Social Indicators Research

, Volume 77, Issue 3, pp 521–548 | Cite as

Measuring Social Isolation in Older Adults: Development and Initial Validation of the Friendship Scale

  • Graeme HawthorneEmail author


Although there are many excellent published scales measuring social isolation, there is need for a short, user-friendly, stand alone scale measuring felt social isolation with good psychometric properties. This study reports the development and preliminary validation of a short, user-friendly scale, the Friendship Scale. The six items measure six of the seven important dimensions that contribute to social isolation and its opposite, social connection. The psychometric properties suggest that it has excellent internal structures as assessed by structural equation modelling (CFI = 0.99, RMSEA = 0.02), that it possesses reliability (Cronbach α = 0.83) and discrimination when assessed against two other short social relationship scales. Tests of concurrent discriminant validity suggest it is sensitive to the known correlates of social isolation. Although further work is needed to validate it in other populations, the results of this study suggest researchers may find the Friendship Scale particularly useful in epidemiology, population surveys or in health-related quality of life evaluation studies where a parsimonious measure of felt social support or social isolation is needed.


loneliness social connectedness social isolation social relationships social support 


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  1. Amir, M., Lev-Wiesel, R. 2003Time does not heal all wounds: quality of life and psychological distress of people who survived the holocaust as children 55 years laterJournal of Traumatic Stress16295299CrossRefGoogle Scholar
  2. Anastasi, A. 1986Evolving concepts of test validationAnnual Review of Psychology37115CrossRefGoogle Scholar
  3. Andrich, D. 1978A rating formulation for ordered response categoriesPsychometrika43561573CrossRefGoogle Scholar
  4. Arbuckle, J., Wothke, W. 1999AmosSmall Waters CorporationChicagoGoogle Scholar
  5. Baltes, P. B., Smith, J. 2002New Frontiers in the Future of Aging: From Successful Aging of the Young old to the Dilemmas of the Fourth AgeMax Plant Institute for Human DevelopmentBerlinGoogle Scholar
  6. Berkman, L., Glass, T. 2000Social Integration, Social Networks, Social Support, and HealthBerkman, L.Kawachi , I. eds. Social EpidemiologyOxford University PressOxford137173Google Scholar
  7. Berkman, L., Syme, L. 1979Social networks, host resistance and mortality: a nine-year follow-up study of Alameda County residentsAmerican Journal of Epidemiology109186204Google Scholar
  8. Bowlby, J. 1971AttachmentPelicanLondonGoogle Scholar
  9. Bowling, A. 1991Measuring Health: A Review of Quality of Life Measurement ScalesOpen UniversityMilton KeynesGoogle Scholar
  10. Browne, M. W., Cudeck, R. 1993Alternative Ways of Assessing Model FitBollen, K. A.Long , J. S. eds. Testing Structural Equation ModelsSageNewbury Park136162Google Scholar
  11. Cantor, N., Sanderson, C. 1999Life task participation and well-being: the importance of taking part in daily lifeKahneman, D.Diener, E.Schwarz, N. eds. Well-Being: The Foundations of Hedonic PsychologyRussell Sage FoundationNew York230243Google Scholar
  12. Cassel, J. 1976The contribution of the social environment to host resistance: the Fourth Wade Hampton Frost LectureAmerican Journal of Epidemiology10410723Google Scholar
  13. Chan, G. W., Ungvari, G. S., Shek, D. T., Leung Dagger, J. J. 2003Hospital and community-based care for patients with chronic schizophrenia in Hong Kong Quality of life and its correlatesSocial Psychiatry and Psychiatric Epidemiology38196203CrossRefGoogle Scholar
  14. Cobb, S. 1976Social support as a moderator of life stressPsychosomatic Medicine317300314Google Scholar
  15. Cronbach, J., Meehl, P. 1955Construct validity in psychological testsPsychological Bulletin52281302CrossRefGoogle Scholar
  16. Crowne, D., Marlowe, D. 1960A new scale for social desirability independent of psychopathologyJournal of Counselling Psychology24349354Google Scholar
