Americans between the ages of 7 and 22 experience much higher rates of loneliness than other generations. Factors such as social media usage contribute to feelings of loneliness, which are compounded by the vulnerability and peer exclusion often experienced during adolescence. Social isolation leads to detrimental effects on both the physical and mental health of teenagers who experience it. Such effects include decreased sleep efficiency, a weakened immune system, and depression. Further, those who are lonely and isolated are more likely to participate in risky behavior such as substance abuse. Leading practices for treating isolation among adolescents (or its causes or effects) include empowering young people and fostering relationships between them, providing a safe place for adolescents, facilitating meaningful online communication, and raising awareness for teen depression and suicide.
Isolation - Social isolation; a lack of contact between an individual and family or society; a lack of good relationships with family, friends, and others. 1
Generation Z (Gen Z) - The generation of individuals born since 1997, with no set endpoint as of 2019 2 , this generation makes up 27% of the US population, and is regarded by some as the largest and most ethnically-diverse generation in US history. Individuals born during this generation are said to be the first raised with the internet and social media. 3
Parasuicide - When an individual harms themselves, but it does not result in death. 4
Cyberbullying - Bullying that takes place over digital devices like cell phones, computers, and tablets. 5
Invisible audience - The perceived audience of an individual who believes that “others are constantly focusing attention on him or her, scrutinizing behaviors, appearance.” 6
In recent years, studies have revealed that Americans—despite being very connected to each other digitally—are more lonely than ever. 7 According to a 2018 survey by health company Cigna, “nearly half of Americans report sometimes or always feeling alone or left out.” 8 The same survey found Generation Z (Gen Z) to be the most isolated generation, with loneliness scores averaging 10 points higher than those of the Greatest Generation (individuals born 1901–1927 9 ). So, while many people associate old age with loneliness, the proportion of those who report feeling lonely actually decreases with age. In the 2018–2019 Community Life Survey in England, 10% of 16- to 24-year-olds reported often or always feeling lonely compared to only 6% of 25- to 34-year-olds. 10 While this was not a survey of American citizens, this demographic is comparable, and England has reported very similar loneliness data to America in other surveys and studies. 11
Feelings of social isolation and loneliness can manifest themselves in a number of ways. Some people may be surrounded by many people but still feel alone, while others may isolate themselves because they prefer to be alone. 12 Both of these circumstances are detrimental to the mental and emotional health of those experiencing loneliness—male and female. Though both boys and girls experience social isolation, research suggests that young girls are more sensitive to social stress than boys and that social networks are particularly important for Gen Z girls. 13
Loneliness rates in the US are some of the highest in the world. An international survey found that more than 1 in 5 adults in the US and UK report often or always feeling lonely while only 1 in 10 adults in Japan report such levels of loneliness. Cases in Japan were, however, much more severe on average. 14 There is little evidence that loneliness increases across generations in these countries, yet the problem persists and shows no evidence of improving over time despite technological developments that have increased opportunities for connection. 15 Furthermore, social media and other digital forms of communication have often been blamed for causing social isolation.
Premier loneliness studies most often employ the UCLA Loneliness Scale, which consists of 20 items that measure the subjective feelings of loneliness and isolation. The scale measures isolation by asking subjects to respond to questions such as “How often do you feel that there is no one you can turn to?” and “How often do you feel that your relationships with others are not meaningful?” by rating 1 (Never) to 4 (Often). 16 Some difficulties with research about social isolation and loneliness exist due to its subjective nature. Regarding direct causes and consequences of loneliness, many studies prove only correlation. Loneliness and substance abuse, for example, are proven to be related, but it is not necessarily proven whether one causes the other. Additionally, there is a great lack of information about social isolation before the year 2000 as well as in developing countries.
Young adults with high social media usage are more likely to be lonely than their counterparts who spend less time on social media. 17 Generation Z is the first generation to have been raised with social media, and as of 2018 over 70% of US teens used more than one social media platform. Additionally, 95% of teens had access to a smartphone and 43% said they were online almost constantly. 18 Watching people connect on social media can induce feelings of loneliness, especially among teenagers. 19 Further, young adults who already feel lonely often turn to social media for compensation, which may actually worsen their loneliness. 20 Media-related loneliness continues to grow as access to digital media grows.
