the dominant metaphor for the human
mind for more than a quarter century—sud-
denly seems dated. Computers today are mas-
sively interconnected devices with capacities
that extend far beyond the resident hardware
and software of a solitary computer. How ironic
that although the telereceptors of the human
brain have provided wireless broadband inter-
connectivity to humans for millennia, it took the
advent of technological innovations for it to
become patently obvious that the isolated com-
puter is a poor metaphor for the human mind.
The qualities of kindness, mercy, empathy,
trust, compassion, justice, love, friendship, de-
votion, and hope—qualities attributed in art,
literature, and religion to the human spirit—did
not comport well with the dominant metaphors
of the mind in the latter part of the 20th century.
Today, these same qualities are simple to incor-
porate into a metaphor of the mind as a mas-
sively networked portable computer, given the
recognition that human genetic transmission re-
lies in part on cooperation and nurturance.
Even useful metaphors have limited utility,
however, if the constructs under study are
poorly defined. In our study of sociality, spiri-
tuality, and meaning making, we define social-
ity as the need for the company of others, mea-
surable as the tendency to form social connec-
tions, to react to perceived social isolation, and
to exhibit the long-term effects of social con-
nectedness on health, successful aging, and
well-being.
By spirituality we mean a theoretical con-
struct that represents what is common in human
qualities such as kindness, mercy, virtue, empa-
thy, trust, compassion, justice, love, friendship,
devotion, and hope. Accordingly, sociality may
underlie spirituality in at least two senses. As
we explain subsequently, we posit that the qual-
ities ascribed in art, literature, and religion to
the human spirit evolved because humans are
fundamentally a social species. Human virtues
are social virtues, potentially lending spiritual-
ity and sociality a common substrate. In addi-
tion, sociality may serve as a model for spiritu-
ality, as when people form a personal relation-
ship with a deity. As in the case of sociality, the
nature and existence of the deity with whom a
person forms a relationship is less important
than the person’s mental representations of the
deity and relationship to the deity. The measur-
able effects of spirituality also mirror those for
sociality, including the tendency to form a men-
tal representation that relates the self to a deity;
to exhibit the long-term effects of such a rela-
tionship on health, effective aging, and well-
being; and to react to perceived separation from
or loss of worth in the eyes of the deity with
behavioral, physiological, and emotional re-
sponses. Spirituality and sociality overlap in
measurable ways such as religious affiliation,
church attendance, and church participation; ac-
cordingly, these variables are also investigated.
Central to sociality and spirituality is mean-
ing making, defined as the construction of an
account or recital of an event or a series of
events, either true or fictitious, that serves to
organize or structure life. Our definition of
meaning making is compatible with current the-
ory in perception and cognition, in which even
visual percepts are generated according to a
wholly empirical strategy that signifies to the
individual the empirical significance of the
stimulus rather than its properties as such
(Purves, Lotto, & Nundy, 2002).
We begin with a brief evolutionary argument
for the importance of sociality in the survival of
the human species. We then describe a neuro-
scientific approach to the study of molar con-
structs such as sociality, spirituality, and mean-
ing making, and we review recent findings from
our program of research on social isolation and
loneliness.
Sociality, Spirituality, and Meaning
Making as Components of Human Nature
The genetic constitution of Homo sapiens
derives not simply from an individual’s repro-
ductive success but more critically from the
success of one’s children to reproduce. The
human infant is born to an extended period of
complete dependency. If infants do not elicit
nurturance and protection from caregivers, or if
caregivers are not motivated to provide such
care over an extended period of time, the infants
perish along with the genetic legacy of the par-
ents. Hunter/gatherers who, in times of danger
144 CACIOPPO, HAWKLEY, RICKETT, AND MASI
or famine, chose not to return to share their food
with mother and child may have survived to
hunt another day, but the genetic constitution
that enabled them to feel so little humanity also
made it less likely their genes were propagated.
In contrast, those who yearned to return despite
personal hardship, and individuals who pro-
tected and nurtured those close to them, were
more likely to have offspring who survived to
propagate.
Even as adults, humans are not particularly
stealthy, strong, or fast relative to other species.
It is their collective action—their ability to
think, communicate, and work together—that
makes Homo sapiens such a formidable species.
Because human collective action provides an
evolutionary advantage over other species and
because genetic transmission is based not on
one’s ability to reproduce but on the success of
one’s children to reproduce, Homo sapiens are
thought to have evolved to be an inherently
social, meaning-making species with qualities
ascribed in art, literature, and religion to a hu-
man spirit. In short, we posit that tens of thou-
sands of years of evolution have deeply planted
sociality, spirituality, and meaning making in
our genome and in our societies. Accordingly,
humans are posited to have evolved a brain and
biology whose functioning benefits from the
formation and maintenance of social bonds, hu-
man/social virtues, and organizational life nar-
ratives. The deprivation of any of these ingre-
dients—such as ruptures of social connected-
ness that result from relocation distant from
friends and family—produces feelings of isola-
tion and dysphoria, physiological alterations,
and a motivation to reinstate connections. Given
the evolutionary origins of these effects, there
should also be heritable individual differences
in the extent to which social disconnectedness
produces such effects.
The extant evidence clearly shows that hu-
mans quickly learn to attend to faces, perceive
communicative displays, comprehend social hi-
erarchies, and form causal attributions (see Ca-
cioppo & Berntson, 2004). People develop a
theory of mind by which the traits, intentions,
and emotions of others are inferred; they com-
municate with others and they sometimes hide
or miscommunicate their own mental contents
from others; they form relationships, unions,
and alliances; and they search for meaning in
events and patterns. Meaning making and soci-
ality are such fundamental components of hu-
man nature that people perceive these charac-
teristics in the movements of simple inanimate
objects. Heider and Simmel (1944), for in-
stance, produced a short film of the movement
of a small triangle, a small circle, and a large
triangle around and into a large rectangle. The
animated film consisted only of these geometric
shapes, yet everyone who viewed the film
“saw” a social drama complete with intentions,
plans, and emotions. Only SM, an individual
without functioning amygdala—an almond-
shaped pair of nuclei deep in the medial tem-
poral lobes of the brain—failed to perceive
these movements as occurring within a social
arena (Adolphs, 1999).
Given our evolutionary history, we would
contend that people’s conceptual representation
of sociality has a specifiable, generalizable, and
possibly universal structure (Hawkley, Browne,
& Cacioppo, 2004). In the first study underlying
this claim, 2,531 undergraduates completed a
scale consisting of 20 questions that differenti-
ated people who perceived themselves to be
socially isolated from those who perceived
themselves to be socially integrated (Hawkley
et al., 2004). An exploratory factor analysis on
half of the sample revealed three correlated
dimensions generalizable across gender, and a
confirmatory factor analysis on the other half of
the sample corroborated this finding: The col-
lege students’ beliefs, feelings, and ideas about
their social connectedness were structured as
three separable but related (oblique) dimen-
sions: isolation, relational connectedness, and
collective connectedness.
In a population-based follow-up study, we
tested a very different sample of individuals, a
statistically representative sample of 230 men
and women (one third African American, one
third Hispanic, one third Caucasian) from Cook
County, Illinois, born between 1935 and 1952
(M age ϭ 57.5 years; Hawkley et al., 2004).
Despite the fact that this sample was an older
urban sample of varying ethnic backgrounds,
socioeconomic status (SES), and occupations,
the confirmatory factor analysis supported the
same three-factor structure found for the college
students. Their feelings of social disconnected-
ness consisted of three related factors: feelings
of isolation/intimate connectedness, feelings of
relational connectedness, and feelings of collec-
tive connectedness.
Importantly, we also found statistically sepa-
rable predictors of each of these facets of soci-
145SPECIAL ISSUE: SOCIALITY, SPIRITUALITY, AND MEANING MAKING
ality. In our urban sample of older adults, we
found marital status to predict feelings of isola-
tion, contact with friends and family to predict
feelings of relational connectedness, and mem-
bership in voluntary groups to predict collective
connectedness (Hawkley et al., 2004). Tests of
the universality of this structure (isolation, re-
lational connections, collective connections) are
needed, but it is worth noting that psychological
theories of the self, which traditionally have
focused on a person’s sense of unique identity
differentiated from others, now distinguish
among the personal self (individual level of
analysis), relational self (interpersonal level of
analysis), and collective self (group level of
analysis; Brewer & Gardner, 1996).
Individuals who score low on personal, rela-
tional, and collective dimensions of sociality
also perceive themselves to be social isolates
and report intense feelings of loneliness and
dysphoria (Cacioppo, Ernst, et al., 2000; Ca-
cioppo et al., in press; Russell, Peplau, & Cut-
rona, 1980). Individual differences in the net
content of this structure are about 50% heritable
and 50% environmental (Boomsma, Willemsen,
Hawkley, & Cacioppo, 2004; S. McGuire &
Clifford, 2000). In an early study of the origins
of these feelings, S. McGuire and Clifford
(2000) examined the heritability of loneliness in
children. In their first study, 69 biologically
related sibling pairs and 64 unrelated pairs in
adoptive families in the Colorado Adoption
Project completed an 8-item loneliness scale
when they were 9, 10, 11, and 12 years of age.
In a second study, 22 monozygotic twins, 40
dizygotic twins, and 80 full siblings 8–14 years
of age completed a 16-item scale to assess lone-
liness in relation to their schoolmates. Results
revealed significant genetic (h2
values of 55%
and 48%, respectively, in Studies 1 and 2) and
unshared environmental contributions to indi-
vidual differences in loneliness.
In the S. McGuire and Clifford (2000) stud-
ies, the sample sizes were relatively small, and
because the studies involved adopted children,
the representativeness of the sample for a pop-
ulation estimate is uncertain. Moreover, herita-
bility estimates of complex traits such as lone-
liness may change across the life span as the
frequency, duration, and range of exposure to
environmental influences accrue. We therefore
extended this work using data from the Nether-
lands Twin Register Study (Boomsma, Ca-
cioppo et al., 2004). Data on loneliness
from 7,665 young adult and adult Dutch twins
(average age: 24 years) were analyzed with
genetic structural equation models. The esti-
mate of genetic contributions to variation in
loneliness in adults was 47%, with the remain-
ing variance explained by unique environmental
factors. Thus, the heritability estimates in adults
were similar to those found previously in chil-
dren, and no evidence was found for sex or age
differences in genetic architecture or configural
effects of the genes. In an ongoing effort to
more specifically identify the genetic locus,
Boomsma, Willemsen, Dolan, Hawkley, and
Cacioppo (in press) conducted a complete ge-
nome scan and found evidence for two quanti-
tative trait loci, suggesting that at least two sets
of genes with additive effects are involved.
