Table 4.

Results related to relationships of social isolation and social connectedness to psychological well-being

First author	Results	Meta-inferences
Quantitative Studies
Avis et al. (2012)	Reported social support was lower among YAs diagnosed with breast cancer who also reported more depressive symptomatology compared to those who did not report depressive symptomatology (M=4.1 vs. 4.4, p<0.001).	• In general, greater social isolation was associated with worse psychological well-being, including:  • Greater stress  • Greater unmet psychological needs • Conversely, greater social connectedness was associated with better psychological well-being, including:  • Less depression  • Less anxiety  • Less severe grief  • Less distress  • Better emotional functioning
Brunet et al. (2014)	Both lower perceived social support (r=−0.68, p<0.05) and not having previously been involved with a support group designed for people with cancer (rpb=−0.25, p<0.05) were associated with greater stress.
Geue et al. (2019a)	Positive social support was negatively associated with anxiety and depression at both baseline (anxiety: β=−0.09, p=0.008, depression: (β=−0.10, p=0.003) and at 12-month follow-up (anxiety: β=−0.09, p=0.003, depression: (β=−0.14, p=0.001). Detrimental interactions were also positively associated with anxiety at baseline only (β=0.07, p=0.042).
Geue et al. (2019b)	Positive social support was positively associated (r=0.16, p<0.05) and detrimental interactions were negatively associated (r=−0.17, p<0.05) with emotional functioning.
Hoyt et al. (2013)	Social connectedness was significantly associated with better cognitive-emotional regulation (rs ranged from 0.67 to 0.72, all ps <0.001).
Okamura et al. (2021)	Poor social support was associated with having greater unmet psychological needs (β=−0.15, p=0.02).
Trevino et al. (2013a)	Among YAs with advanced cancer, greater overall social support was associated with greater psychological HRQOL (β=0.43, p<0.001), greater existential HRQOL (β=0.43, p<0.001), and less severe grief (β=−0.28, p<0.05). Greater reported appraisal support, or having someone to talk to about problems, was also associated with greater psychological HRQOL (β=0.37, p<0.01) and greater existential HRQOL (β=0.30, p<0.05) adjusting for metastatic disease, as well as less severe grief (β=−0.29, p<0.05). Greater reported tangible support, or material aid, was associated only with greater psychological (β=0.47, p<0.01) and existential (β=0.31, p<0.05) HRQOL. Finally, greater belonging support, or the sense of having someone to engage in activity with, was associated only with greater existential HRQOL (β=0.34, p<0.01).
Xie et al. (2017)	Greater social support was associated with less distress (r=−0.81, p<0.001) as well as less anxiety and depression (r=−0.84, p<0.001).
Zebrack et al. (2017)	Reported social support was lower among distressed YAs (M=3.53, SD=0.89, range: 1-5) than non-distressed YAs (M=4.13, SD=0.78, range: 1-5; β=−0.54, p=0.001).
Qualitative Studies
Easley et al. (2013)	One YA with thyroid cancer discussed the psychological effects of mandatory physical isolation following radioactive iodine treatment. They described the treatment as “traumatic” and that it made them feel like they “had a plague or something.”	• Social isolation was related to worse psychological well-being, including feelings of:  • Distress  • Trauma  • Anxiety  • Depression  • Emotional instability • Specifically in the context of the COVID-19 pandemic, for some YAs increased social isolation enabled time off for recovery, reflection, peace, and quiet. • Increased social connectedness was sometimes related to worse psychological well-being, including feelings of worry and guilt related to feeling responsible for loved ones emotions, as well as trauma related to hearing other survivors cancer stories.
Hamid et al. (2021)	Social support from healthcare professionals was associated with decreased negative feelings, increased positive coping, and decreased fears related to disease, treatment, results, and recovery.
Hanghøj et al. (2021)	Isolation from others was related to feelings of being alone with negative thoughts, increased anxiety, emotional instability, and symptoms related to depression. Conversely, increased isolation during the COVID-19 pandemic made it easier for some YAs to have time off for reflection and find peace and quiet.
Kenen et al. (2006)	YA breast cancer survivors with strong social support expressed feelings of worry and guilt related to feeling responsible for the emotional well-being of their loved ones. Greater connectedness with other cancer survivors sometimes contributed to “trauma” related to hearing other people’s cancer stories.
Kumar et al. (2013)	Lack of family and social support was associated with emotional distress and feeling “dejected and frustrated.”
Mishra et al. (2018)	One YA explained that being around family and friends was associated with increased feelings of happiness.
Musiello et al. (2014)	Feeling isolated in the treatment environment was associated with feelings of distress.
Snyder et al. (2010)	YAs reported that support received from family improved emotional well-being.