Social media use itself does not always cause feelings of loneliness. Rather, studies have shown that the motives behind young adults’ social media use play a crucial role in how it makes them feel. 21 Young adults who use social media for social skill compensation, interpersonal contact, and self-expression experience overall increased loneliness, while those who use it with the intent of maintaining contact, following friends, and making new friends are reportedly less lonely. 22 23 Additionally, adolescents who spend large amounts of time passively scrolling through their feed experience increased feelings of isolation and an overall decreased sense of well-being. 24
One study with adolescent subjects found that “family communication quality moderate[s] the relationship between daily CMC [computer-mediated communication] use and loneliness,” showing that youth with strong family relationships are likely less susceptible to the isolating effects of social media. 25 The families of Gen Zers are more diverse and non-traditional than those of any other generation—many members of Gen Z are raised in single parent homes, for example. 26 Although families may look different for Gen Zers, there is no evidence that these circumstances have negative effects on the relationships Gen Zers have with their family members and, regardless of family structure, adolescents with strong family relationships are less prone to experiencing isolation as a result of social media use. 27
Any young adult who spends less time developing relationships with friends would be pulled from healthy social networks involving face-to-face interaction. Research shows, however, that girls are affected in greater numbers. Although both Gen Z boys and girls are affected by social isolation, the University of Michigan’s Monitoring the Future project indicates that, since the beginning of the smartphone era in 2007, girls have “dramatically decreased the amount of time they spend . . . seeing friends” or participating in other social activities. 28
Adolescence is a critical period of psychological development for boys and girls, and substantial changes to the brain during this period make teens particularly vulnerable to “emotional turmoil and behavioral extremes.” 29 The adolescent stage of development is marked by rapid increases in mental capabilities and is also characterized by difficulty controlling behavior and emotions. 30 This lack of control is manifest in adolescents’ strong, emotional reactions to traumatic social situations such as rejection or a breakup. 31 Such experiences have been shown to lead individuals to isolate themselves from their peers. 32 Adolescent girls are particularly susceptible to low self-esteem and feelings of anxiety, which consequently makes them more prone to feeling lonely. 33
Another phenomenon of adolescent psychology is the invisible audience. A term developed by David Elkind, the invisible audience is an individual’s belief that “others are constantly focusing attention on him or her, scrutinizing behaviors [and] appearance.” 34 While anyone can experience the invisible audience, it is exhibited primarily in adolescents. Due to its difficulty to measure, the proportion of adolescents who experience its effect cannot be quantified. 35 Multiple studies suggest that if an adolescent feels as though they are constantly being watched and scrutinized by their peers, it fuels their social anxiety and contributes to feelings of loneliness. 36 While adults have coping skills necessary to combat loneliness, adolescents are still developing those skills and are therefore more vulnerable to loneliness during a time in their lives when being accepted is crucial to how they feel about themselves. 37
Peer exclusion is common among teenagers and contributes to loneliness. Fear of social rejection plays a significant role in the lives of teenagers because, when individuals transition from childhood to adolescence, relationships with their peers take on heightened importance. 38 Many adolescents focus a large amount of their energy on what their peers think of them and are more “reactive to explicit cues indicative of social inclusion or exclusion” as a result. 39 Research from the National Academy of Sciences shows social rejection producing the same sensory response in the brain as physical pain. 40 Teenagers’ emotional responses to social exclusion oftentimes lead them to isolate themselves from others because they feel like they do not belong, which can be a painful and difficult feeling to continually experience. 41
Chronically lonely adolescents are also hypersensitive to social exclusion and consistently demonstrate “more negative emotional responses when confronted with social exclusion.” 42 Such sensitivity causes these adolescents to adopt a “prevention-focused interaction style” of avoiding negative social experiences rather than seeking out relationships and friendships with their peers. They also demonstrate hypersensitivity to social inclusion, feeling reduced tension and anxiety when they get included but not necessarily feeling deeply satisfying emotions. 43
Adolescents who are excluded or bullied by peers often draw away and choose to isolate themselves in an attempt to avoid further social discomfort. 44 In the age of digital media, cyberbullying has emerged as a significant problem among Gen Z individuals. 45 Cyberbullying is a new form of bullying and harassment that occurs over text message, email, phone call, or social network site, 46 and loneliness is found to be a predictor of cybervictimization. 47 According to the National Center for Educational Statistics (NCES), during the 2014–2015 school year over 20% of students aged 12–18 reported being bullied. 48 In a 2017 survey distributed to American students grades 9–12, 15% of the students reported being cyberbullied specifically sometime in the 12 months prior to the survey. 49 Roughly 14% of students who report being bullied indicate that it does have a negative effect on their relationships with friends and family, 50 and this percentage is likely even higher as this is only a measurement of those who reported such an effect.
