Real-Life Emotional Support, Social-Media-Based Emotional Support, and Loneliness Among US Adults: A Nationally Representative Study.

BACKGROUND: Loneliness is associated with all-cause mortality among US adults. Although social media is increasingly used for alleviating loneliness among adults, the relative potency of real-life emotional support and emotional support from social media to alleviate loneliness is not known. OBJECTIVE: To assess associations between real-life emotional support versus social-media-based emotional support and loneliness among a nationally representative sample of US adults. DESIGN AND PARTICIPANTS: We assessed 1512 US adults ages 30-70 years recruited in July and August of 2023. MAIN MEASURES: Loneliness was measured using the perceived social isolation subscale of the Patient-Reported Outcomes Measurement Information System (PROMIS). Real-life emotional support was assessed using items adapted from the PROMIS emotional support subscale, and social-media-based emotional support was measured with the exact wording of the real-life scale replacing "real-life" with "social media." KEY RESULTS: Logistic regression assessed associations between real-life emotional support versus social-media-based support and loneliness while controlling for seven sociodemographic variables and integrating survey weights to make results nationally representative. In model 1, which examined real-life emotional support and loneliness, compared with those in the highest quartile of real-life emotional support, those in the lowest quartile had eight times the odds of loneliness (AOR = 8.14; 95% CI, 5.35, 12.39). In model 2, which examined social-media-based emotional support and loneliness, compared with those in the highest quartile of social-media-based emotional support, those in the lowest quartile had 45% increased odds of loneliness (AOR = 1.45; 95% CI, 1.05, 2.00). In model 3, a fully adjusted multivariable model that included both independent variables, only low real-life emotional support retained its significant association with loneliness (p < 0.001) while social-media-based emotional support did not (p = 0.37). CONCLUSIONS: Social-media-based emotional support is less strongly associated with loneliness compared with real-life emotional support. Longitudinal and qualitative studies can elucidate the reasons for these associations.