The striking development of the human cere-
bral cortex, especially the frontal and temporal
regions, is believed to be largely responsible for
evolutionary advances in social and cognitive
capacities. The cerebral cortex is a mantle of
between 2.6 and 16 billion neurons, with each
neuron receiving 10,000 to 100,000 connections
from other neurons (e.g., Pakkenberg, 1966).
The human frontal (front part of the brain) and
temporal (right and left sides) lobes constitute
32% and 23% of the cerebral cortex, respec-
tively, arguably rendering the sensorimotor cor-
tices that dominate most mammalian brains to
minority status in the human brain. The expan-
sion of the frontal regions in the human brain is
largely responsible for the human capacity for
reasoning, planning, and performing mental
simulations, and an intact frontal region contrib-
utes to the human ability to reason, remember,
and work together, thereby contributing to the
evolutionary success of humans (Bar-On,
Tranel, Denburg, & Bechara, 2003; Krin-
gelbach & Rolls, 2004). The temporal and pa-
rietal regions, in turn, play essential roles in
social perception, social reasoning, and commu-
nication (cf. Adolphs, 1999, 2001; Berntson,
Boysen, & Cacioppo, 1993; Saxe & Kanwisher,
2003).
Despite these evolutionary advances, human
cognition and meaning making are often biased
and counterfactual. The sensory load from the
physical environment is minor in comparison
with the quantity and complexity of the infor-
mation that comes from other individuals,
groups, alliances, and cultures, including the
potential for benevolence or treachery posed by
each. Human cognition is not an objective in-
146 CACIOPPO, HAWKLEY, RICKETT, AND MASI
formation process but instead is rife with the
operation of self-interest, self-enhancement,
and self-protective processes. Because humans
encounter more information than can possibly
be processed, they tend to economize on
thought when forming beliefs that are not per-
sonally relevant (Petty & Cacioppo, 1986) and
tend to search for and attend to evidence that
confirms what they already believe to be true
(Snyder & Swann, 1978).
Information processing is also biased in ways
that protect the self from symbolic as well as
actual threats and that promote reproductive
success (e.g., Jones & Berglas, 1978). In fact,
people are not particularly good at knowing the
causes of their feelings or behavior (Nisbett &
Wilson, 1977). People overestimate their
strengths and underestimate their faults (M.
Ross & Sicoly, 1979). They overestimate the
importance of their input, the pervasiveness of
their beliefs, and the likelihood that a desired
event will occur (W. J. McGuire, 1981), all
while underestimating the contributions of oth-
ers and the likelihood that risks in the world
apply to them (L. Ross, Greene, & House,
1977). Events that unfold unexpectedly are not
reasoned as much as they are rationalized
(Aronson, 1968), and the act of remembering is
far more of a biased reconstruction than an
accurate record of actual events (McDonald &
Hirt, 1997; Roediger, Buckner, & McDermott,
1999). Many of these biases in social cognition
are spontaneous, do not require cognitive effort,
and represent normative processing.
A crucial consequence of the nuances of the
biased fashion in which humans make meaning
is that humans have much more influence in the
creation of their lives and social relationships
than most realize (Downey, Freitas, Michaelis,
& Khouri, 1998; Murray, Holmes, & Griffin,
1996). If an individual is led to believe a new
acquaintance is fun and nice, for instance, the
individual behaves in a fashion that draws out
pleasant and enjoyable behaviors from the per-
son. If an individual is led to think a child is
intelligent, the individual does and says things
that make a smarter child than would result if
the individual was led to believe the child was
of average intelligence. Another instance of bi-
ased meaning making is the tendency of people
to self-handicap when they think they will fail at
an important task. By subtly producing insur-
mountable obstacles to success, they can at-
tribute their subsequent failure to these obsta-
cles rather than to themselves.
Importantly in the present context, bias in
social cognition is also at work when people
who feel socially connected construe the world
as presenting challenges to be overcome with
the aid of others and react to interpersonal con-
flicts in peaceful and constructive rather than
offensive and aggressive ways, thereby produc-
ing an environment that others want to inhabit
(Cacioppo & Hawkley, in press). In contrast,
lonely individuals are more likely to construe
their world (including the behavior of others) as
potentially threatening or punitive. Conse-
quently, lonely individuals are more likely to be
socially anxious, hold more negative expecta-
tions for their treatment by others, and adopt a
prevention focus rather than a promotion focus
in their social interactions. These individuals
are also more likely to appraise stressors as
threats rather than challenges and to cope with
stressors in a passive, isolative fashion rather
than an active fashion that includes actively
seeking the help and support of others. To-
gether, these differences in social cognition pre-
dictably result in an increased likelihood of
lonely individuals acting in self-protective and,
paradoxically, self-defeating ways (Cacioppo &
Hawkley, in press). In each instance, the indi-
viduals may be oblivious to the fact that the way
in which they perceived and thought about their
social world contributed to their social realities.
We noted at the outset that biases against the
scientific study of constructs such as sociality,
spirituality, and meaning making are attribut-
able to imprecise definitions, nonfalsifiable or
nonreplicable effects, a focus on associations
rather than underlying mechanisms, and the ab-
sence of a broad scientific framework within
which to study abstract constructs of this sort.
We next address the latter issue. Specifically,
we argue that a neuroscience perspective may
provide a framework that allows theoretical
constructs and associations to be rigorously de-
fined, tested, and parsed so as to investigate
their underlying mechanisms.
Social Neuroscience Perspective
During the latter half of the 20th century, the
nature of the human mind was plumbed through
clever experimental designs that used measures
of verbal reports, judgments, and reaction time.
These methodologies proved limited, however.
147SPECIAL ISSUE: SOCIALITY, SPIRITUALITY, AND MEANING MAKING
Social cognition and interactions range from
affect laden to habitual, and nuances deriving
from these features may prove difficult to cap-
ture fully using subjective measures and re-
sponse latencies to semantic (e.g., lexical deci-
sion) tasks alone (LeDoux, 2000; Zajonc,
1980). A new approach, termed social neuro-
science, first introduced just over a decade ago
(Cacioppo & Berntson, 1992), represents a new
development in the study of the human mind,
including how sociality, spirituality, and the
meaning of life might modulate brain and
biology.
Human nature is recognized as being com-
plex. To simplify the study of human nature,
neuroscientists in the past century tended to
ignore or hold constant social influences,
whereas cognitive and social scientists tended
to ignore the biological constraints on and
mechanisms through which cognition, affect,
and conation are expressed. In the neuro-
sciences, the architects of development and be-
havior were conceived as anatomical structures
and genetic strings sculpted by the forces of
evolution operating over millennia, the builders
were cast as encapsulated within living cells far
from the reach of social influences, and the
brain was treated as an analytical information-
processing machine. The additional information
that might be attributable to the social world
was thought to be best considered last, if the
need arose. Social factors, the reasoning often
went, had minimal implications for basic devel-
opment, structure, or processes of the brain or
mind, in which case the consideration of social
factors is entirely irrelevant. And even if rele-
vant, consideration of social factors may render
the study of the human mind and behavior too
complicated to sustain scientific progress.
The attitude toward the neurosciences among
cognitive and social scientists throughout most
of the 20th century was no less antagonistic
(Berntson & Cacioppo, 2000; Cacioppo, 2002).
World wars, the Great Depression, and civil
injustices made it amply clear that social and
cultural forces were too important to address to
await the full explication of cellular and molec-
ular mechanisms. Biological constraints, mech-
anisms, and insights tended to be ignored, often
under the misguided auspice of protecting the
behavioral sciences from the onslaught of re-
ductionism. The specialized knowledge and
fundamental research that were required to cul-
tivate descriptive taxonomies, theoretical for-
mulations, and methodologies—coupled with
an early emphasis on isolated scientific work—
all but ensured that social and biological per-
spectives would evolve insulated from develop-
ments in the other.
For decades, the central precept of molecular
biology was that all of the information we need
to construct a mammalian body, whether man or
mouse, is contained in the approximately hun-
dred thousand genes of mammalian DNA and
that a set of master genes activates the DNA
necessary to produce the appropriate proteins
for development and behavior (Crick, 1970;
Panksepp, 1998). In this scheme, DNA encodes
the sequence of amino acids in proteins and
peptides using the sequence of nucleotides in
the gene as a template. The DNA sequential
code is transferred to messenger RNA (mRNA)
via transcription, a process involving enzymes
(RNA polymerases), followed by translation
from mRNA to polypeptide chains (protein
pieces) and proteins. The process of DNA to
RNA transcription has been assumed to be re-
stricted to the confines of living cells outside the
influence of personal and social ties.
As neuroscientific approaches have been ap-
plied to more complex questions, however,
these presumably basic principles have begun to
be questioned. Recent research suggests that
even DNA to RNA transcription can be subject
to modulation by the social environment (Ca-
cioppo, Berntson, Sheridan, & McClintock,
2000). In an illustrative study, we investigated
the DNA to RNA transcription for a growth
hormone that occurs within a type of immune
cell called a lymphocyte. The production of this
growth hormone is of interest because it is
thought to be involved in the effectiveness of
lymphocytes to combat pathogens. We recently
found that caregivers of spouses with Alzhei-
mer’s disease (AD) had markedly suppressed
lymphocyte growth hormone mRNA levels rel-
ative to age- and gender-matched controls (Wu
et al., 1999). It is reasonable to assume that the
spouses of AD patients were essentially ran-
domly assigned to caregiver or noncaregiver
roles by their spouse’s unexpected development
of AD, in which case these results indicate that
social roles can modulate DNA to RNA tran-
scription processes.
The behavior of strains of mice with specific
genes inactivated (i.e., knockout mice) has been
known to depend on genetic background,
whereas the effects of the social context have
148 CACIOPPO, HAWKLEY, RICKETT, AND MASI
been thought to be unimportant. Contrary to this
latter belief, however, Crabbe, Wahlsten, and
Dudek (1999) found that the specific behavioral
effects associated with a given knockout could
vary dramatically across experimenters, testing
environments, and laboratories. The implication
of these and related studies is that aspects of
genetic expression, which were thought to be
encapsulated within each living cell far from the
reach of personal ties or social influences, are in
fact subject to modulation by the social
environment.