  17. Cutrona, C. 1986Objective determinants of perceived social supportJournal of Personality and Social Psychology50349355CrossRefGoogle Scholar
  18. D’Ath, P., Katona, P., Mullan, E., Evans, S., Katona, C. 1994Screening, detection and management of depression in elderly primary care attenders. I: The acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versionsFamily Practice11260266Google Scholar
  19. Jong-Gierveld, J., Tilburg, T. 1999Living arrangements of older adults in the Netherlands and Italy: coresidence values and behaviour and their consequences for lonelinessJournal of Cross Cultural Gerontology14124CrossRefGoogle Scholar
  20. Dillman, D. 1978Mail and Telephone Surveys: the Total Design MethodWileyNew YorkGoogle Scholar
  21. Dykstra, P.: 1990, Next of (non)kin: The Importance of Primary Relationships for Older Adults’ Well-Being (Swets and Zeitlinger, Lisse)Google Scholar
  22. Dykstra, P. 1995Loneliness among the never and formerly married: The importance of supportive friendships and a desire for independenceJournals of Gerontology: Series B: Psychological Sciences and Social Sciences50BS321S239Google Scholar
  23. Ellaway, A., Wood, S., MacIntyre, S. 1999Someone to talk to? The role of loneliness as a factor in the frequency of GP consultationsBritish Journal of General Practice49363367Google Scholar
  24. Ellis, P., Hickie, I. 2001What causes mental illness?Bloch, S.Singh , B. eds. Foundations of Clinical PsychiatryMelbourne University PressMelbourne4362Google Scholar
  25. Everard, K. M., Lach, H. W., Fisher, E. B., Baum, M. C. 2000Relationship of activity and social support to the functional health of older adultsJournal of Gerontology: Series B: Psychological Sciences and Social Sciences55S208S212Google Scholar
  26. Farmer, I., Meyer, P., Ramsey, D., Goff, D., Wear, M., Labarthe, D., Nichaman, M. 1996Higher levels of social support predict greater survival following acute myocardial infarction: the Corpus Christi Heart ProjectBehavioural Medicine225966CrossRefGoogle Scholar
  27. Folstein, M., Folstein, S., McHugh, P. 1975‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinicianJournal of Psychiatric Research12189198CrossRefGoogle Scholar
  28. Fratiglioni, L., Wang, H., Ericsson, K., Maytan, M., Winblad, B. 2000Influence of social network on occurrence of dementia: a community-based longitudinal studyLancet35513151319CrossRefGoogle Scholar
  29. Furnham, A., Henderson, M. 1982The good, the bad and the mad: response bias in self-report measuresPersonality and Individual Differences3311320CrossRefGoogle Scholar
  30. Gallagher, T., Andersen, R., Koegel, P., Gelberg, L. 1997Determinants of regular source of care among homeless adults in Los AngelesMedical Care35814830CrossRefGoogle Scholar
  31. Gierveld, J. 1998A review of loneliness: concept and definitions, determinants and consequencesReviews in Clinical Gerontology87380CrossRefGoogle Scholar
  32. Goldney, R., Fisher, L., Wilson, D., Cheok, F. 2000aMajor depression and its associated morbidity and quality of life in a random, representative Australian community sampleAustralian and New Zealand Journal of Psychiatry3410221029CrossRefGoogle Scholar
  33. Goldney, R. D., Wilson, D., Dal Grande, E., Fisher, L. J., McFarlane, A. C. 2000bSuicidal ideation in a random community sample: attributable risk due to depression and psychosocial and traumatic eventsAustralian and New Zealand Journal of Psychiatry3498106CrossRefGoogle Scholar
  34. Hawthorne, G., Cheok, F., Goldney, R., Fisher, L. 2003The excess cost of depression in South Australia: a comparative study of two methods of calculating burdenAustralian and New Zealand Journal of Psychiatry37362373CrossRefGoogle Scholar
  35. Hawthorne, G., H. Herrman, and B. Murphy: In Press, Interpreting the WHOQOL-Brèf: preliminary population norms and effect sizes. Social Indicators Research (Accepted April 2005)Google Scholar