Social isolation has been proven to cause long-term psychological damage. One study found that lonely people report being less happy, less satisfied, and more pessimistic and experiencing more depressive symptoms overall. 51 Loneliness is known to be an important factor in the development of depression. 52 Social isolation contributes to depression as well as other mental health disorders such as post-traumatic stress disorder. 53 Researchers attribute this correlation between loneliness and mental health problems to the fact that, when one is lonely, one has “tendency to develop low self esteem, difficulty or inability in developing and maintaining relationships with others, poor problem solving skills, and an unstable self-concept.” 54 Adolescents are already more prone than other individuals to develop mental health disorders such as anxiety or depression, and feelings of loneliness and isolation only amplify the risk of developing such disorders. 55 Other factors related to loneliness, such as lack of social support and lack of sense of belonging, are also proven to contribute to depression in adolescents. 56
Studies show that, during adolescence, girls experience depression at twice the rate of boys and, regardless of sex, feelings of loneliness grow alongside depression. 57 Mental health problems, therefore, are not completely unique to girls but are more common among them than among boys. In the worst cases, loneliness and social isolation have been linked to suicide among adolescents. There is a strong relationship between suicide ideation and both the subjective feeling of loneliness and the objective state of being alone. 58
In addition to emotional and mental health, physical health is another important factor to assess when evaluating the consequences of loneliness. Research published by the US National Library of Medicine shows that high levels of loneliness and weak social networks are associated with poor antibody responses to vaccines, proving loneliness has harmful effects on the immune system and the body’s ability to fight harmful diseases. 59 The same study shows loneliness is also associated with “greater psychological stress” and “poorer sleep efficiency.” 60 The demands on a teenager’s body are already significant due to increased amounts of growth, so the strong stress response and high cortisol levels caused by loneliness are particularly damaging for that age group. Additionally, proper sleep is critical to a teenager’s development, and poor sleep efficiency contributes to a variety of other problems including decreased emotional regulation and increased risk of developing depression. 61
A 2010 Brigham Young University study found “a lack of social relationships is a risk factor for death.” In other words, the resultant stress imposed on the body may actually decrease life expectancy. 62 Loneliness expert Julianne Holt-Lunstad describes low social interaction as a health risk equivalent to smoking 15 cigarettes a day. Additionally, loneliness presents a greater risk for mortality among young populations than among older populations and social isolation is more predictive of death for people under 65. 63
Researchers studying the relationship between loneliness and physical health found loneliness related chronic stress can cause low-grade peripheral inflammation, which has been linked to cardiovascular diseases. 64 Low-grade peripheral inflammation is a process that triggers an immune response in the body similar to a fever. 65 It can be caused by a number of things including infection or other inflammatory conditions such as loneliness. 66 There have also been various studies suggesting loneliness causes obesity, physiological aging, cancer, and poor hearing. Loneliness has real, damaging effects on the physiological processes of the brain and body. The effects on adolescent girls are amplified, in that lonely girls are more likely than lonely boys to report later consequences of obesity and poor health. 67
Substance abuse among teenagers is a persistent issue in the United States and globally, and it must be considered alongside the issue of loneliness and social isolation. Adolescents tend to exhibit risky behaviors, and those behaviors—including substance abuse—are further fueled by feelings of loneliness and social isolation. One specific study that employed the UCLA Loneliness Scale found a correlation between loneliness and drinking problems and evidence that loneliness is likely a “source of vulnerability to alcohol problems.” 68 As teenagers, many Gen Zers lack healthy coping mechanisms when it comes to mental distress and therefore turn to harmful substances, including alcohol, when they are struggling emotionally. This is a particularly dangerous behavior because alcohol abuse or other substance abuse problems can lead a teenager to further isolate themselves to hide their problem. 69 70
While substance abuse is an issue that affects both boys and girls, research also suggests there are increased risks for lonely female adolescents. 71 One study found that being lonely and female significantly increased the odds that one had recently, or ever, consumed an alcoholic beverage. 72 Alcoholism and other forms of substance abuse are incredibly dangerous and harmful to overall health, especially when addictions are developed during adolescence. Substance abuse during adolescence damages the brain by interfering with neurotransmitters, and alcoholism, specifically, damages the liver and reproductive systems. 73 Substance abuse is, therefore, a consequence of social isolation that also further worsens the other negative effects of loneliness.