In the twilight of the 20th century, neurosci-
entists and cognitive scientists began to collab-
orate more systematically, united by the com-
mon view that information processing could
best be understood by appeal to the brain as well
as its emergent manifestation in mind and by the
goal of understanding how the mind works.
These collaborations have helped unravel puz-
zles of the mind including aspects of perception,
imagery, attention, and memory. Many aspects
of human nature require a more comprehensive
approach, however. These include aspects of the
human spirit such as sociality, altruism, affilia-
tion, attachment, kin recognition, social identi-
fication, communication, cooperation, com-
merce, empathy, morality, contagion, love, nur-
turance, kindness, mercy, compassion, justice,
friendship, and hope. All can be conceptualized
as invisible forces emanating from the operation
of the human brain within a social arena with
measurable effects not only on subjective well-
being but on brain, biology, and health.
Brain imaging studies clearly point to the
attention given to social stimuli. If an individual
views a novel picture of an evocative image
(e.g., snowcapped mountains) or an equally
pleasant, arousing, and statistically infrequent
image of a person (e.g., a smiling baby), the
social stimulus elicits a larger amplitude late
positive electrocortical (event-related brain) po-
tential that peaks about 550 ms after stimulus
onset (Ito & Cacioppo, 2000). In addition, the
differential event-related response emerges
even when the task is simply to classify whether
the picture is pleasant or unpleasant. That is, the
brain is spontaneously extracting information
about the presence of conspecifics even when
the explicit task has nothing to do with this
distinction (Ito & Cacioppo, 2000). Functional
magnetic resonance imaging studies have simi-
larly suggested that social perception and social
reasoning are robust elicitors of localized re-
gions of brain activation and reflect distinct
aspects of social and emotional processing (e.g.,
see Blakemore, Winston, & Frith, 2004; Ca-
cioppo & Berntson, 2004).
The field of social neuroscience, of course,
stretches far beyond social cognition, human
studies, or brain imaging methodologies (see
Cacioppo & Berntson, in press-b; Cacioppo,
Berntson, et al., 2002). As the 21st century
dawns, there is a recognition that much of the
groundwork for multidisciplinary scientific col-
laborations has been laid by the giants of the
preceding three centuries. Neuroscientists, cog-
nitive scientists, and social scientists are mov-
ing beyond simplifying assumptions and are
placing less emphasis on the arbitrary division
between the social and the biological sciences to
work collaboratively toward developing more
comprehensive theories of mind, brain, biology,
and behavior. Through the efforts of such indi-
viduals, the broad multidisciplinary perspective
of social neuroscience is gaining momentum,
making more feasible the rigorous scientific
study of questions such as how sociality, spiri-
tuality, and the meaning of life operate.
Throughout this article, we have described such
examples from our own research, ranging from
behavioral genetics to brain imaging. In the
remainder of the article, we survey results from
our multidisciplinary research to examine the
mechanisms underlying the association between
social connectedness and longevity and
well-being.
Chicago Health, Aging, and Social
Relations Study
In 2002, we began a population-based longi-
tudinal study of 230 English-speaking Blacks/
African Americans, non-Black Hispanics, and
non-Hispanic Caucasians between the ages
of 50 and 67 years from Cook County, Illinois,
to investigate the social, behavioral, cognitive,
emotional, brain, autonomic, neuroendocrine,
cellular, and molecular transduction pathways
by which the social world affects well-being
and health (e.g., Cacioppo & Berntson, in
press-a, in press-b; Cacioppo & Hawkley, 2003;
Cacioppo, Hawkley, & Berntson, 2003). The
Chicago Health, Aging, and Social Relations
Study (CHASRS) was built on our previous
research on thousands of young adults (Ca-
cioppo, Ernst, et al., 2000; Cacioppo, Hawkley,
Berntson, et al., 2002; Cacioppo, Hawkley,
149SPECIAL ISSUE: SOCIALITY, SPIRITUALITY, AND MEANING MAKING
Crawford, et al., 2002; Hawkley et al., 2004)
and older adults (Cacioppo et al., 1998; Uchino,
Kiecolt-Glaser, & Cacioppo, 1994) and on
meta-analyses of the literature (e.g., Uchino,
Cacioppo, & Kiecolt-Glaser, 1996).
Among our findings from this earlier work
was that socially connected individuals are
more likely to meet everyday stressors by active
coping and recruiting others’ help. Individuals
who feel socially isolated are more likely to
construe their world (including the behavior of
others) as threatening or punitive. They are
more likely to appraise stressors as threats
rather than challenges and to cope with stressors
in a passive fashion by isolating themselves
from others and withdrawing from the problem
situation. Together, these differences in mean-
ing making result in an increased likelihood of
socially connected individuals acting in a hu-
mane, selfless fashion, reinforcing their connec-
tions with others and enhancing their self-es-
teem, and of lonely individuals acting in self-
protective and, paradoxically, socially acidic
and self-defeating ways (Cacioppo, Ernst, et al.,
2000; Cacioppo & Hawkley, in press; Hawkley,
Burleson, Berntson, & Cacioppo, 2003).
Why might lonely individuals be more emo-
tionally withdrawn in social settings? Personal-
ity differences such as shyness, sociability, neg-
ativity, and fear of negative evaluation may
provide a partial explanation. In addition, be-
cause social settings can be overwhelming, so-
cial effectiveness depends on an individual’s
ability to exert voluntary control over his or her
attentional focus. Moreover, regulating one’s
attention can help one garner social approval.
Do lonely individuals differ in their ability to
voluntarily control their attentional focus? As a
means of exploring self-regulation, participants
in our study of loneliness in young adults per-
formed a dichotic listening task while at the
clinical research center. The dichotic listening
task required that participants identify the con-
sonant–vowel pair presented to their right or left
ear. Because the auditory system is predomi-
nantly crossed and because language is left-
lateralized in most right-handed individuals,
right-handed individuals tend to perform better
when verbal stimuli are presented to the right
than left ear. (All of the participants in this
study were right-handed.) Superimposed on this
general right-ear advantage, however, are the
effects of attention, as individuals generally per-
form better when verbal stimuli are presented to
the ear to which they are focusing their atten-
tion. The former effect is said to be data driven
or bottom-up, whereas the latter is said to be
conceptually driven or top-down.
As predicted, we found an overall right-ear
advantage across loneliness groups (lonely, nor-
mal, and nonlonely) and instructional condi-
tions (Cacioppo, Ernst, et al., 2000). In addition,
however, a significant main effect of attentional
instruction showed that individuals performed
better with left-ear stimuli when they were in-
structed to focus on the stimuli presented to
their left ear than in the other conditions. More-
over, lonely individuals tended to show the
strongest right-ear advantage in the no-instruc-
tion condition, presumably reflecting the po-
tency of bottom-up (stimulus-driven) atten-
tional processing, but failed to shift to the left-
ear advantage when instructed to focus on their
left ear. Specific planned contrasts confirmed
that all three groups showed a significant right-
ear advantage during the focus on right-ear con-
dition, but only the normal and nonlonely indi-
viduals were able to shift to a significant left-ear
advantage in the focus on left-ear condition.
Together, these results are consistent with the
notion that attentional control appears compa-
rable in lonely and nonlonely individuals until
voluntary attentional control conflicts with au-
tomatic attentional processes, at which point
lonely individuals show an attentional deficit.
This result raises the possibility that lonely in-
dividuals may feel threatened or overwhelmed
and therefore withdraw from the social environ-
ment, especially new or complex social envi-
ronments, because they have less control over
the focus of their attention than nonlonely indi-
viduals. In fact, Baumeister and colleagues re-
cently found that experimental manipulations of
social exclusion could produce a similar effect
on dichotic listening and self-regulation
(Baumeister & DeWall, in press).
A measure of the importance of social con-
nectedness is that it predicts morbidity and mor-
tality from broad-based causes (e.g., Seeman,
2000). The reasons for this effect remain un-
clear. As noted earlier, few differences in tradi-
tional health behaviors (e.g., smoking, exercise,
or nutrition) have been found to differentiate
lonely and nonlonely individuals, for instance
(Cacioppo, Hawkley, Crawford, et al., 2002;
Seeman, 2000). We therefore have explored
other possible mechanisms by which loneliness
may have deleterious effects on health: health
150 CACIOPPO, HAWKLEY, RICKETT, AND MASI
behaviors, cardiovascular activation, cortisol
levels, and sleep (Cacioppo et al., 2003).
In one study, we assessed autonomic activity,
salivary cortisol levels, sleep quality, and health
behaviors in undergraduate students selected,
on the basis of pretests, to be among the top or
bottom quintile in feelings of loneliness (Ca-
cioppo, Hawkley, Crawford, et al., 2002). We
found that the total peripheral resistance to
blood flow through the circulatory system in the
body was higher in lonely than nonlonely par-
ticipants, whereas cardiac contractility (the
force of a heartbeat), heart rate, and cardiac
output were higher in nonlonely than lonely
participants. Such differences, although not det-
rimental in the robust cardiovascular system of
young adults, may constitute a source of wear
and tear on the vascular system and on regula-
tory controls of blood pressure, with cardiovas-
cular dysfunctions not appearing until later in
life. We also found that lonely individuals re-
ported poorer sleep than nonlonely individuals.
Differences in sleep efficiency in young adults,
as with differences in cardiovascular function,
may have minimal health consequences in the
short term but may influence significant health
outcomes over time, especially in later life
when physiological functions become more
fragile.
In a follow-up study, we assessed blood pres-
sure, heart rate, salivary cortisol levels, sleep
quality, and health behaviors in older adults
whose loneliness was assessed at the time of
testing at their residence (Cacioppo, Hawkley,
Crawford, et al., 2002). Results indicated
greater age-related increases in blood pressure
and poorer sleep quality in lonely than non-
lonely older adults. These results suggest that
the stress and dysphoria associated with feeling
isolated contribute to wear and tear on the body
and, over time, to the degradation of central and
peripheral regulatory systems.