  36. Hawthorne, G., Hogan, A. 2002Measuring disability-specific patient benefit in cochlear implant programs: developing a short form of the Glasgow Health Status Inventory, the Hearing Participation ScaleInternational Journal of Audiology4153544CrossRefGoogle Scholar
  37. Hawthorne, G., Osborne, R. 2005Population norms and meaningful differences for the Assessment of Quality of Life (AQoL) measureAustralian and New Zealand Journal of Public Health29136142Google Scholar
  38. Hawthorne, G., Richardson, J., Day, N. A. 2001A comparison of the Assessment of Quality of Life (AQoL) with four other generic utility instrumentsAnnals of Medicine33358370Google Scholar
  39. Hawthorne, G., Richardson, J., Osborne, R. 1999The Assessment of Quality of Life (AQoL) instrument: a psychometric measure of health related quality of lifeQuality of Life Research8209224CrossRefGoogle Scholar
  40. Henderson, S., Duncan-Jones, P., Byrne, D., Scott, R. 1980Measuring social relationships: the Interview Schedule for Social InteractionPsychological Medicine10723734CrossRefGoogle Scholar
  41. Herrman, H., Hawthorne, G., Thomas, R. 2002aQuality of life assessment in people living with psychosisSocial Psychiatry and Psychiatric Epidemiology37510518CrossRefGoogle Scholar
  42. Herrman, H., Patrick, D. L., Diehr, P., Martin, M. L., Fleck, M., Simon, G. E., Buesching, D. P. 2002bLongitudinal investigation of depression outcomes in primary care in six countries: the LIDO study. Functional status, health service use and treatment of people with depressive symptomsPsychological Medicine32889902CrossRefGoogle Scholar
  43. House, J., Robbins, C., Metzner, H. 1982The association of social relationships and activities with mortality: prospective evidence from the Tecumseh Community Health StudyAmerican Journal of Epidemiology116123140Google Scholar
  44. Hunt, S., McEwan, J., McKenna, S. 1985Measuring health status: a new tool for clinicians and epidemiologistsJournal of the Royal College of General Practitioners35185188Google Scholar
  45. Hunt, S., McKenna, S., McEwen, J. 1989The Nottingham Health Profile User’s ManualGalen Research & ConsultanciesManchesterGoogle Scholar
  46. Hunt, S., McKenna, S., McEwen, J., Williams, J., Papp, E. 1981The Nottingham Health Profile: subjective health status and medical consultationsSocial Science and Medicine15A221229Google Scholar
  47. Jackson, H. J., Burgess, P. M. 2002Personality disorders in the community: results from the Australian National Survey of Mental Health and Wellbeing Part II. Relationships between personality disorder, Axis I mental disorders and physical conditions with disability and health consultationsSocial Psychiatry and Psychiatric Epidemiology37251260CrossRefGoogle Scholar
  48. Kawachi, I., Colditz, G., Ascherio, A., Rimm, E., Giovannucci, E., Stampfer, M., Willett, W. 1996A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USAJournal of Epidemiology and Community Health50245251Google Scholar
  49. Kissane, D. W., Clarke, D. M., Street, A. F. 2001Demoralization syndrome – a relevant psychiatric diagnosis for palliative careJournal of Palliative Care171221Google Scholar
  50. Lauber, C., Nordt, C., Falcato, L., Rossler, W. 2004Factors influencing social distance toward people with mental illnessCommunity Mental Health Journal4026574CrossRefGoogle Scholar
  51. Lee, R. M., Robbins, S. B. 1995Measuring belongingness: the Social Connectedness and the Social Assurance scalesJournal of Counseling Psychology42232241CrossRefGoogle Scholar
  52. Lester, D., Yang, B. 1992Social and economic correlates of the elderly suicide rateSuicide and Life Threatening Behavior223647Google Scholar
  53. Lewin Epstein, N. 1991Determinants of regular source of health care in black, Mexican, Puerto Rican, and non-Hispanic white populationsMedical Care29543557Google Scholar
  54. Lugton, J. 1997The nature of social support as experienced by women treated for breast cancerJournal of Advanced Nursing2511841191CrossRefGoogle Scholar
  55. Masters, G. 1982A Rasch model for partial credit scoringPsychometrika47149174CrossRefGoogle Scholar