There are organizations that strive to provide a safe place for adolescents and create an environment where they can connect, build relationships, and receive help with regards to social isolation or other emotional struggles. Environment plays a key role in how teenagers feel about themselves and how they develop meaningful relationships. 74 Providing safe environments for teens may make them less likely to engage in risky behaviors, such as substance abuse, that could further isolate them from others. 75 This intervention includes providing a safe environment for teens and building their self-esteem, which are factors that can offset destructive feelings of loneliness and social isolation. 76
An organization employing this practice is Newport Academy, a unique teen rehabilitation center that seeks to empower struggling teens through “clinical expertise and holistic care.” 77 They provide safety for their admits and focus on offering unconditional love to teenagers and their families. Newport Academy treatment centers welcome teens that struggle with eating disorders, anxiety, and substance abuse as well as loneliness and social isolation. With a staff of more than 200 clinicians, therapists, and specialists, Newport Academy targets underlying causes of destructive behaviors in order to prevent any relapses into such behaviors. Newport Academy provides a variety of specific programs for teen females, teen males, young adult females, and young adult males, all attempting to ensure that individuals receive care tailored to their needs. Newport Academy’s philosophy for assisting lonely teens is based on research and involves holding therapy sessions to facilitate strong family bonds and providing teens with frequent, meaningful, in-person interactions, helping to build healthy habits. 78
Newport Academy devotes a substantial amount of resources to measuring the outcomes of their programs. More than 400 Newport Academy participants were surveyed in the latest measurement of outcomes, which reported, on average, a 58% decrease in levels of anxiety after 3 weeks at Newport Academy. 79 To measure outcomes, they utilized the General Anxiety Disorder Assessment (GAD-7) to measure or assess the severity of generalized anxiety disorder and the Patient Health Questionnaire (PHQ-9) to measure the severity of depression. 80 81 Newport Academy admits began the program with an average GAD-7 score of roughly 9.5, a moderate anxiety level. After 12 weeks, however, participants were scoring below 5 on average, a mild anxiety score. Newport Academy admits saw similar decreases in levels of depression during their stays, measured using the PHQ-9. Average rates of overall well-being (according to the WHO-5 Well-Being Index) among the teenagers and young adults of all genders went up throughout the weeks spent at Newport Academy. 82 Newport Academy does not provide information on direct impact through randomized control trials, which may have been infeasible and unethical in this case because randomized control trials would require that some struggling teenagers be left without treatment.
While evidence of healthy communication and decreased levels of anxiety and depression may suggest lower levels of social isolation among the teenagers admitted to Newport Academy, social isolation is not directly measured by Newport Academy. As a result, there is not conclusive evidence that the practice actually reduced loneliness among teens. Additionally, although Newport Academy has locations in all 50 states and serves a total of 3,500 families, their program is only able to provide an intervention to those who are admitted to one of their locations. According to the Cigna survey on loneliness among Americans, there are likely millions of additional Generation Z individuals who feel lonely or who are socially isolated. 83 This indicates that only a small percentage of lonely American’s experience Newport Academy’s holistic, hands-on approach to combating feelings of isolation.
Empowering young people when they hit adolescence by connecting them to a community of other young people can decrease levels of loneliness and improve overall mental health. Girls experience specific struggles during adolescence related to self-confidence, and they benefit greatly from strong relationships. Studies have consistently shown that, when girls hit adolescence, their confidence and self-esteem drop dramatically. 84 Research reveals that boys’ and girls’ confidence levels are essentially the same up to age 12, but after that “a confidence gap opens between boys and girls that doesn’t close through adolescence.” 85 Researchers have recorded girls’ confidence levels at nearly 30% lower than boys’, at their lowest point. 86 Positive, confidence-building experiences with peers during adolescence may help girls develop meaningful relationships that combat loneliness and social isolation.
