Looking This Way and That, and Learning to Adapt to the World

Todd Heisler/The New York Times

Miles Byrin Tani, 14 months, is fitted with a camera system in an N.Y.U. lab.

Published: August 16, 2010


The infants and toddlers resemble cyborgs as they waddle and crawl around the playroom with backpacks carrying wireless transmitters and cameras strapped to their heads. Each has one camera aimed at the right eye and another at the field of view, and both send video to monitors nearby. When the video feeds are combined, the result is a recording in which red cross hairs mark the target of a child’s gaze.

Scientists are using the eye-tracking setup to learn how children look at the world as they figure out how to interact with it. In the lab, children 5 months and older crawl and walk up, down and over an obstacle course of adjustable wooden slopes, cliffs, gaps and steps. And to add to the challenge, the subjects are sometimes outfitted with Teflon-coated shoes or lead-weighted vests.

It may seem like the set for a new reality television show, but there are no prizes, except perhaps for the researchers. They hope to understand what prompts one child to respond to another, how infants coordinate their gaze with their hands and feet to navigate around obstructions or handle objects, and how these very young children adapt to changes, like those brought on by slippery footwear.

The findings provided by these eye-trackers so far (the first light enough for children to wear) suggest that infants may be more capable of understanding and acting on what they see than had been thought. “Quick gazes at obstacles in front of them or at their mothers’ faces may be all they need to get the information they want. They seem to be surprisingly efficient,” said John Franchak, a doctoral candidate in developmental psychology at New York University.

Although vision might largely seem effortless to us, in reality we actively choose what we look at, making about two to four eye movements every second for some 150,000 motions daily, said Karen Adolph, also a developmental psychologist at N.Y.U. “Vision is not passive,” she said. “We actively coordinate our eye movements with the motions of our hands and bodies.”

Eye-tracking studies have existed for more than a century, but the instruments involved were typically desk machines. The wearable eye-trackers that Dr. Adolph, Mr. Franchak and their colleagues use are based on devices developed over the last decade by Positive Science, a New York company, with money from the United States Naval Research Laboratory. They were designed to help scientists discover things like how combatants spot camouflaged targets in the field. Eye-trackers are currently being used in studies to learn the differences in how amateur and professional geologists scan landscapes and how people examine signs when looking for exits during emergencies.

To adapt the eye-trackers for children, whose noses and ears are too small for the eyeglass-mounted versions employed with adults, the founder of Positive Science, Jason Babcock, used padded headbands, spandex caps and Velcro tabs to keep the cameras in place. The headgear weighs just 1.6 ounces, about as much as a pocketful of change. Since infants often fall headfirst, spotters hold straps attached to vests the children wear to prevent them from injuring themselves with the cameras, but the children are otherwise free to move.

The scientists recruit parents and children for their work from maternity wards. Although a few toddlers could not be coaxed into donning the eye-trackers, so far the researchers have tested about 70 children with the devices.

“The beauty of this is how it helps capture what infants are thinking about during natural behavior. Since what they are looking at is related to their ongoing actions, tracking eye movements allows a pretty direct readout of what might be going on in their heads,” said Mary Hayhoe, a perceptual psychologist at the University of Texas at Austin, who did not take part in the research.

In studies of six 14-month-olds allowed to roam a playroom in Dr. Adolph’s lab cluttered with colorful balls, plush dolls and toy cars, the researchers found that in roughly a quarter of all encounters with obstacles, the infants could navigate past without centering their gaze on them. “Adults only fixate on obstacles about a third of the time, and 4- to 8-year-old children fixate on obstacles about 60 percent of the time, but it’s remarkable that infants can even navigate without looking,” Mr. Franchak said.

The researchers also found that during the studies infants looked at their mothers just 16 percent of the time. That is surprisingly low, Dr. Adolph said, given the importance a large body of past research has placed on children watching the faces of adults as they name objects to learn languages.

“These findings suggest children may not have to look very long to get the information they need, either from people or objects,” said Jeffrey Lockman, a developmental psychologist at Tulane University, who did not participate in the studies. “This gives new insights into how much information they need, or how quickly children might process this information.”

These preliminary experiments only scratch the surface of what scientists might find out about children with the eye-trackers. For instance, Dr. Hayhoe said, learning at what age infants start to look at the ground when someone drops a ball could shed light on when children are able to predict the likely consequences of actions, an important step in cognitive development.