Humans are not static mechanical devices
that simply wear out, but instead, human phys-
iology includes anabolic processes that promote
repair and maintenance (e.g., wound healing)
and growth (e.g., muscular development) in re-
sponse to stressors. Sleep is the quintessential
restorative behavior, however, and sleep in-
volves no obvious social interaction. We there-
fore next asked whether the restorative power of
sleep was greater for people who felt low rather
than high levels of loneliness (Cacioppo, Hawk-
ley, Berntson, et al., 2002). All participants
were tested one night in the clinical research
center of an academic hospital and several ad-
ditional nights in their residence. Results re-
vealed that lonely and nonlonely individuals
allocated the same amount of time in bed for
sleep, but lonely individuals evinced poorer
sleep efficiency and more time awake after
sleep onset than nonlonely individuals. These
results suggest that lonely individuals may be
less resilient than nonlonely individuals in part
because they sleep more poorly. These results
also raise the possibility that feelings of social
connectedness may influence the extent to
which wear and tear on the brain and body can
be slowed or reversed by inherent anabolic pro-
cesses. That is, sociality not only may influence
the selection of health behaviors but may mod-
ulate the salubrity of restorative behaviors.
We designed the CHASRS to include de-
tailed medical histories, health assessments,
measures of health care use, health behavior
measures (both self-report and objective), sleep
quality indexes, personality measures (e.g., Big
Five), life event assessments, nutrition and ex-
ercise measures, markers of metabolic and in-
flammatory processes, endocrine and immune
assays, baseline autonomic (especially cardio-
vascular) assessments and tests, tests of mem-
ory and cognitive function, exposure and reac-
tivity to stressors, mood, volunteerism, opti-
mism, hopefulness, church attendance, and
religiosity. Finally, economic and sociological
components (e.g., neighborhood characteristics,
education, income, and social networks) have
been incorporated into the design of the
CHASRS. We have used these data, for in-
stance, to examine the social, behavioral, cog-
nitive, and emotional pathways through which
neighborhoods affect health and well-being. Us-
ing data from the CHASRS, we recently found
that neighborhood contexts predict self-reported
health in older adulthood even after controlling
for age and gender (Wen, Hawkley, & Ca-
cioppo, 2004). More important, we found that
the impact of neighborhood SES (e.g., educa-
tion and income) on health was mediated in our
population-based study through the subjective
perception (meaning making) of neighborhood.
The data further showed that these neighbor-
hood effects on health were mediated indepen-
dently by individual SES, loneliness/connected-
ness, and depression but not by size of social
networks or perceived support.
151SPECIAL ISSUE: SOCIALITY, SPIRITUALITY, AND MEANING MAKING
As a complement to the Chicago population-
based longitudinal study and in collaboration
with Linda Waite and M. E. Hughes, a three-
item measure of loneliness was included in the
2002 wave of the Health and Retirement Study,
a longitudinal study of the later life course in a
nationally representative sample of individuals
born in 1947 or earlier (e.g., Hughes, Waite,
Hawkley, & Cacioppo, 2004). At each wave
(interview), detailed information is collected
about the respondent’s health, family relation-
ships, employment, income and wealth, and de-
mographic background. A nationally represen-
tative sample of 2,182 individuals completed
the module administered as part of the
CHASRS. The three-item survey scale of lone-
liness was found to have adequate internal con-
sistency and to correlate highly with the full
revised UCLA Loneliness Scale (Hughes et al.,
2004).
Analyses of the Health and Retirement Study
and the Chicago population-based sample fur-
ther indicated that objective social isolation and
loneliness are related and that loneliness in both
samples was similarly associated with poorer
self-reported health, poorer self-reported emo-
tional health, and a greater number of chronic
health conditions. As noted earlier, the hypoth-
esis that the health behaviors of patients account
for higher levels of morbidity and mortality
among lonely or isolated individuals has re-
ceived weak support. Care for patients has come
under scrutiny in the past decade because stud-
ies have shown that health care in the United
States falls short of basic quality standards and
that health care provision is influenced subtly by
various extraneous factors such as gender, race,
and age. We reasoned that if the health care
provided to patients who appear to be socially
isolated is of lower quality than that provided to
patients with family and friends, then at least
part of the explanation for the morbidity/mor-
tality relationship may be attributable to the
decisions and behaviors of health care providers
rather than to the health behaviors of the pa-
tients themselves (Cacioppo, Brown, & Hawk-
ley, 2004).
As an initial exploration of this hypothesis,
we conducted a national study, randomly sam-
pling 600 physicians whose practice centers on
the treatment of older adults. The physicians
were asked a series of questions comparing the
care of hospital inpatients with constructive and
involved family members or friends and inpa-
tients who were socially isolated, along with
another series of questions comparing the care
of inpatients with difficult or hostile family
members or friends and inpatients who were
socially isolated. In each series of questions, the
physicians indicated the health care they ob-
served to be provided by nurses, doctors, ancil-
lary staff (e.g., physical therapists and nurses
aides), and themselves. To allow the same sur-
vey question to be used for physicians from
different medical specialties and to address the
care provided by various health care agents
(doctors, nurses, and ancillary staff), respon-
dents were asked simply to indicate who re-
ceived “better care.” Finally, we assessed at-
tributes of the physicians such as medical spe-
cialty, region of the country in which they
practiced, years of experience, and type of med-
ical facility (e.g., hospital) to determine whether
these factors moderated physicians’ beliefs
about the effects of their patients’ social milieu
on health care provision.
Survey results indicated that physicians re-
ported that they and other physicians, nurses,
and ancillary staff provide better medical care to
inpatients with constructive family and friends
than inpatients without family or friends,
whereas inpatients with hostile family and
friends receive treatment comparable to that
received by socially isolated inpatients. These
findings held for outpatients as well as inpa-
tients and regardless of the physician’s medical
specialty, type of hospital in which the physi-
cian practiced, years of experience, and region
of the country. These results indicate that social
isolation may be associated with broad-based
morbidity and mortality at least in part because
the care provided by physicians and health care
professionals differs.
Results from the CHASRS also confirmed
that sociality has profound effects on physio-
logical functioning and sleep. As in our earlier
studies, we have observed that lonely older
adults exhibit evidence of chronically elevated
sympathetic activation (e.g., higher overnight
urinary epinephrine and resting blood pressure),
greater arterial stiffness, and less efficient or
effective sleep. These results suggest that social
isolation and loneliness have the potential to
simultaneously increase physiological load via
sympathetic activation and decrease the capac-
ity to recover from that load via reduced quality
of sleep.
152 CACIOPPO, HAWKLEY, RICKETT, AND MASI
Conclusion
Although the ancestral heritage of Homo sa-
piens has placed an emphasis on sociality,
Western thought and culture value individual
excellence over collective achievement. The ev-
idence we have reviewed suggests our ancestral
heritage is not easily ignored even if its effects
are not immediately obvious. Specifically, we
have argued that the human brain has evolved to
facilitate social information processing and ac-
tion and that human contact and nurturance are
necessary for normal brain development and
function. Loneliness is in part heritable, with
individual differences in the level of social con-
nectedness required to feel right. Feelings of
social connectedness, or the lack thereof (i.e.,
loneliness), were further found to be repre-
sented conceptually as three facets of a single
overarching construct, the facets being isola-
tion/intimate connectedness, relational connect-
edness, and collective connectedness. These
facets are correlated but are nevertheless related
distinctively and predictably to life circum-
stances. In addition, data from the CHASRS
indicate that an individual’s self-esteem and
sense of purpose in life reflect the individual’s
perceived intimate, relational, and collective
connectedness. Dysphoria/depression, too, has
been found to be a distinct but related theoret-
ical construct commonly triggered by social re-
jection or disturbances (Cacioppo et al., in
press).
How we think about people in everyday life
may be profoundly affected by feelings of social
connectedness as well. For instance, lonely in-
dividuals are more likely than nonlonely indi-
viduals to construe their world, including the
behavior of others, as threatening or punitive.
Consequently, lonely individuals are more
likely to be socially anxious, hold more nega-
tive expectations for their treatment by others,
and adopt a prevention focus rather than a pro-
motion focus in their social interactions.
Lonely, relative to nonlonely, individuals are
also more likely to appraise stressors as threats
rather than challenges and to cope with stressors
in a passive, isolative fashion rather than an
active fashion that includes actively seeking the
help and support of others. Together, these dif-
ferences in social cognition result predictably in
an increased likelihood of lonely individuals
acting in self-protective and, paradoxically,
self-defeating ways. These dispositions, in turn,
activate social neurobehavioral mechanisms
that may contribute to the association between
loneliness and mortality.
In summary, we would argue that it is time to
move beyond the solitary computer as a meta-
phor for the human mind. Computers today are
massively interconnected devices with capaci-
ties that extend far beyond the resident hard-
ware and software of a solitary computer. In this
development, contemporary computers are be-
coming a better metaphor for the human mind,
as the telereceptors of the brain have provided
wireless broadband interconnectivity to humans
for millennia.