One of the most well-known organizations employing this practice is Girls on the Run (GOTR). Girls on the Run works to involve 3rd through 8th grade girls throughout the US in running activities and races to build their self-esteem as they enter adolescence, with the overall aim to strengthen both the emotional and physical health of girls. 87 Their curriculum considers “the whole girl” and focuses on the important connection between mind and body with a combination of targeted lessons and physical activity. The organization has 3 individual programs: one for 3rd through 5th grade girls, one for 6th through 8th grade girls, and a week-long program called Camp GOTR, also for 3rd through 5th grade girls. Elementary aged girls run twice a week and are taught lessons with a research-based curriculum that covers topics such as “understanding ourselves,” “valuing relationships and teamwork,” and “recognizing how we can shape the world at large.” 88 For middle school aged girls, the curriculum covers topics more applicable to their lives with the following objectives: learn more about themselves, become independent and critical thinkers, develop skills to write their own stories, and find inner strength through physical activity.
Of the girls who participated in GOTR, 97% said “they [learned] critical life skills including resolving conflict, helping others or making intentional decisions.” 89 GOTR serves over 200,000 girls annually, and, according to their measurements, there was a “40% increase in physical activity level among girls who were least active at the start of the season.” 90 Another outcome of the program is that “85% of girls improved in confidence, caring, competence, character development or connection to others.” 91 Because low self-esteem is a risk factor for loneliness in adolescence, improving confidence is a productive step toward decreasing occurences of loneliness among adolescents. 92
Girls on the Run achieves excellent outcomes in building confidence in adolescent girls; however, their program only indirectly addresses social isolation and loneliness. Because Girls on the Run only involves girls in their programs, they do not reach adolescent boys dealing with similar feelings of loneliness or low self-esteem. Additionally, while the training groups and coach mentors are likely to foster meaningful relationships, that result is not guaranteed. It is also difficult to know just how effective the lessons are because direct impact is not measured. However, because peer exclusion is a contributing factor to social isolation, increased interactions with peers is an effective intervention for social isolation among Gen Z. 93
As was previously discussed, social isolation and feelings of loneliness likely contribute to emotional disorders such as depression. 94 Further, “prevalence of suicide ideation and parasuicide [increase] with the degree of loneliness” an individual is experiencing. 95 Raising awareness and educating teenagers and their parents about the signs of depression can empower individuals to intervene sooner rather than later, potentially saving lives. The practice of raising awareness also includes destigmatizing depression and isolation and facilitating positive conversations about the signs of these conditions and the more severe signs of suicide ideation.
One organization called the Society for the Prevention of Teen Suicide (SPTS) aims to reduce the number of teenage suicides and attempted suicides by employing this practice. They raise awareness for teen suicide by developing and promoting programs that educate parents and youth about the signs of depression. Ingrained in their work is a dedication to remove societal stigmas about suicide. 96 SPTS has developed “solid prevention programs that are grounded in research to ensure state-of-science applicability,” and they have a clinical advisory board made up of experts in suicide prevention. 97 SPTS has also created a specific curriculum titled Lifelines that educates teachers on how to work with students struggling with depression. Additionally, although it is designed for implementation in middle and high schools, the curriculum is created for the “whole school community” and provides resources for school faculty and parents. 98 For parents of adolescents, SPTS has created a short, free video about identifying signs of depression and isolation.
The Society for the Prevention of Teen Suicide measures and provides information about its outputs, including the number of students that have received SPTS training on suicide prevention and the number of schools that have connected faculty, staff, and parents to the program. Approximately 350,000 educators in the United States have taken the free online course provided by SPTS. SPTS has also presented their curriculum in person to over 12,500 educators. As estimated in their outcome report, if “most of these educators [have] direct contact with at least 25 students, over 8.75 million students may have been impacted by the positive lessons these educators have received about identifying and reaching out to students” who are at risk of committing suicide. 99 Additionally, SPTS’s free video titled Not My Kid: What Every Parent Should Know About Youth Suicide has been viewed over 45,000 times on their website and hard copies were distributed directly to about 20,000 schools. 100
The largest gap of this practice, in relation to social isolation, is that it treats only a possible consequence of social isolation, not the issue itself. While research would suggest that loneliness and social isolation contribute to emotional disorders such as depression, 101 it should be noted that social isolation does not lead to depression in all cases, and depression as a mental illness cannot always be prevented. There are many conditions that often precede depression which are not addressed by SPTS, and the intervention happens after contributing conditions have already developed. Overall, there is a shortage of evidence confirming the effectiveness of this practice because it is difficult to determine whether or not the message and curriculum are effectively received by teachers and internalized by students.