Studies on what visual cues draw the attention of children with autism or on how children with motor disabilities interact with the world could be useful in tracking their progress or developing therapeutic interventions, Dr. Lockman said.

“This is a whole new way of asking questions that’s limited only by your imagination,” Dr. Adolph said.


When Doctors Admit Their Mistakes

Walker and Walker/Getty Images

Published: August 19, 2010


One afternoon, I overheard a nurse asking another physician how she was feeling. The physician, a young woman known throughout the hospital for her cheery disposition and sunny bedside manner, looked ashen. She smiled weakly in response and insisted that nothing was wrong.


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“She’s lying,” the nurse whispered to me as the doctor walked away. “She’s upset because risk management wouldn’t let her go to that patient’s funeral.”

That the optimistic young physician would grieve following a patient’s death hardly surprised anyone. We had all seen her go through the death of a patient before: she worked in a specialty where such loss was relatively common, yet she fearlessly continued to develop deep relationships with those she cared for. However, as the nurse so perceptively noted that afternoon, what was more difficult for her to bear this time was not the loss but the constraint imposed on the relationship afterward.

Her patient had died in the hospital a week earlier. In conversations in the hallways and clinics, other doctors and nurses combed through the facts of the event hoping to find some detail — a physiological oddity, an honest misunderstanding, even an error — that could help prevent the same thing from happening to our patients in the future.

But then rumors that the family was considering a lawsuit began to make the rounds. Soon afterward, administrators from risk management, the department of the hospital devoted to improving safety, began warning us not to talk about the case — not to one another, not to the news media and, most of all, not to the family. It was not hard to understand why under this new order of silence attending a patient’s funeral might be discouraged.

Several weeks later, I ran into my colleague once more and asked if she had heard anything about the patient’s family. “Yes,” she said lowering her voice. She pulled me over to a quiet end of the hallway and recounted a recent phone conversation with the patient’s mother. Then she took a deep breath and began grinning broadly. “I know the hospital and the lawyers and the other doctors might disagree with what I did, but I had to talk to the family,” she said. “I just couldn’t abandon them.”

Despite the best efforts of health care professionals, bad things can happen in hospitals. Up until more recently, when errors occurred, the scenario that played out was always the same. Clinicians, devastated but fearful of litigation, would shut down. Patients and their families, grieving but desperate to make sense of the event, would find that their doctors and nurses were no longer responsive or available. Eventually, the most important relationship in health care, that between patient and doctor, would cede to the most adversarial one, that between plaintiff and defendant.

In the late 1980s, one hospital system, the Veterans Affairs Medical Center in Lexington, Ky., decided to try another approach to medical mistakes. Doctors there eventually published a paper describing their ”humanistic risk management policy.” It included early review of the events that took place, full disclosure to patients of accidents or errors, fair compensation for injuries and ongoing attention to the relationship between clinicians and patients. And it appeared to decrease liability claims and costs.

Encouraged by these early results and by emerging data linking open disclosure with patient satisfaction, quality of care and improved overall safety, a few other intrepid health care systems across the country began to experiment with similar programs.

Few at the time could argue against the benefits to patients of open disclosure. But in the years since, one question has remained: are these policies also beneficial to physicians, many of whom are already struggling just to get their work done?

According to a study released this week in The Annals of Internal Medicine and the experience of one of the early-adopter institutions, the answer appears to be yes.

Since 2001, the University of Michigan Health System has handled patient injuries by initiating discussions with patients and families, conducting internal investigations and offering apologies with offers of compensation should those investigations reveal medical errors. To examine the repercussions of such an open disclosure with compensation policy, researchers analyzed the number of claims and lawsuits filed against the hospital system between 1995 and 2007, comparing data from before and after the policy took effect.


Innovate, Yes, but Make It Practical

Published: August 14, 2010

Kevin P. Casey for The New York Times

John Tao, with Kristi Hudson at a Weyerhaeuser lab in Federal Way, Wash., has led a search for new markets for lignin, a byproduct of pulp.

Kevin P. Casey for The New York Times

Lignin, shown in fiber form on spools, is typically recycled as a fuel for pulp plants.

That, it seems, is the best way to examine the steady rise in the practice of innovation management. A search of the database of the professional networking site LinkedIn found that more than 700 people listed their current job title as “chief innovation officer” and that nearly 25,000 had the word “innovation” in their job title. Many others may not have the word in their titles, but their job is to pursue opportunities that result in new products, services and more efficient ways of doing things.

