Social anxiety predicts future loneliness, study finds — but not the other way around

New research has found that people who reported symptoms of social anxiety at the start of a five-year period were more likely to experience increased loneliness later on. In contrast, initial feelings of loneliness were not associated with later symptoms of social anxiety. The study was published in Psychological Medicine.

Loneliness is a subjective emotional state that occurs when a person feels a lack of meaningful social connection or companionship. It is different from simply being alone; a person can feel lonely even when surrounded by others. Loneliness arises when there is a mismatch between the social relationships a person desires and those they actually have. It can be temporary—such as after a move or breakup—or chronic, persisting over time and significantly affecting well-being.

Loneliness can lead to emotional distress, including sadness, low self-esteem, and a sense of isolation. Prolonged loneliness has been linked to physical health problems such as weakened immune function, cardiovascular issues, and an increased risk of early mortality. It also raises the likelihood of developing mental health conditions, including depression and anxiety. While people of all ages can experience loneliness, it is especially common during major life transitions, such as adolescence, retirement, or bereavement.

Study author Anna C. Reinwarth and her colleagues set out to explore whether and how loneliness affects symptoms of social anxiety—and vice versa—over a five-year period in a large sample drawn from the German population. They also aimed to estimate the overall prevalence of loneliness and social anxiety symptoms in the general population.

The researchers analyzed data from the ongoing Gutenberg Health Study, a large-scale longitudinal project based in the Rhine-Main region of Germany. The study, which began in 2007, primarily investigates cardiovascular health outcomes such as myocardial infarction and cardiovascular death. Participants were randomly selected from local registries in Mainz and the surrounding district of Mainz-Bingen, with sampling stratified by age and sex to ensure representativeness. Eligible participants were between 35 and 74 years old.

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Participants provided sociodemographic information and completed assessments measuring loneliness (via a single-item question: “I am frequently alone/have few contacts”), social anxiety symptoms (using the three-item short form of the Social Phobia Inventory), depressive symptoms (using the Patient Health Questionnaire-9), generalized anxiety symptoms (using the two-item Generalized Anxiety Disorder Screener), and perceived social support (using the six-item Brief Social Support Scale, BS-6).

Data for the current analysis came from two assessment waves: the baseline wave conducted between 2007 and 2012, and a follow-up wave conducted five years later between 2012 and 2017. In total, 15,010 people participated in the baseline wave, and 12,423 were followed up five years later. Approximately 49% of participants were women, and the average age at baseline was 55 years.

The results showed that 11% of participants reported feelings of loneliness, and 7% reported symptoms indicative of social anxiety. Over the five-year period, symptoms of social anxiety were found to be more stable than loneliness, although both showed some consistency over time.

Participants who reported higher levels of social anxiety symptoms at baseline were more likely to report increased loneliness five years later. However, initial feelings of loneliness were not significantly associated with later increases in social anxiety symptoms after adjusting for relevant factors.

“Findings provided evidence that symptoms of social anxiety are predictive for loneliness. Thus, prevention and intervention efforts for loneliness need to address symptoms of social anxiety,” the study authors concluded.

The study sheds light on the longitudinal links between social anxiety and loneliness. However, it should be noted that all data came from self-reports, while feelings of loneliness were assessed using a single item. This left room for reporting bias and measurement quality issues to affect the results.

The paper, “Loneliness and social anxiety in the general population over time – results of a cross-lagged panel analysis,” was authored by Anna C. Reinwarth, Manfred E. Beutel, Peter Schmidt, Philipp S. Wild, Thomas Münzel, Jochem König, Stavros V. Konstantinides, Jörn M. Schattenberg, Karl J. Lackner, Alexander K. Schuster, Oliver Tüscher, and Katharina Geschke.