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Accepted September 28, 2004 Ⅲ
155SPECIAL ISSUE: SOCIALITY, SPIRITUALITY, AND MEANING MAKING

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Sociality,spirituality, and meaning making

  • 1. Sociality, Spirituality, and Meaning Making: Chicago Health, Aging, and Social Relations Study John T. Cacioppo, Louise C. Hawkley, Edith M. Rickett, and Christopher M. Masi University of Chicago Scientific theories in the natural sciences posit invisible forces operating with measur- able effects on physical bodies, but the scientific study of invisible forces acting on human bodies has made limited progress. The topics of sociality, spirituality, and meaning making are cases in point. The authors discuss some of the possible reasons for this as well as contemporary developments in the social sciences and neurosciences that may make such study possible and productive. In approximately 600 BCE, the Greek philos- opher Heraclitus referred to the mind as an overwhelming space whose boundaries could never be fully comprehended. For the next 2,300 years, little changed in this regard. Indeed, before the enlightenment of the 18th century, scholars generally believed that thought was instantaneous and that action was governed by an indivisible mind separate from the body. As a result of the belief that the mind was infinitely fast and essentially unanalyzable, there was no point in trying to understand it using scientific means. The human spirit—en- compassing the qualities of kindness, mercy, empathy, trust, compassion, justice, love, friendship, devotion, and hope—was champi- oned in art, literature, and religion but was at best ignored by the scientific community. The past three centuries have been a period of unparalleled advance in science. Scientific the- ories of magnetism, gravity, and dark matter have emerged to posit invisible forces operating with measurable effects on physical bodies. During this same period, the scientific study of invisible forces acting on human bodies has made limited progress. Research on the dimen- sions of sociality, spirituality, and meaning making for instance, has been blunted by biases against what were regarded as soft or religious topics, misguided by metaphors such as the human brain as a solitary computer, and over- looked in a funding climate that demands time and attention be given to societal, psychologi- cal, and physiological deficits rather than capac- ities. Although the history and causes of such biases are complex, little is achieved to mitigate these biases when the constructs of sociality, spirituality, and meaning making are defined imprecisely, their predicted effects are not fal- sifiable or are difficult to replicate, or the un- derlying mechanisms for such effects are not delineated within a framework that is recog- nized by the scientific community. The dawn of the 21st century may herald a paradigm shift in constructs deemed amenable to scientific inquiry. With new developments and instruments in genetics, neuroscience, brain science, and behavioral science, long-standing scientific biases are being challenged by rigor- ous quantitative analysis. Fueling these chal- lenges is the recognition that the traditional focus by founding and federal funding agencies on maladies and disease misses the mark on some of the most complex yet pressing and enduring questions of humankind. The guiding metaphors are also undergoing dramatic transformations. Now that the human genome has been sequenced and has been found to involve fewer genes than anticipated, it has become apparent that humans are not inextrica- bly determined by their genotype irrespective of their social environment. In addition, the ex- John T. Cacioppo and Louise C. Hawkley, Department of Psychology and Center for Cognitive and Social Neuro- science, University of Chicago; Edith M. Rickett, Depart- ment of Psychology, University of Chicago; Christopher M. Masi, Department of Medicine and Center for Cognitive and Social Sciences, University of Chicago. This research was supported by National Institute on Aging Grant PO1 AG18911. Correspondence concerning this article should be ad- dressed to John T. Cacioppo, Department of Psychology, University of Chicago, 5848 South University Avenue, Chi- cago, IL 60637. E-mail: cacioppo@uchicago.edu Review of General Psychology Copyright 2005 by the Educational Publishing Foundation 2005, Vol. 9, No. 2, 143–155 1089-2680/05/$12.00 DOI: 10.1037/1089-2680.9.2.143 143
  • 2. tended period of utter dependency of the human infant has led to the recognition that human genetic transmission is based not on an individ- ual’s selfish ability to reproduce but on the success of offspring to reproduce (Dawkins, 1976). Accordingly, we have a better apprecia- tion of how humans have evolved to be an inherently social, meaning-making species. Moreover, the notion of the solitary com- puter—the dominant metaphor for the human mind for more than a quarter century—sud- denly seems dated. Computers today are mas- sively interconnected devices with capacities that extend far beyond the resident hardware and software of a solitary computer. How ironic that although the telereceptors of the human brain have provided wireless broadband inter- connectivity to humans for millennia, it took the advent of technological innovations for it to become patently obvious that the isolated com- puter is a poor metaphor for the human mind. The qualities of kindness, mercy, empathy, trust, compassion, justice, love, friendship, de- votion, and hope—qualities attributed in art, literature, and religion to the human spirit—did not comport well with the dominant metaphors of the mind in the latter part of the 20th century. Today, these same qualities are simple to incor- porate into a metaphor of the mind as a mas- sively networked portable computer, given the recognition that human genetic transmission re- lies in part on cooperation and nurturance. Even useful metaphors have limited utility, however, if the constructs under study are poorly defined. In our study of sociality, spiri- tuality, and meaning making, we define social- ity as the need for the company of others, mea- surable as the tendency to form social connec- tions, to react to perceived social isolation, and to exhibit the long-term effects of social con- nectedness on health, successful aging, and well-being. By spirituality we mean a theoretical con- struct that represents what is common in human qualities such as kindness, mercy, virtue, empa- thy, trust, compassion, justice, love, friendship, devotion, and hope. Accordingly, sociality may underlie spirituality in at least two senses. As we explain subsequently, we posit that the qual- ities ascribed in art, literature, and religion to the human spirit evolved because humans are fundamentally a social species. Human virtues are social virtues, potentially lending spiritual- ity and sociality a common substrate. In addi- tion, sociality may serve as a model for spiritu- ality, as when people form a personal relation- ship with a deity. As in the case of sociality, the nature and existence of the deity with whom a person forms a relationship is less important than the person’s mental representations of the deity and relationship to the deity. The measur- able effects of spirituality also mirror those for sociality, including the tendency to form a men- tal representation that relates the self to a deity; to exhibit the long-term effects of such a rela- tionship on health, effective aging, and well- being; and to react to perceived separation from or loss of worth in the eyes of the deity with behavioral, physiological, and emotional re- sponses. Spirituality and sociality overlap in measurable ways such as religious affiliation, church attendance, and church participation; ac- cordingly, these variables are also investigated. Central to sociality and spirituality is mean- ing making, defined as the construction of an account or recital of an event or a series of events, either true or fictitious, that serves to organize or structure life. Our definition of meaning making is compatible with current the- ory in perception and cognition, in which even visual percepts are generated according to a wholly empirical strategy that signifies to the individual the empirical significance of the stimulus rather than its properties as such (Purves, Lotto, & Nundy, 2002). We begin with a brief evolutionary argument for the importance of sociality in the survival of the human species. We then describe a neuro- scientific approach to the study of molar con- structs such as sociality, spirituality, and mean- ing making, and we review recent findings from our program of research on social isolation and loneliness. Sociality, Spirituality, and Meaning Making as Components of Human Nature The genetic constitution of Homo sapiens derives not simply from an individual’s repro- ductive success but more critically from the success of one’s children to reproduce. The human infant is born to an extended period of complete dependency. If infants do not elicit nurturance and protection from caregivers, or if caregivers are not motivated to provide such care over an extended period of time, the infants perish along with the genetic legacy of the par- ents. Hunter/gatherers who, in times of danger 144 CACIOPPO, HAWKLEY, RICKETT, AND MASI
  • 3. or famine, chose not to return to share their food with mother and child may have survived to hunt another day, but the genetic constitution that enabled them to feel so little humanity also made it less likely their genes were propagated. In contrast, those who yearned to return despite personal hardship, and individuals who pro- tected and nurtured those close to them, were more likely to have offspring who survived to propagate. Even as adults, humans are not particularly stealthy, strong, or fast relative to other species. It is their collective action—their ability to think, communicate, and work together—that makes Homo sapiens such a formidable species. Because human collective action provides an evolutionary advantage over other species and because genetic transmission is based not on one’s ability to reproduce but on the success of one’s children to reproduce, Homo sapiens are thought to have evolved to be an inherently social, meaning-making species with qualities ascribed in art, literature, and religion to a hu- man spirit. In short, we posit that tens of thou- sands of years of evolution have deeply planted sociality, spirituality, and meaning making in our genome and in our societies. Accordingly, humans are posited to have evolved a brain and biology whose functioning benefits from the formation and maintenance of social bonds, hu- man/social virtues, and organizational life nar- ratives. The deprivation of any of these ingre- dients—such as ruptures of social connected- ness that result from relocation distant from friends and family—produces feelings of isola- tion and dysphoria, physiological alterations, and a motivation to reinstate connections. Given the evolutionary origins of these effects, there should also be heritable individual differences in the extent to which social disconnectedness produces such effects. The extant evidence clearly shows that hu- mans quickly learn to attend to faces, perceive communicative displays, comprehend social hi- erarchies, and form causal attributions (see Ca- cioppo & Berntson, 2004). People develop a theory of mind by which the traits, intentions, and emotions of others are inferred; they com- municate with others and they sometimes hide or miscommunicate their own mental contents from others; they form relationships, unions, and alliances; and they search for meaning in events and patterns. Meaning making and soci- ality are such fundamental components of hu- man nature that people perceive these charac- teristics in the movements of simple inanimate objects. Heider and Simmel (1944), for in- stance, produced a short film of the movement of a small triangle, a small circle, and a large triangle around and into a large rectangle. The animated film consisted only of these geometric shapes, yet everyone who viewed the film “saw” a social drama complete with intentions, plans, and emotions. Only SM, an individual without functioning amygdala—an almond- shaped pair of nuclei deep in the medial tem- poral lobes of the brain—failed to perceive these movements as occurring within a social arena (Adolphs, 1999). Given our evolutionary history, we would contend that people’s conceptual representation of sociality has a specifiable, generalizable, and possibly universal structure (Hawkley, Browne, & Cacioppo, 2004). In the first study underlying this claim, 2,531 undergraduates completed a scale consisting of 20 questions that differenti- ated people who perceived themselves to be socially isolated from those who perceived themselves to be socially integrated (Hawkley et al., 2004). An exploratory factor analysis on half of the sample revealed three correlated dimensions generalizable across gender, and a confirmatory factor analysis on the other half of the sample corroborated this finding: The col- lege students’ beliefs, feelings, and ideas about their social connectedness were structured as three separable but related (oblique) dimen- sions: isolation, relational connectedness, and collective connectedness. In a population-based follow-up study, we tested a very different sample of individuals, a statistically representative sample of 230 men and women (one third African American, one third Hispanic, one third Caucasian) from Cook County, Illinois, born between 1935 and 1952 (M age ϭ 57.5 years; Hawkley et al., 2004). Despite the fact that this sample was an older urban sample of varying ethnic backgrounds, socioeconomic status (SES), and occupations, the confirmatory factor analysis supported the same three-factor structure found for the college students. Their feelings of social disconnected- ness consisted of three related factors: feelings of isolation/intimate connectedness, feelings of relational connectedness, and feelings of collec- tive connectedness. Importantly, we also found statistically sepa- rable predictors of each of these facets of soci- 145SPECIAL ISSUE: SOCIALITY, SPIRITUALITY, AND MEANING MAKING