So what does work in the innovation game? No single formula, to be sure. But some recent interviews with executives, consultants and academics can be distilled into three recommendations: think broadly, borrow from the entrepreneurial Silicon Valley model, and pay close attention to customers and to emerging user needs.

Here, then, are three innovation works in progress that include those ingredients, whether or not the efforts will ultimately prove to be winners:

Marching Into New Markets

John Tao joined Weyerhaeuser, the wood and pulp producer, two years ago as its vice president for open innovation, coming from Air Products and Chemicals. At Weyerhaeuser, Mr. Tao has led an initiative to find new markets for lignin, a chemical compound that binds cellulose fibers together in trees. Lignin is extracted during pulp-making as a black liquor, and is typically recycled as a fuel for pulp plants.

Yet lignin can also be converted to a solid and serve as a chemical feedstock for making a range of products. Mr. Tao, a Ph.D. chemical engineer, and his staff studied the market, including the curbs on carbon emissions that chemical producers will likely face in the future.

Lignin can be a nonpolluting alternative for producing goods as different as seat cushions and carbon fiber. Automakers, for example, are beginning to use carbon fiber as a lightweight but strong substitute for metal to improve fuel efficiency.

As a chemical feedstock, lignin is worth 10 to 20 times its value as a pulp-plant fuel, Mr. Tao said. Weyerhaeuser has a pilot plant in North Carolina to produce specialized lignin chemicals. Mr. Tao has met with chemical companies, carbon fiber makers and the Department of Energy to try to nurture new lignin markets. “You have to have some technical background,” he said, “but a lot of this work is market analysis, communications and networking with industry partners.”

Customized Discounts

For innovation champions, titles matter far less than their independence, breadth of knowledge and corporate clout, experts say. “Whatever you call it, there is a real need for a senior-level executive to be able to reach across a company and beyond to tap ideas, skills and resources,” said Henry Chesbrough, executive director of the Center for Open Innovation at the University of California, Berkeley. “It is this systems integration aspect that is central to innovation as a field and a discipline.”

Money helps too. Rick Rommel, a senior vice president of the new-business group at Best Buy, says his unit has “an internal venture capital mind-set.” Best Buy gave his group additional financing this year to sharply increase investments in experimental ventures that, he said, “explore what customers think and what technologies are ready for widespread adoption.”

The new-business group has been working with a start-up, Shopkick, which is introducing an application for iPhones, and later for other smartphones, that retailers can use to track when shoppers have entered a store and reward them with discounts.

When linked to other online browsing and buying data, the discount offers can be not only immediate, when a person is in the store, but also tailored to individual interests. A person who has browsed computer Web sites, for example, might be offered a 10 percent discount on a notebook computer.

“This really moves toward one-to-one marketing,” Mr. Rommel said.

Banks of the Future

At Citigroup, Deborah Hopkins, chief innovation officer, is also in charge of the bank’s venture investing arm. This year, she decided to move from New York to Silicon Valley to be close to its entrepreneurial networks. “It’s a small community out there,” she explained.

One Citigroup investment is in Bundle.com, a social media start-up where users can compare their spending and saving habits with those of others. The idea came from the Citigroup innovation unit, and Bundle’s C.E.O., Jaidev Shergill, came from Citigroup. The other investors in Bundle are Microsoft and Morningstar. “The whole social networking phenomenon is moving so fast, and we need to be invested in some way,” said Don Callahan, Citigroup’s chief administrative officer, who oversees the innovation unit. “Whatever the outcome, we’re going to learn a lot.”

Ms. Hopkins sees her role as “being a catalyst, to challenge people to think differently, but also pursue new ideas with a lot of rigor.” An example of that systematic approach to innovation is Citigroup’s “bank of the future” project. The first two redesigned bank branches opened in April in Japan, but the concepts will eventually be transplanted to America, tailored to local markets.

The overhaul began with a shift in mind-set, from one oriented around banking products to one focused on customers. Months of extensive customer and demographic research resulted in personality profiles of four customer types, from up-and-comers in their 30s to retiring baby boomers. Customer service and marketing were geared toward those four affluent groups.

The branches have been remade as digital banks, with touch-screen work stations and videoconferencing links to financial experts. Traditional banks have up to 100 paper forms, while the redesigned branches are almost paperless, says Darren Buckley, president of Citibank Japan. The design imprint of Eight Inc., a firm that worked on Apple’s stores, is evident in the open, minimalist interiors of the new branches.