Social media and other online communications contribute to social isolation and loneliness. However, constructive online connections can also mitigate feelings of loneliness by helping individuals to share their emotions in a healthy way. This practice aims to take advantage of the connected nature of the internet by providing an online platform where people can talk to each other about loneliness and how it affects their lives. There is a strong stigma against loneliness—people are more likely to admit they are depressed than to admit they are lonely. 102 Online platforms make it easier to express feelings of loneliness, regain feelings of connectedness, and develop meaningful relationships with others.
One online organization named The Cost of Loneliness Project employs the practice of creating an online platform with resources for lonely and socially isolated people. They increase awareness of the detrimental effects of loneliness and work to destroy stigmas against loneliness in our society. They accomplish this by sending newsletters, sharing uplifting podcasts, and allowing people to communicate about their emotional burdens. 103 Their interactive website has features that allow people to learn about loneliness as an emotional crisis and receive advice on addressing feelings of isolation within themselves. The website also provides contact information for a variety of resources to help people feel connected or receive professional help if they need it. The resources that help users connect with other people include organizations such as VolunteerMatch, the American Hiking Society, and the Boys and Girls Club. Resources cited to help those who require professional help include the Suicide Prevention Lifeline and the Jed Foundation, an organization that empowers teens and young adults with “skills and support to grow into healthy, thriving adults.” 104 The Cost of Loneliness Project website also features a page titled “Faces of Loneliness,” which includes stories about people and their personal experiences with social isolation, shared in an attempt to help users feel they are not alone.
Another effort to decrease levels of loneliness through an online platform was made in 2018 when Mark Zuckerberg, CEO of Facebook, voiced the company’s efforts to reduce the number of viral videos on their network. Although this effort caused a significant drop in Facebook’s stock, Zuckerberg stood behind his decision, indicating that their focus was on “making sure Facebook isn't just fun to use, but also good for people's well-being and for society.” 105 These efforts aim to reduce feelings of loneliness and encourage meaningful interaction between people online.
The Cost of Loneliness Project, a digitally native organization, does not measure its outcomes or impact. Because nearly all of their operations occur online, tracking down users to measure the outcomes and impact of the organization may invade the privacy of users or may simply be infeasible. Information on outputs is also limited, meaning there is very little evidence of whether or not the intervention is improving circumstances for lonely, isolated adolescents in the United States.
Facebook’s effort in 2018 was meant to “[encourage] meaningful connections between people rather than passive consumption of content,” and it resulted in 50 million less hours spent on Facebook per day. 106 Because time spent passively scrolling through social media is a contributing factor to loneliness, this intervention is very likely to be effective at combating loneliness among Facebook users, although impact has not been measured.
The Cost of Loneliness Project does not cater to a specific demographic but attempts to reach all kinds of people who are feeling lonely or isolated. Because its operations exist primarily online, however, there is no guarantee the resources provided will actually be used. The impersonal nature of this intervention makes it difficult to understand whether users are helped, hurt, or left unchanged. The webpage may provide useful information about loneliness and supply viewers with ways to meet people in the community, but it does not address the situation of people who feel debilitated by social isolation and are, therefore, unwilling or unable to utilize the resources. The intervention only has the potential to be successful for a user who discovers the website and takes the initiative themselves to use the resources provided. Additionally, studies have shown that meaningful face-to-face interactions have the most potential to improve conditions of loneliness, and The Cost of Loneliness Project is not able to provide users this kind of important human interaction. 107
Because Facebook has over 1.5 billion daily active users as of 2019, 108 their efforts to decrease the amount of viral videos circling through their network reached many people, but were not necessarily directed toward Gen Z. Also, Gen Zers use Facebook less than other generations and spend much more time on Instagram, Snapchat and YouTube. 109 Levels of loneliness among Facebook users were not measured before and after the change, so it is unknown whether levels of loneliness changed as a result of less passive consumption.
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