  • 4. ality. In our urban sample of older adults, we found marital status to predict feelings of isola- tion, contact with friends and family to predict feelings of relational connectedness, and mem- bership in voluntary groups to predict collective connectedness (Hawkley et al., 2004). Tests of the universality of this structure (isolation, re- lational connections, collective connections) are needed, but it is worth noting that psychological theories of the self, which traditionally have focused on a person’s sense of unique identity differentiated from others, now distinguish among the personal self (individual level of analysis), relational self (interpersonal level of analysis), and collective self (group level of analysis; Brewer & Gardner, 1996). Individuals who score low on personal, rela- tional, and collective dimensions of sociality also perceive themselves to be social isolates and report intense feelings of loneliness and dysphoria (Cacioppo, Ernst, et al., 2000; Ca- cioppo et al., in press; Russell, Peplau, & Cut- rona, 1980). Individual differences in the net content of this structure are about 50% heritable and 50% environmental (Boomsma, Willemsen, Hawkley, & Cacioppo, 2004; S. McGuire & Clifford, 2000). In an early study of the origins of these feelings, S. McGuire and Clifford (2000) examined the heritability of loneliness in children. In their first study, 69 biologically related sibling pairs and 64 unrelated pairs in adoptive families in the Colorado Adoption Project completed an 8-item loneliness scale when they were 9, 10, 11, and 12 years of age. In a second study, 22 monozygotic twins, 40 dizygotic twins, and 80 full siblings 8–14 years of age completed a 16-item scale to assess lone- liness in relation to their schoolmates. Results revealed significant genetic (h2 values of 55% and 48%, respectively, in Studies 1 and 2) and unshared environmental contributions to indi- vidual differences in loneliness. In the S. McGuire and Clifford (2000) stud- ies, the sample sizes were relatively small, and because the studies involved adopted children, the representativeness of the sample for a pop- ulation estimate is uncertain. Moreover, herita- bility estimates of complex traits such as lone- liness may change across the life span as the frequency, duration, and range of exposure to environmental influences accrue. We therefore extended this work using data from the Nether- lands Twin Register Study (Boomsma, Ca- cioppo et al., 2004). Data on loneliness from 7,665 young adult and adult Dutch twins (average age: 24 years) were analyzed with genetic structural equation models. The esti- mate of genetic contributions to variation in loneliness in adults was 47%, with the remain- ing variance explained by unique environmental factors. Thus, the heritability estimates in adults were similar to those found previously in chil- dren, and no evidence was found for sex or age differences in genetic architecture or configural effects of the genes. In an ongoing effort to more specifically identify the genetic locus, Boomsma, Willemsen, Dolan, Hawkley, and Cacioppo (in press) conducted a complete ge- nome scan and found evidence for two quanti- tative trait loci, suggesting that at least two sets of genes with additive effects are involved. The striking development of the human cere- bral cortex, especially the frontal and temporal regions, is believed to be largely responsible for evolutionary advances in social and cognitive capacities. The cerebral cortex is a mantle of between 2.6 and 16 billion neurons, with each neuron receiving 10,000 to 100,000 connections from other neurons (e.g., Pakkenberg, 1966). The human frontal (front part of the brain) and temporal (right and left sides) lobes constitute 32% and 23% of the cerebral cortex, respec- tively, arguably rendering the sensorimotor cor- tices that dominate most mammalian brains to minority status in the human brain. The expan- sion of the frontal regions in the human brain is largely responsible for the human capacity for reasoning, planning, and performing mental simulations, and an intact frontal region contrib- utes to the human ability to reason, remember, and work together, thereby contributing to the evolutionary success of humans (Bar-On, Tranel, Denburg, & Bechara, 2003; Krin- gelbach & Rolls, 2004). The temporal and pa- rietal regions, in turn, play essential roles in social perception, social reasoning, and commu- nication (cf. Adolphs, 1999, 2001; Berntson, Boysen, & Cacioppo, 1993; Saxe & Kanwisher, 2003). Despite these evolutionary advances, human cognition and meaning making are often biased and counterfactual. The sensory load from the physical environment is minor in comparison with the quantity and complexity of the infor- mation that comes from other individuals, groups, alliances, and cultures, including the potential for benevolence or treachery posed by each. Human cognition is not an objective in- 146 CACIOPPO, HAWKLEY, RICKETT, AND MASI
  • 5. formation process but instead is rife with the operation of self-interest, self-enhancement, and self-protective processes. Because humans encounter more information than can possibly be processed, they tend to economize on thought when forming beliefs that are not per- sonally relevant (Petty & Cacioppo, 1986) and tend to search for and attend to evidence that confirms what they already believe to be true (Snyder & Swann, 1978). Information processing is also biased in ways that protect the self from symbolic as well as actual threats and that promote reproductive success (e.g., Jones & Berglas, 1978). In fact, people are not particularly good at knowing the causes of their feelings or behavior (Nisbett & Wilson, 1977). People overestimate their strengths and underestimate their faults (M. Ross & Sicoly, 1979). They overestimate the importance of their input, the pervasiveness of their beliefs, and the likelihood that a desired event will occur (W. J. McGuire, 1981), all while underestimating the contributions of oth- ers and the likelihood that risks in the world apply to them (L. Ross, Greene, & House, 1977). Events that unfold unexpectedly are not reasoned as much as they are rationalized (Aronson, 1968), and the act of remembering is far more of a biased reconstruction than an accurate record of actual events (McDonald & Hirt, 1997; Roediger, Buckner, & McDermott, 1999). Many of these biases in social cognition are spontaneous, do not require cognitive effort, and represent normative processing. A crucial consequence of the nuances of the biased fashion in which humans make meaning is that humans have much more influence in the creation of their lives and social relationships than most realize (Downey, Freitas, Michaelis, & Khouri, 1998; Murray, Holmes, & Griffin, 1996). If an individual is led to believe a new acquaintance is fun and nice, for instance, the individual behaves in a fashion that draws out pleasant and enjoyable behaviors from the per- son. If an individual is led to think a child is intelligent, the individual does and says things that make a smarter child than would result if the individual was led to believe the child was of average intelligence. Another instance of bi- ased meaning making is the tendency of people to self-handicap when they think they will fail at an important task. By subtly producing insur- mountable obstacles to success, they can at- tribute their subsequent failure to these obsta- cles rather than to themselves. Importantly in the present context, bias in social cognition is also at work when people who feel socially connected construe the world as presenting challenges to be overcome with the aid of others and react to interpersonal con- flicts in peaceful and constructive rather than offensive and aggressive ways, thereby produc- ing an environment that others want to inhabit (Cacioppo & Hawkley, in press). In contrast, lonely individuals are more likely to construe their world (including the behavior of others) as potentially threatening or punitive. Conse- quently, lonely individuals are more likely to be socially anxious, hold more negative expecta- tions for their treatment by others, and adopt a prevention focus rather than a promotion focus in their social interactions. These individuals are also more likely to appraise stressors as threats rather than challenges and to cope with stressors in a passive, isolative fashion rather than an active fashion that includes actively seeking the help and support of others. To- gether, these differences in social cognition pre- dictably result in an increased likelihood of lonely individuals acting in self-protective and, paradoxically, self-defeating ways (Cacioppo & Hawkley, in press). In each instance, the indi- viduals may be oblivious to the fact that the way in which they perceived and thought about their social world contributed to their social realities. We noted at the outset that biases against the scientific study of constructs such as sociality, spirituality, and meaning making are attribut- able to imprecise definitions, nonfalsifiable or nonreplicable effects, a focus on associations rather than underlying mechanisms, and the ab- sence of a broad scientific framework within which to study abstract constructs of this sort. We next address the latter issue. Specifically, we argue that a neuroscience perspective may provide a framework that allows theoretical constructs and associations to be rigorously de- fined, tested, and parsed so as to investigate their underlying mechanisms. Social Neuroscience Perspective During the latter half of the 20th century, the nature of the human mind was plumbed through clever experimental designs that used measures of verbal reports, judgments, and reaction time. These methodologies proved limited, however. 147SPECIAL ISSUE: SOCIALITY, SPIRITUALITY, AND MEANING MAKING
  • 6. Social cognition and interactions range from affect laden to habitual, and nuances deriving from these features may prove difficult to cap- ture fully using subjective measures and re- sponse latencies to semantic (e.g., lexical deci- sion) tasks alone (LeDoux, 2000; Zajonc, 1980). A new approach, termed social neuro- science, first introduced just over a decade ago (Cacioppo & Berntson, 1992), represents a new development in the study of the human mind, including how sociality, spirituality, and the meaning of life might modulate brain and biology. Human nature is recognized as being com- plex. To simplify the study of human nature, neuroscientists in the past century tended to ignore or hold constant social influences, whereas cognitive and social scientists tended to ignore the biological constraints on and mechanisms through which cognition, affect, and conation are expressed. In the neuro- sciences, the architects of development and be- havior were conceived as anatomical structures and genetic strings sculpted by the forces of evolution operating over millennia, the builders were cast as encapsulated within living cells far from the reach of social influences, and the brain was treated as an analytical information- processing machine. The additional information that might be attributable to the social world was thought to be best considered last, if the need arose. Social factors, the reasoning often went, had minimal implications for basic devel- opment, structure, or processes of the brain or mind, in which case the consideration of social factors is entirely irrelevant. And even if rele- vant, consideration of social factors may render the study of the human mind and behavior too complicated to sustain scientific progress. The attitude toward the neurosciences among cognitive and social scientists throughout most of the 20th century was no less antagonistic (Berntson & Cacioppo, 2000; Cacioppo, 2002). World wars, the Great Depression, and civil injustices made it amply clear that social and cultural forces were too important to address to await the full explication of cellular and molec- ular mechanisms. Biological constraints, mech- anisms, and insights tended to be ignored, often under the misguided auspice of protecting the behavioral sciences from the onslaught of re- ductionism. The specialized knowledge and fundamental research that were required to cul- tivate descriptive taxonomies, theoretical for- mulations, and methodologies—coupled with an early emphasis on isolated scientific work— all but ensured that social and biological per- spectives would evolve insulated from develop- ments