“We’re incubating ideas, but what we’re doing in Japan is absolutely something that can be scaled out elsewhere,” said Chris Kay, a managing director of Citigroup’s innovation arm.

Tapping the Wisdom of the Crowd

Published: August 4, 2010

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Kevin Moloney for The New York Times

Seth Haber, the founder of Trek Light Gear, used crowdsourcing to decide how to expand his business.

Quick Tips:

  • Be clear about the precise task.
  • Use Twitter to get feedback on crowdsourcing firms.
  • Stay involved. Give the “crowd” feedback throughout the project.
  • Be sure to understand the expertise of the crowd you’ve chosen.


  • The definitive book on crowdsourcing.
  • View crowdsourcing examples and find a partner.
  • A group of 35 companies, including Trada, CrowdSpring and CrowdFlower, is preparing to launch an industry Web site, possibly this month.

FROM all appearances, Trek Light Gear is a substantial operation. The company sells many products, like its signature lightweight hammock, backpacks, tarps and apparel. It operates a flagship store in Boulder, Colo., distributes products online and sells at festivals and events all over the country.

But Trek Light has a full-time staff of one: Seth Haber, the founder. “I’m always trying to seem bigger,” he said.

For example, when it comes to product development, branding and market research, he has felt the pinch of being a small operation. So last year, he turned to crowdsourcing for help.

Through a local company called Napkin Labs, Mr. Haber gained access to a large pool of consumers for feedback on how the company was presenting itself and where it should be going. The process began with a brainstorming session with the principals of Napkin Labs, Riley Gibson and Warren Ng.

They filled a white board with diagrams and notes, clarified Mr. Haber’s goals for his business and identified his crucial branding question: Should he focus his efforts on the company’s hammock or expand into related areas, like products for campers?

To get an answer, a series of exploratory questions was posted to the Napkin Labs crowd members, asking them about their camping experiences and what frustrations they might have endured. Additionally, they were asked for feedback on the brand itself.

After a few weeks, Napkin Labs tallied up the responses and delivered the crowd’s verdict: expand the business. “It really confirmed my decision not to pigeonhole the business around the lightweight hammock,” Mr. Haber said.

Napkin Labs later delivered a more detailed report and is now deploying its crowd to work with Mr. Haber on new product ideas. Although compensation varies by project, the crowd is paid based on a point system that evaluates the frequency of participation, quality of ideas and influence on the outcome. Mr. Haber’s project was treated as a test case, but Napkin Labs typically charges $10,000 and up for a project that involves both crowdsourcing and consulting.

The process of crowdsourcing involves turning to resources outside your company. But instead of outsourcing a specific task or business function to a single company, crowdsourcing — also known as expert-sourcing and open innovation — makes a public, or semipublic, invitation to a community at large to provide input or work.

Thousands of crowdsourcing providers have emerged offering things like product development, logo design, fund-raising and sales-lead generation. What follows are suggestions based on the experiences of other small-business owners.

DEFINE THE JOB For the Rosen Law Firm in Raleigh, N.C., the task was improving the pay-per-click text ads it uses to generate business online. The process of strategically apportioning the monthly $6,000 budget among 80 to 100 keywords seemed an arduous task for his limited staff, said Lee Rosen, president of the firm, which specializes in divorce cases.

The company had been updating keyword campaigns based on how they performed, a time-consuming process with inconsistent results. “We were on overload,” he said, “and the bottom line is we didn’t know how well it was working.”

The firm tried automated keyword buying, but, Mr. Rosen said, found the computers failed to position the business and capture the market it wanted. Selecting keywords, Mr. Rosen concluded, is more art than science: “We needed a human being.” Or, perhaps, many human beings.

Then, Mr. Rosen heard a podcast by Niel Robertson, chief executive of Trada, a crowdsourcing firm based in Boulder that specializes in pay-per-click advertising. Trada’s more than 500 pay-per-click experts compete for their advertising clients’ business and take home the difference between what the advertisers are willing to pay for a click and what the experts actually spend to generate it.

In consultation with Trada executives, Mr. Rosen broke his $6,000 monthly budget into a daily amount and determined a maximum rate he would spend on each click and where he wanted to advertise. Trada then posted the campaign to its crowd of experts, who set about creating ads and a list of keywords. If the campaigns come in under budget, the experts pocket the difference.