  56. Maxwell, G., Coebergh, B. 1986Patterns of loneliness in a New Zealand populationCommunity Mental Health in New Zealand24861Google Scholar
  57. McCall, W. A. 1922How to Measure in EducationMacmillanNew YorkGoogle Scholar
  58. Midlarsky, E., Kahana, E., Corley, R., Nemeroff, R., Schonbar, R. A. 1999Altruistic moral judgment among older adultsInternational Journal of Aging and Human Development492741CrossRefGoogle Scholar
  59. Min, S. K., Kim, K. I., Lee, C. I., Jung, Y. C., Suh, S. Y., Kim, D. K. 2002Development of the Korean versions of WHO Quality of Life scale and WHOQOL-BREFQuality of Life Research11593600CrossRefGoogle Scholar
  60. Mullins, L., Elston, C., Gutkowski, S. 1996Social determinants of loneliness among older AmericansGenetic, Social, and General Psychology Monographs122453473Google Scholar
  61. Norholm, V., Bech, P. 2001The WHO Quality of Life (WHOQOL) Questionnaire: Danish validation studyNordic Journal of Psychiatry55229235CrossRefGoogle Scholar
  62. Nunally, J. 1967Psychometric TheoryMcGraw HillNew YorkGoogle Scholar
  63. Osborne, R. H., Hawthorne, G., Lew, E. A., Gray, L. C. 2003Quality of Life assessment in the community-dwelling elderly: validation of the Assessment of Quality of Life (AQoL) instrument and comparison with the SF-36Journal of Clinical Epidemiology56138147CrossRefGoogle Scholar
  64. Pedhazur, E., Schmelkin, L. 1991Measurement, Design and Analysis: An Integrated ApproachLawrence ErlbaumHillsdaleGoogle Scholar
  65. Plopa, M. 1996Anxiety dynamics in sea isolation: family determinantsPolish Psychological Bulletin27359371Google Scholar
  66. Plouffe, L., Jomphe Hill, A. 1996Distressed and lonely: health and social determinants among residents in seniors’ housingJournal of Clinical Geropsychology25160Google Scholar
  67. Polansky, N. 1985Determinants of loneliness among neglectful and other low-income mothersJournal of Social Service Research8115CrossRefGoogle Scholar
  68. Reiser, M., Wallace, M., Schuessler, K. 1986Direction-of-wording effects in dichotomous social life feeling itemsTuma, N. eds. Sociological MethodologyJossey-BassSan FranciscoGoogle Scholar
  69. Retsinas, J., Garrity, P. 1985Nursing home friendshipsGerontologist25376381Google Scholar
  70. Rokach, A. 2000Loneliness and the life cyclePsychological Reports86629642Google Scholar
  71. Rose, L. E., Campbell, J., Kub, J. 2000The role of social support and family relationships in women’s responses to batteringHealth Care for Women International212739CrossRefGoogle Scholar
  72. Ruberman, W., Weinblatt, E., Goldberg, J., Chaudhary, B. 1984Psychosocial influences on mortality after myocardial infarctionNew England Journal of Medicine311552559CrossRefGoogle Scholar
  73. Russell, D. 1982The measurement of lonelinessPeplau, L.Perlman , D. eds. Loneliness: A Sourcebook of Current Theory, Research and TherapyJohn WileyNew York81104Google Scholar
  74. Russell, D., Cutrona, C., Rose, J., Yurko, K. 1984Social and emotional loneliness: an examination of Weiss’s typology of lonelinessJournal of Personality and Social Psychology4613131321CrossRefGoogle Scholar
  75. Russell, D., Peplau, L., Cutrona, C. 1980The revised UCLA Loneliness Scale: concurrent and discriminant validity evidenceJournal of Personality and Social Psychology39472480CrossRefGoogle Scholar
  76. Sarason, B. R., Shearin, E. N., Pierce, G. R., Sarason, I. G. 1987aInterrelations of social support measures: theoretical and practical implicationsJournal of Personality and Social Psychology52813832CrossRefGoogle Scholar
  77. Sarason, I., Sarason, B., Shearin, E., Pierce, G. 1987bA brief measure of social suppport: practical and theoretical implicationsJournal of Social and Personal Relationships4497510Google Scholar
  78. Scheier, L., Botvin, G. 1996Purpose in life, cognitive efficacy, and general deviance as determinants of drug abuse in urban black youthJournal of Child and Adolescent Substance Abuse5126CrossRefGoogle Scholar
  79. Sherbourne, C., Stewart, A. 1991The MOS social support surveySocial Science and Medicine32705714CrossRefGoogle Scholar