in the other. For decades, the central precept of molecular biology was that all of the information we need to construct a mammalian body, whether man or mouse, is contained in the approximately hun- dred thousand genes of mammalian DNA and that a set of master genes activates the DNA necessary to produce the appropriate proteins for development and behavior (Crick, 1970; Panksepp, 1998). In this scheme, DNA encodes the sequence of amino acids in proteins and peptides using the sequence of nucleotides in the gene as a template. The DNA sequential code is transferred to messenger RNA (mRNA) via transcription, a process involving enzymes (RNA polymerases), followed by translation from mRNA to polypeptide chains (protein pieces) and proteins. The process of DNA to RNA transcription has been assumed to be re- stricted to the confines of living cells outside the influence of personal and social ties. As neuroscientific approaches have been ap- plied to more complex questions, however, these presumably basic principles have begun to be questioned. Recent research suggests that even DNA to RNA transcription can be subject to modulation by the social environment (Ca- cioppo, Berntson, Sheridan, & McClintock, 2000). In an illustrative study, we investigated the DNA to RNA transcription for a growth hormone that occurs within a type of immune cell called a lymphocyte. The production of this growth hormone is of interest because it is thought to be involved in the effectiveness of lymphocytes to combat pathogens. We recently found that caregivers of spouses with Alzhei- mer’s disease (AD) had markedly suppressed lymphocyte growth hormone mRNA levels rel- ative to age- and gender-matched controls (Wu et al., 1999). It is reasonable to assume that the spouses of AD patients were essentially ran- domly assigned to caregiver or noncaregiver roles by their spouse’s unexpected development of AD, in which case these results indicate that social roles can modulate DNA to RNA tran- scription processes. The behavior of strains of mice with specific genes inactivated (i.e., knockout mice) has been known to depend on genetic background, whereas the effects of the social context have 148 CACIOPPO, HAWKLEY, RICKETT, AND MASI
  • 7. been thought to be unimportant. Contrary to this latter belief, however, Crabbe, Wahlsten, and Dudek (1999) found that the specific behavioral effects associated with a given knockout could vary dramatically across experimenters, testing environments, and laboratories. The implication of these and related studies is that aspects of genetic expression, which were thought to be encapsulated within each living cell far from the reach of personal ties or social influences, are in fact subject to modulation by the social environment. In the twilight of the 20th century, neurosci- entists and cognitive scientists began to collab- orate more systematically, united by the com- mon view that information processing could best be understood by appeal to the brain as well as its emergent manifestation in mind and by the goal of understanding how the mind works. These collaborations have helped unravel puz- zles of the mind including aspects of perception, imagery, attention, and memory. Many aspects of human nature require a more comprehensive approach, however. These include aspects of the human spirit such as sociality, altruism, affilia- tion, attachment, kin recognition, social identi- fication, communication, cooperation, com- merce, empathy, morality, contagion, love, nur- turance, kindness, mercy, compassion, justice, friendship, and hope. All can be conceptualized as invisible forces emanating from the operation of the human brain within a social arena with measurable effects not only on subjective well- being but on brain, biology, and health. Brain imaging studies clearly point to the attention given to social stimuli. If an individual views a novel picture of an evocative image (e.g., snowcapped mountains) or an equally pleasant, arousing, and statistically infrequent image of a person (e.g., a smiling baby), the social stimulus elicits a larger amplitude late positive electrocortical (event-related brain) po- tential that peaks about 550 ms after stimulus onset (Ito & Cacioppo, 2000). In addition, the differential event-related response emerges even when the task is simply to classify whether the picture is pleasant or unpleasant. That is, the brain is spontaneously extracting information about the presence of conspecifics even when the explicit task has nothing to do with this distinction (Ito & Cacioppo, 2000). Functional magnetic resonance imaging studies have simi- larly suggested that social perception and social reasoning are robust elicitors of localized re- gions of brain activation and reflect distinct aspects of social and emotional processing (e.g., see Blakemore, Winston, & Frith, 2004; Ca- cioppo & Berntson, 2004). The field of social neuroscience, of course, stretches far beyond social cognition, human studies, or brain imaging methodologies (see Cacioppo & Berntson, in press-b; Cacioppo, Berntson, et al., 2002). As the 21st century dawns, there is a recognition that much of the groundwork for multidisciplinary scientific col- laborations has been laid by the giants of the preceding three centuries. Neuroscientists, cog- nitive scientists, and social scientists are mov- ing beyond simplifying assumptions and are placing less emphasis on the arbitrary division between the social and the biological sciences to work collaboratively toward developing more comprehensive theories of mind, brain, biology, and behavior. Through the efforts of such indi- viduals, the broad multidisciplinary perspective of social neuroscience is gaining momentum, making more feasible the rigorous scientific study of questions such as how sociality, spiri- tuality, and the meaning of life operate. Throughout this article, we have described such examples from our own research, ranging from behavioral genetics to brain imaging. In the remainder of the article, we survey results from our multidisciplinary research to examine the mechanisms underlying the association between social connectedness and longevity and well-being. Chicago Health, Aging, and Social Relations Study In 2002, we began a population-based longi- tudinal study of 230 English-speaking Blacks/ African Americans, non-Black Hispanics, and non-Hispanic Caucasians between the ages of 50 and 67 years from Cook County, Illinois, to investigate the social, behavioral, cognitive, emotional, brain, autonomic, neuroendocrine, cellular, and molecular transduction pathways by which the social world affects well-being and health (e.g., Cacioppo & Berntson, in press-a, in press-b; Cacioppo & Hawkley, 2003; Cacioppo, Hawkley, & Berntson, 2003). The Chicago Health, Aging, and Social Relations Study (CHASRS) was built on our previous research on thousands of young adults (Ca- cioppo, Ernst, et al., 2000; Cacioppo, Hawkley, Berntson, et al., 2002; Cacioppo, Hawkley, 149SPECIAL ISSUE: SOCIALITY, SPIRITUALITY, AND MEANING MAKING
  • 8. Crawford, et al., 2002; Hawkley et al., 2004) and older adults (Cacioppo et al., 1998; Uchino, Kiecolt-Glaser, & Cacioppo, 1994) and on meta-analyses of the literature (e.g., Uchino, Cacioppo, & Kiecolt-Glaser, 1996). Among our findings from this earlier work was that socially connected individuals are more likely to meet everyday stressors by active coping and recruiting others’ help. Individuals who feel socially isolated are more likely to construe their world (including the behavior of others) as threatening or punitive. They are more likely to appraise stressors as threats rather than challenges and to cope with stressors in a passive fashion by isolating themselves from others and withdrawing from the problem situation. Together, these differences in mean- ing making result in an increased likelihood of socially connected individuals acting in a hu- mane, selfless fashion, reinforcing their connec- tions with others and enhancing their self-es- teem, and of lonely individuals acting in self- protective and, paradoxically, socially acidic and self-defeating ways (Cacioppo, Ernst, et al., 2000; Cacioppo & Hawkley, in press; Hawkley, Burleson, Berntson, & Cacioppo, 2003). Why might lonely individuals be more emo- tionally withdrawn in social settings? Personal- ity differences such as shyness, sociability, neg- ativity, and fear of negative evaluation may provide a partial explanation. In addition, be- cause social settings can be overwhelming, so- cial effectiveness depends on an individual’s ability to exert voluntary control over his or her attentional focus. Moreover, regulating one’s attention can help one garner social approval. Do lonely individuals differ in their ability to voluntarily control their attentional focus? As a means of exploring self-regulation, participants in our study of loneliness in young adults per- formed a dichotic listening task while at the clinical research center. The dichotic listening task required that participants identify the con- sonant–vowel pair presented to their right or left ear. Because the auditory system is predomi- nantly crossed and because language is left- lateralized in most right-handed individuals, right-handed individuals tend to perform better when verbal stimuli are presented to the right than left ear. (All of the participants in this study were right-handed.) Superimposed on this general right-ear advantage, however, are the effects of attention, as individuals generally per- form better when verbal stimuli are presented to the ear to which they are focusing their atten- tion. The former effect is said to be data driven or bottom-up, whereas the latter is said to be conceptually driven or top-down. As predicted, we found an overall right-ear advantage across loneliness groups (lonely, nor- mal, and nonlonely) and instructional condi- tions (Cacioppo, Ernst, et al., 2000). In addition, however, a significant main effect of attentional instruction showed that individuals performed better with left-ear stimuli when they were in- structed to focus on the stimuli presented to their left ear than in the other conditions. More- over, lonely individuals tended to show the strongest right-ear advantage in the no-instruc- tion condition, presumably reflecting the po- tency of bottom-up (stimulus-driven) atten- tional processing, but failed to shift to the left- ear advantage when instructed to focus on their left ear. Specific planned contrasts confirmed that all three groups showed a significant right- ear advantage during the focus on right-ear con- dition, but only the normal and nonlonely indi- viduals were able to shift to a significant left-ear advantage in the focus on left-ear condition. Together, these results are consistent with the notion that attentional control appears compa- rable in lonely and nonlonely individuals until voluntary attentional control conflicts with au- tomatic attentional processes, at which point lonely individuals show an attentional deficit. This result raises the possibility that lonely in- dividuals may feel threatened or overwhelmed and therefore withdraw from the social environ- ment, especially new or complex social envi- ronments, because they have less control over the focus of their attention than nonlonely indi- viduals. In fact, Baumeister and colleagues re- cently found that experimental manipulations of social exclusion could produce a similar effect on dichotic listening and self-regulation (Baumeister & DeWall, in press). A measure of the importance of social con- nectedness is that it predicts morbidity and mor- tality from broad-based causes (e.g., Seeman, 2000). The reasons for this effect remain un- clear. As noted earlier, few differences in tradi- tional health behaviors (e.g., smoking, exercise, or nutrition) have been found to differentiate lonely and nonlonely individuals, for instance (Cacioppo, Hawkley, Crawford, et al., 2002; Seeman, 2000). We therefore have explored other possible mechanisms by which loneliness may have deleterious effects on health: health 150 CACIOPPO, HAWKLEY, RICKETT, AND MASI