Trada, which recently received $5.75 million in an investment round led by Google, now handles the planning and spending for about 5,000 keyword campaigns for the Rosen Law Firm. Mr. Rosen’s budget remains the same as it was before he retained Trada — but his employees have been freed.

Quick Tips:

  • Be clear about the precise task.
  • Use Twitter to get feedback on crowdsourcing firms.
  • Stay involved. Give the “crowd” feedback throughout the project.
  • Be sure to understand the expertise of the crowd you’ve chosen.


  • The definitive book on crowdsourcing.
  • View crowdsourcing examples and find a partner.
  • A group of 35 companies, including Trada, CrowdSpring and CrowdFlower, is preparing to launch an industry Web site, possibly this month.

“Really,” he said, “it’s magical.”

FIND A PARTNER IN THE CROWD To find prospective firms, combine a Web search for the task you want completed with the term “crowdsourcing.”

Once you have identified candidates, turn to Twitter. “This is a place where social media can be superhelpful,” Mr. Robertson said. He suggested that business owners solicit feedback on crowdsourcing providers by asking for guidance on Twitter. Be sure to include the tag “#crowdsourcing” in your post.

HONE YOUR GOAL Mr. Gibson, chief executive of Napkin Labs, said that setting clear goals made all the difference. The best queries, he suggested, are exploratory in nature: “What are people’s thoughts on product A? How can we make it better? And what will it look like in five years?” Mr. Robertson, the Trada chief executive, said that businesses needed to explain their project, their customers and their company in detail. “It’s not always easy from looking at a site to discern these subtleties,” he said. “It really helps someone who’s browsing a marketplace to understand who the customers are.”

PAY ATTENTION Mr. Rosen, the divorce lawyer, also turned to crowdsourcing for a company logo. Through 99Designs, which is based in San Francisco and specializes in graphic and Web design, he put out a query that, he said, reached designers around the world. Throughout the process, Mr. Rosen’s firm gave feedback to designers who had questions, explaining where the work was on track and where it was not. The process led to a logo that he thought reflected the company’s mission.

On Trada’s pay-per-click platform, businesses can track the individuals working on their campaigns and how those individuals are performing, offering feedback and suggestions. Engagement is crucial, Mr. Robertson said: “Don’t look at crowdsourcing as set and forget.”

PAY FOR WHAT YOU GET Crowdsourcing can lead to significant savings. Lukas Biewald, chief executive of CrowdFlower, based in San Francisco, likens the crowd to the “cloud” in that you do not have to predict what your scale is going to be — you can scale as you go, and pay as you go.

InnoCentive, a crowdsourcing company based in Waltham, Mass., worked with Precyse Technologies, a wireless technology company based in Atlanta that wanted to conserve its own engineering resources, to develop a product that would activate a device remotely.

InnoCentive helped Precyse draw up a detailed description of its goals, and the project was listed on InnoCentive’s Marketplace. The price tag was listed as $50,000. Problem “solvers,” as InnoCentive calls its work force, selected Precyse’s project from among others in the queue. The result: hundreds of ideas for a technology that could activate a device remotely. “They delivered not just a solution, but also the algorithm and calculations that proved the solution could be done,” said Rom Eizenberg, chief marketing officer at Precyse.

But if a project does not work out, the money you paid often can be refunded. When PocketMac, a software developer in San Diego, hired 99Designs to create a shopping cart icon for its site, it was dissatisfied with the results; 99Designs returned the company’s $200 upfront payment.

Redbox Steps up Offerings By Adding Blu-Ray Choices

Redbox, the popular DVD rental kiosk provider, announced it has started rolling out Blu-ray titles with availability at approximately 13,300 kiosks nationwide. Redbox will rent Blu-ray Discs at $1.50 per night plus tax and the company expects to have availability across its network of approximately 23,000 kiosk locations by the fall.

“Offering Blu-ray rentals is an exciting opportunity for Redbox to expand our product offerings and build on the relationships that we’ve established with millions of consumers nationwide,” said Mitch Lowe, president, Redbox. “Redbox is a convenient, affordable home entertainment provider and we’re delighted to offer consumers their favorite movies on the increasingly popular Blu-ray Disc format.”