  80. Smith, A. A. 2003Intimacy and family relationships of women with chronic painPain Management Nursing413442CrossRefGoogle Scholar
  81. SPSS,2003SPSS for Windows11.5SPSS IncChicagoGoogle Scholar
  82. Stansfeld, S. 1999Social support and social cohesionMarmot, M.Wilkinson, R. eds. Social Determinants of HealthOxford University PressOxford155178Google Scholar
  83. Straits Troster, K. Patterson, T. Semple, S. Temoshok, L. Roth, P. McCutchan, J. Chandler, J. Grant, I. The AHRC Group1994The relationship between loneliness, interpersonal competence, and immunologic status in HIV-infected menPsychology and Health9205219Google Scholar
  84. Streiner, D., Norman, G. 1995Health Measurement Scales: A Practical Guide to their Development and UseOxford Medical PublicationsOxfordGoogle Scholar
  85. Tabachnick, B. G., Fidell, L. S. 2001Using Multivariate StatisticsHarper CollinsNew YorkGoogle Scholar
  86. Taylor, A. W., Wilson, D. H., Dal Grande, E., Ben-Tovim, D., Elzinga, R. H., Goldney, R. D., McFarlane, A. C., Cheok, F., Kirke, K. 2000Mental health status of the South Australian populationAustralian and New Zealand Journal of Public Health212034Google Scholar
  87. Thoits, P. 1982Conceptual, methodological and theroretical problems in studying social support as a buffer against life stressJournal of Health and Social Behaviour23145159CrossRefGoogle Scholar
  88. Turner, R. J. 1981Social support as a contingency in psychological wellbeingJournal of Health and Social Behavior22357367CrossRefGoogle Scholar
  89. van Oostrom, M. A., Tijhuis, M. A., Van Haes, J. C., Tempelaar, R., Kromhout, D. 1995A measurement of social support in epidemiological research: the social experiences checklist tested in a general population in The NetherlandsJournal of Epidemiology and Community Health4951824CrossRefGoogle Scholar
  90. Victor, C., J. Bond, A. Bowling and S. Scambler: 2000, Growing older: The ESRC Research Programme on Extending Quality of Life: Loneliness, Social Isolation and Living Alone in Later Life. Electronic source: Access date: 15 December 2000Google Scholar
  91. Ware, J., Kosinski, M., Keller, S. 1996A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validityMedical Care34220233CrossRefGoogle Scholar
  92. Ware, J., Kosinski, M., Keller, S. 1995SF-12: How to Score the SF-12 Physical and Mental Health Summary ScalesThe Health Institute, New England Medical CenterBostonGoogle Scholar
  93. Ware, J. E., Snow, K. K., Kosinski, M., Gandek, B. 1993SF-36 Health Survey: Manual and Interpretation GuideThe Health Institute, New England Medical CentreBostonGoogle Scholar
  94. Weiss, R. 1974The provisions of social relationshipsRubin, Z. eds. Doing Unto OthersPrentice HallEnglewood Cliffs1726Google Scholar
  95. WHOQoL Group1993Study protocol for the World Health Organization project to develop a quality of life assessment instrument (WHOQOL)Quality of Life Research2153159CrossRefGoogle Scholar
  96. WHOQoL Group: 1996, WHOQOL-Bref: Introduction, Administration, Scoring and Generic Version of the Assessment (World Health Organization, Geneva)Google Scholar
  97. WHOQoL Group1998Development of the World Health Organization WHOQOL-BREF Quality of Life AssessmentPsychological Medicine28551558CrossRefGoogle Scholar
  98. Williams, R., Barefoot, J., Califf, R., Haney, T., Saunders, W., Pryor, D., Hlatky, M., Siegler, I., Mark, D. 1992Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery diseaseJournal of the American Medical Association267520524CrossRefGoogle Scholar
  99. Wu, M., Adams, R., Wilson, M. 2000ACER Conquest: Generalised Item Response Modelling SoftwareACER pressMelbourneGoogle Scholar
  100. Yammarino, F., Skinner, S., Childers, T. 1991Understanding mail survey response behavior: a meta-analysisPublic Opinion Quarterly55613639CrossRefGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  1. 1.Australian Centre for Posttraumatic Mental Health, Department of PsychiatryThe University of MelbourneWest HeidelbergAustralia

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