  • 9. behaviors, cardiovascular activation, cortisol levels, and sleep (Cacioppo et al., 2003). In one study, we assessed autonomic activity, salivary cortisol levels, sleep quality, and health behaviors in undergraduate students selected, on the basis of pretests, to be among the top or bottom quintile in feelings of loneliness (Ca- cioppo, Hawkley, Crawford, et al., 2002). We found that the total peripheral resistance to blood flow through the circulatory system in the body was higher in lonely than nonlonely par- ticipants, whereas cardiac contractility (the force of a heartbeat), heart rate, and cardiac output were higher in nonlonely than lonely participants. Such differences, although not det- rimental in the robust cardiovascular system of young adults, may constitute a source of wear and tear on the vascular system and on regula- tory controls of blood pressure, with cardiovas- cular dysfunctions not appearing until later in life. We also found that lonely individuals re- ported poorer sleep than nonlonely individuals. Differences in sleep efficiency in young adults, as with differences in cardiovascular function, may have minimal health consequences in the short term but may influence significant health outcomes over time, especially in later life when physiological functions become more fragile. In a follow-up study, we assessed blood pres- sure, heart rate, salivary cortisol levels, sleep quality, and health behaviors in older adults whose loneliness was assessed at the time of testing at their residence (Cacioppo, Hawkley, Crawford, et al., 2002). Results indicated greater age-related increases in blood pressure and poorer sleep quality in lonely than non- lonely older adults. These results suggest that the stress and dysphoria associated with feeling isolated contribute to wear and tear on the body and, over time, to the degradation of central and peripheral regulatory systems. Humans are not static mechanical devices that simply wear out, but instead, human phys- iology includes anabolic processes that promote repair and maintenance (e.g., wound healing) and growth (e.g., muscular development) in re- sponse to stressors. Sleep is the quintessential restorative behavior, however, and sleep in- volves no obvious social interaction. We there- fore next asked whether the restorative power of sleep was greater for people who felt low rather than high levels of loneliness (Cacioppo, Hawk- ley, Berntson, et al., 2002). All participants were tested one night in the clinical research center of an academic hospital and several ad- ditional nights in their residence. Results re- vealed that lonely and nonlonely individuals allocated the same amount of time in bed for sleep, but lonely individuals evinced poorer sleep efficiency and more time awake after sleep onset than nonlonely individuals. These results suggest that lonely individuals may be less resilient than nonlonely individuals in part because they sleep more poorly. These results also raise the possibility that feelings of social connectedness may influence the extent to which wear and tear on the brain and body can be slowed or reversed by inherent anabolic pro- cesses. That is, sociality not only may influence the selection of health behaviors but may mod- ulate the salubrity of restorative behaviors. We designed the CHASRS to include de- tailed medical histories, health assessments, measures of health care use, health behavior measures (both self-report and objective), sleep quality indexes, personality measures (e.g., Big Five), life event assessments, nutrition and ex- ercise measures, markers of metabolic and in- flammatory processes, endocrine and immune assays, baseline autonomic (especially cardio- vascular) assessments and tests, tests of mem- ory and cognitive function, exposure and reac- tivity to stressors, mood, volunteerism, opti- mism, hopefulness, church attendance, and religiosity. Finally, economic and sociological components (e.g., neighborhood characteristics, education, income, and social networks) have been incorporated into the design of the CHASRS. We have used these data, for in- stance, to examine the social, behavioral, cog- nitive, and emotional pathways through which neighborhoods affect health and well-being. Us- ing data from the CHASRS, we recently found that neighborhood contexts predict self-reported health in older adulthood even after controlling for age and gender (Wen, Hawkley, & Ca- cioppo, 2004). More important, we found that the impact of neighborhood SES (e.g., educa- tion and income) on health was mediated in our population-based study through the subjective perception (meaning making) of neighborhood. The data further showed that these neighbor- hood effects on health were mediated indepen- dently by individual SES, loneliness/connected- ness, and depression but not by size of social networks or perceived support. 151SPECIAL ISSUE: SOCIALITY, SPIRITUALITY, AND MEANING MAKING
  • 10. As a complement to the Chicago population- based longitudinal study and in collaboration with Linda Waite and M. E. Hughes, a three- item measure of loneliness was included in the 2002 wave of the Health and Retirement Study, a longitudinal study of the later life course in a nationally representative sample of individuals born in 1947 or earlier (e.g., Hughes, Waite, Hawkley, & Cacioppo, 2004). At each wave (interview), detailed information is collected about the respondent’s health, family relation- ships, employment, income and wealth, and de- mographic background. A nationally represen- tative sample of 2,182 individuals completed the module administered as part of the CHASRS. The three-item survey scale of lone- liness was found to have adequate internal con- sistency and to correlate highly with the full revised UCLA Loneliness Scale (Hughes et al., 2004). Analyses of the Health and Retirement Study and the Chicago population-based sample fur- ther indicated that objective social isolation and loneliness are related and that loneliness in both samples was similarly associated with poorer self-reported health, poorer self-reported emo- tional health, and a greater number of chronic health conditions. As noted earlier, the hypoth- esis that the health behaviors of patients account for higher levels of morbidity and mortality among lonely or isolated individuals has re- ceived weak support. Care for patients has come under scrutiny in the past decade because stud- ies have shown that health care in the United States falls short of basic quality standards and that health care provision is influenced subtly by various extraneous factors such as gender, race, and age. We reasoned that if the health care provided to patients who appear to be socially isolated is of lower quality than that provided to patients with family and friends, then at least part of the explanation for the morbidity/mor- tality relationship may be attributable to the decisions and behaviors of health care providers rather than to the health behaviors of the pa- tients themselves (Cacioppo, Brown, & Hawk- ley, 2004). As an initial exploration of this hypothesis, we conducted a national study, randomly sam- pling 600 physicians whose practice centers on the treatment of older adults. The physicians were asked a series of questions comparing the care of hospital inpatients with constructive and involved family members or friends and inpa- tients who were socially isolated, along with another series of questions comparing the care of inpatients with difficult or hostile family members or friends and inpatients who were socially isolated. In each series of questions, the physicians indicated the health care they ob- served to be provided by nurses, doctors, ancil- lary staff (e.g., physical therapists and nurses aides), and themselves. To allow the same sur- vey question to be used for physicians from different medical specialties and to address the care provided by various health care agents (doctors, nurses, and ancillary staff), respon- dents were asked simply to indicate who re- ceived “better care.” Finally, we assessed at- tributes of the physicians such as medical spe- cialty, region of the country in which they practiced, years of experience, and type of med- ical facility (e.g., hospital) to determine whether these factors moderated physicians’ beliefs about the effects of their patients’ social milieu on health care provision. Survey results indicated that physicians re- ported that they and other physicians, nurses, and ancillary staff provide better medical care to inpatients with constructive family and friends than inpatients without family or friends, whereas inpatients with hostile family and friends receive treatment comparable to that received by socially isolated inpatients. These findings held for outpatients as well as inpa- tients and regardless of the physician’s medical specialty, type of hospital in which the physi- cian practiced, years of experience, and region of the country. These results indicate that social isolation may be associated with broad-based morbidity and mortality at least in part because the care provided by physicians and health care professionals differs. Results from the CHASRS also confirmed that sociality has profound effects on physio- logical functioning and sleep. As in our earlier studies, we have observed that lonely older adults exhibit evidence of chronically elevated sympathetic activation (e.g., higher overnight urinary epinephrine and resting blood pressure), greater arterial stiffness, and less efficient or effective sleep. These results suggest that social isolation and loneliness have the potential to simultaneously increase physiological load via sympathetic activation and decrease the capac- ity to recover from that load via reduced quality of sleep. 152 CACIOPPO, HAWKLEY, RICKETT, AND MASI
  • 11. Conclusion Although the ancestral heritage of Homo sa- piens has placed an emphasis on sociality, Western thought and culture value individual excellence over collective achievement. The ev- idence we have reviewed suggests our ancestral heritage is not easily ignored even if its effects are not immediately obvious. Specifically, we have argued that the human brain has evolved to facilitate social information processing and ac- tion and that human contact and nurturance are necessary for normal brain development and function. Loneliness is in part heritable, with individual differences in the level of social con- nectedness required to feel right. Feelings of social connectedness, or the lack thereof (i.e., loneliness), were further found to be repre- sented conceptually as three facets of a single overarching construct, the facets being isola- tion/intimate connectedness, relational connect- edness, and collective connectedness. These facets are correlated but are nevertheless related distinctively and predictably to life circum- stances. In addition, data from the CHASRS indicate that an individual’s self-esteem and sense of purpose in life reflect the individual’s perceived intimate, relational, and collective connectedness. Dysphoria/depression, too, has been found to be a distinct but related theoret- ical construct commonly triggered by social re- jection or disturbances (Cacioppo et al., in press). How we think about people in everyday life may be profoundly affected by feelings of social connectedness as well. For instance, lonely in- dividuals are more likely than nonlonely indi- viduals to construe their world, including the behavior of others, as threatening or punitive. Consequently, lonely individuals are more likely to be socially anxious, hold more nega- tive expectations for their treatment by others, and adopt a prevention focus rather than a pro- motion focus in their social interactions. Lonely, relative to nonlonely, individuals are also more likely to appraise stressors as threats rather than challenges and to cope with stressors in a passive, isolative fashion rather than an active fashion that includes actively seeking the help and support of others. Together, these dif- ferences in social cognition result predictably in an increased likelihood of lonely individuals acting in self-protective and, paradoxically, self-defeating ways. These dispositions, in turn, activate social neurobehavioral mechanisms that may contribute to the association between loneliness and mortality. In summary, we would argue that it is time to move beyond the solitary computer as a meta- phor for the human mind. Computers today are massively interconnected devices with capaci- ties that extend far beyond the resident hard- ware and software of a solitary computer. In this development, contemporary computers are be- coming a better metaphor for the human mind, as the telereceptors of the brain have provided wireless broadband interconnectivity to humans for millennia. References Adolphs, R. (1999). Social cognition and the human brain. Trends in Cognitive Sciences, 3, 469–479. Adolphs, R. (2001). The neurobiology of social cog- nition. Current Opinions in Neurobiology, 11, 231–239. Aronson, E. (1968). Dissonance theory: Progress and problems. In R. P. Abelson, E. Aronson, W. J. McGuire, T. M. Newcomb, M. J. Rosenberg, & P. H. Tannenbaum (Eds.), Theories of cognitive consistency: A sourcebook (pp. 5–27). Chicago: Rand McNally. Bar-On, R., Tranel, D., Denburg, N. L., & Bechara, A. (2003). Exploring the neurological substrate of emotional and social intelligence. Brain, 126, 1790–1800. Baumeister, R. F., & DeWall, C. N. (in press). The inner dimension of social exclusion: Intelligent thought and self-regulation among rejected per- sons. In K. Williams, J. P. Forgas, & W. von Hippel (Eds.), Sydney Social Psychology Sympo- sium. Mahwah, NJ: Erlbaum. Berntson, G. G., Boysen, S. T., & Cacioppo, J. T. (1993). Neurobehavioral organization and the car- dinal principle of evaluative bivalence. Annals of the New York Academy of Sciences, 702, 75–102. Berntson, G. G., & Cacioppo, J. T. (2000). Psycho- biology and social psychology: Past, present, and future. Personality and Social Psychology Re- view, 4, 3–15. Blakemore, S., Winston, J., & Frith, U. (2004). Social cognitive neuroscience: Where are we heading? Trends in Cognitive Sciences, 8, 216–222. Boomsma, D. I., Willemsen, G., Dolan, C. V., Hawk- ley, L. C., & Cacioppo, J. T. (in press). Genetic and environmental contributions to loneliness in adults: The Netherlands Twin Register Study. Be- havior Genetics. Manuscript submitted for publi- cation. Boomsma, D. I., Willemsen, G., Hawkley, L. C., & Cacioppo, J. T. (2004). Genetic and environmental 153SPECIAL ISSUE: SOCIALITY, SPIRITUALITY, AND MEANING MAKING
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