According to a recent report by the Digital Entertainment Group, sales of Blu-ray players increased 103 percent in the first half of this year. The sale of almost two million set-top players during this time has increased the total number of Blu-ray players sold to an estimated 19.4 million, resulting in more consumers entering the Blu-ray rental market.

“The Book of Eli,” “Bounty Hunter,” “Brooklyn’s Finest” and “Green Zone” are among the Blu-ray titles currently available at Redbox kiosks. The number of Blu-ray titles and copies will vary by kiosk and location with new titles being added each week. Consumers can visit www.redbox.com/bluray to find a nearby Redbox location and to check Blu-ray availability in their area. Consumers can return their Blu-ray rentals to any Redbox location as part of the company’s rent-and-return anywhere policy.

Each fully automated Redbox kiosk holds 630 discs, representing up to 200 titles, including standard definition DVDs and Blu-ray Discs at select locations. Consumers simply use a touch screen to select their favorite movies, swipe a valid credit or debit card and go.

The Happiness Effect

The next time you get the flu, there will almost certainly be someone you can blame for your pain. There’s the inconsiderate co-worker who decided to drag himself to the office and spent the day sniffling, sneezing and shivering in the cubicle next to yours. Or your child’s best friend, the one who showed up for a playdate with a runny nose and a short supply of tissues. Then there’s the guy at the gym who spent more time sneezing than sweating on the treadmill before you used it.

You’re right to pass the blame. Pathogens like the influenza virus pass like a holiday fruitcake from person to person, but you probably don’t think much past the one who gave it directly to you. An infectious-disease expert, on the other hand, would not be satisfied to stop there. What about the person who passed the virus on to your colleague, the one before him and others earlier still? Contagious diseases operate like a giant infectious network, spreading like the latest YouTube clip among friends of friends online. We’re social animals; we share. (See the Year in Health, from A to Z.)

So public-health experts are beginning to wonder whether certain health-related behaviors are just as contagious as microbes. If you’re struggling with your weight, did you in effect catch a case of fat by learning poor eating and exercise habits from a friend or family member who was similarly infected by someone else? If you smoke, do you light up because you were behaviorally contaminated by smokers who convinced you of the coolness of the habit? Even more important, if such unhealthy behaviors are contagious, are healthy ones–like quitting smoking or exercising–equally so? And what if not only behaviors but also moods and mental states work the same way? Can you catch a case of happy?

Increasingly, the answer seems to be yes. That’s the intriguing conclusion from a body of work by Harvard social scientist Dr. Nicholas Christakis and his political-science colleague James Fowler at the University of California at San Diego. The pair created a sensation with their announcement earlier this month of a 20-year study showing that emotions can pass among a network of people up to three degrees of separation away, so your joy may, to a larger extent than you realize, be determined by how cheerful your friends’ friends’ friends are, even if some of the people in this chain are total strangers to you.

If that’s so, it creates a whole new paradigm for the way people get sick and, more important, how to get them healthy. It may mean that an individual’s well-being is the product not just of his behaviors and emotions but more of the way they feed into a larger social network. Think of it as health Facebook-style. “We have a collective identity as a population that transcends individual identity,” says Christakis. “This superorganism has an anatomy, physiology, structure and function that we are trying to understand.”

Read “Is Our Happiness Preordained?”

Feeling Alone Together: How Loneliness Spreads

Despite the way it feels, loneliness often has nothing to do with being alone. For some people, feelings of isolation are sharpest during times that are in fact defined by togetherness — celebrations or the holidays, for instance. Walk into a bustling shopping mall or a buzzing holiday party this time of year, and even within a crowd — or perhaps especially in a crowd — it’s possible to feel unbearably alone.

New research from experts in neuroscience and social science may give us a clue as to why. Although we tend to think of it as a self-contained emotional state — a condition that affects people individually, either by circumstance or by dint of an antisocial personality — researchers now say that loneliness is more far-reaching than that. John Cacioppo, a psychologist at the University of Chicago, believes it is a social phenomenon that exists within a society and can spread through it, from person to person, like a disease. And while everyone feels lonely once in a while, for some it becomes a persistent condition, one that has been associated with more serious psychological ills like depression, sleep dysfunction, high blood pressure and even an increased risk of dementia in older age.

For Cacioppo’s latest study, published in the Journal of Personality and Social Psychology, he partnered with leading social-network scientists Dr. Nicholas Christakis of Harvard University and James Fowler of the University of California, San Diego, who make up the team best known for its series of studies showing that emotional states and behaviors — including happiness, obesity and quitting smoking — can propagate like a wave throughout a network of people. To examine whether the contagion effect existed with loneliness, the researchers used the same data set that Christakis and Fowler had mined for their earlier studies — the Framingham Heart Study, an ongoing trial originally begun in 1948 to identify risk factors for cardiovascular disease. Thanks to the meticulous way the trial was initially set up, with investigators noting the close family members and friends of each participant to ensure follow-up over the years, Cacioppo, Christakis and Fowler now had access to a rich social network for each volunteer in their study — from family members and friends to colleagues and neighbors.

Cacioppo and his team focused on the children of the original Framingham cohort, which included more than 5,200 middle-aged men and women. Starting in 1983, more than 4,500 volunteers were asked to fill out three questionnaires, spaced two years apart, about how many days in the previous week they had felt lonely. Because most of the participants’ friends and family members were also part of the Framingham study, the scientists could track, over time, whether one person’s report of loneliness had any impact on the feelings of isolation in other members in his or her social network. Researchers were thus able to rule out the possibility that lonely people simply congregated with other lonely people, or that a shared environmental event, such as a fatal fire in the neighborhood, could have triggered mass feelings of loneliness.

The results were illuminating: If one person reported feeling lonely at one evaluation, his closest connections (either family or close friends) were 52% more likely to also report feeling lonely two years later. The effect was strongest among those in close relationships, waning as the connections became more distant, but remained significant up to three degrees of separation — in other words, one lonely person could influence whether his friend’s friend’s friend felt lonely. “Loneliness has been conceived in the past as depression, introversion, shyness or poor social skills,” says Cacioppo. “Those turn out not to be right. Research we and others have done suggests that it really is a fundamental human motivational state very much like hunger, thirst or pain.”

In other words, loneliness is not so much a symptom of being companionless as it is a driving force behind social isolation. Rather than simply reflecting the emotional state of one person, Cacioppo says, loneliness is more like an indicator of the social health of our species on the whole — a temperature reading, if you will, of how well- or not so well-integrated we are as a population.

That’s an important measure, he says, because we are, by nature, a social species; we feed off our interactions with one another and thrive when we are inspired, challenged and supported by one another. While occasional feelings of isolation are perfectly natural and normal, the new study suggests that loneliness can begin to fester in a society like a cancer if it is allowed to transmit unchecked from one person to another.

But how does a person “catch” loneliness? Based on the new data, Cacioppo theorizes that it is passed on through feelings of mistrust and negativity. “People who feel lonely view the social world as more threatening,” he says. “They may not be aware they are doing it, but lonely individuals think negatively about other people. So if you are my friend, and I started to treat you negatively, then over time, we would stop being friends. But in the meantime, our interactions caused you to treat other people less positively, so you’re likely to lose friends, and they in turn are likely to lose friends. That appears to be the means of transmission for loneliness.” People may be spreading their negative feelings simply by frowning or making other unpleasant facial expressions, making hurtful remarks or even adopting uninviting body postures.

Over time, lonely people find themselves banished to the periphery of their social networks; as they lose friends and connections, they are pushed to the fringes, where they are only marginally connected to the community. Viewed that way, say experts, the loneliness factor in a neighborhood or an apartment complex or a workplace may be an indication of how cohesive, and therefore mentally healthy, that population is. “Loneliness can be a signal for when that social connection is fraying,” says Cacioppo.

If these results hold up, treating loneliness should involve more than individual therapy for patients. It requires addressing larger, society-based issues. “People are not going to realize that there is almost a wave of loneliness that is being propagated by people two or three connections removed from them,” says Dr. Richard Suzman, director of the division of behavioral and social research at the National Institute on Aging, which funded the study. “This does suggest that one has got to look at both the network and individual simultaneously when you try to repair what seems to be a cascading, spiraling descent in which loneliness gets increasingly paired with isolation.”

That strategy may mean looking at things such as community design or social-support networks that allow some populations to keep all their members hovering near the center of their networks, rather than drifting to the edges. It’s not necessarily the number of connections people have that matters but the quality of them. Communities that encourage regular interaction among its members, either through regular gatherings or mutually beneficial projects that require everyone’s input, for example, are more likely to foster stronger, more meaningful connections than those that don’t encourage social investment. “Ultimately, what we hope to do is not only intervene at the individual level, but also at the city planner and development level as well,” says Cacioppo.

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