自尊、社交焦虑与生活满意度：基于失明/正常视力青少年的有中介调节模型

郑 爽 李美荣 洪秀秀 凌 虹

(1.华南师范大学心理学院和心理应用研究中心，广州 510631;2.广东省心理健康与认知科学重点实验室，广州 510631;3.广东省急救心理援助与应急技术中心，广州 510631;4.汕头大学教师发展与教育评估中心，汕头 515063)

1 Introduction

Previous research supports the notion that life satisfaction is not only a key indicator of subjective well-being (Proctor,Linley,& Maltby,2009),but also an important construct in positive psychology (Gilman & Huebner,2003).Numerous studies have found that positive evaluations of life satisfaction are linked with success across multiple life domains (e.g.,less stress:Samaha & Hawi,2016;social support:Adams,Rabin,Silva,Katz,Fogel,& Lipton,2016;personality:Boyce,Wood,& Powdthavee,2013).However,most of these studies are primarily based on general samples;there are only a few studies carried out with blind adolescents concerning their life satisfaction (Broman et al.,2002;Labudzki,Jakub,& Tasiemski,2013).Blindness is associated with severe consequences in people’s life and development (Angelopoulou-Sakantami,2002).Due to the constraints in orientation,mobility,access to information and communication people with visual impairment often suffer from a lack of interpersonal relationships and accessibility to health care.Thus,it is not surprising that visual impairment is a critical factor in determining self-esteem (e.g.,Bowen,2010),social anxiety (e.g.,van der Aa et al.,2015),and life satisfaction (e.g.,Brown & Barrett,2011).Children with visual impairment face severe difficulties in their everyday life in the cognitive,social and motor domains of their development (Kotsis & Andreou,2004).Life satisfaction is a core construct as it reflects the perceived quality of life and one’s feeling and attitude about their life.The present study mainly focused on how factors,such as self-esteem and social anxiety,affected life satisfaction in blind adolescents relative to their sighted peers.

1.1 The relationship between self-esteem and life satisfaction

Self-esteem is one’s attitude towards the self,referring to the general sense of his or her value or worth (Mäkikangas & Kinnunen,2003).Several reports have shown that individual differences in life satisfaction are closely and positively correlated with self-esteem in adolescents (e.g.,Moksnes & Espnes,2013) and adults (e.g.,Bozorgpour,& Salimi,2012) across individualistic cultures and collectivistic cultures (Diener & Diener,2009).That is,the more positive a person is regarding his or her self-evaluation,the higher level of life satisfaction she or he will have.For example,some evidence shows that self esteem provides benefits to one’s life satisfaction (Proctor,Linley,& Maltby,2009).Furthermore,a cross-culture study involving more than ten thousand undergraduates from 31 countries has found that the correlation index of self-esteem and life-satisfaction was as high as 0.47 (Diener & Diener,2009).

Additionally,it has been found that self-esteem could affect many aspects of life satisfaction such as academic achievement (Booth & Gerard,2011) and social relationships (Erol & Orth,2016).What is more,cross-sectional analyses have shown that self-esteem is the most important determinant of life satisfaction among the predictors such as capacity,personality and demographic variables (e.g.,Gilman & Huebner,2003;Zhang & Leung,2002).However,in reviewing the literature,the interaction between self-esteem and life satisfaction has not been fully examined in blind adolescents in previous studies.People with visual disability feel alone and usually have trouble making new friends.They have lower self-esteem and social skills than sighted people (Bakhshi,2017).Low self-esteem leads to physical and mental disorders such as anxiety,depression,behavioral and communication problems,and deviant behaviors (e.g.,Mann,Hosman,Schaalma,& de Vries,2004).In a study done by Papadopoulos,Montgomery and Chronopoulou (2009),the level of sexual self-esteem was very low among both blind and visually impaired youths.Similarly,Vanhalst,Luyckx,Scholte,Engels and Goossens (2013) showed that low self-esteem of an individual could provide the underlying conditions for feelings of loneliness,indifference,depression,and hopelessness.Such consequences are likely to cause impaired social and interpersonal relationships as well as life satisfaction.Thus,there is potential relationship between self-esteem and life satisfaction in blind adolescents.

Blindness has been found to be associated with increased risk to self-esteem and life satisfaction (Stelmack,2001;Robinson & Lieberman,2004).Several studies have shown that blind individuals usually have lower self-esteem,more passivity,more learned helplessness,and limited assertiveness (Papadopoulos,Montgomery,& Chronopoulou,2013),and tended to report decreased functional status and quality of life,but increased emotional distress relative to their sighted peers (Stelmack,2001).Tuttle and Tuttle (2004) suggested that the lower level of self-esteem in visual-impaired people may be due to a disproportionate number of negative self-reflections they may experience in comparison with their sighted peers.Adolescents who are visually impaired may have more difficulties developing positive self-esteem.The failure to ask for help from sighted peers also contributes to their lower level of self-esteem (e.g.,Huurre,Komulainen,& Aro,1999).Therefore,we proposed being blind or not would moderate the relationship between self-esteem and life satisfaction.

1.2 The role of social anxiety

Social anxiety is a feeling of discomfort,fear,or worry that is centered on one’s interactions with others (Antony & Swinson,2000).It is typically characterized by an intense fear of being judged negatively by others,which results in insecure feelings and lack of confidence (Stopa,& Clark,2000;Schneier,Blanco,Antia,& Liebowitz,2002).Previous studies have indicated a negative correlation between anxiety and life satisfaction,as well as between anxiety and self-esteem (Sola-Carmona et al.,2013).For example,de Jong (2002) used an Implicit Association Test as a measure of Implicit self-esteem (ISE) and found relatively low ISE in females scoring high on symptoms of social anxiety.Abdollahi et al.(2016) showed that adolescents with poor self-esteem were more likely to have social anxiety problem.Additionally,it was found that self-esteem served as a protective factor against social anxiety.That is,high levels of self-esteem would help reduce anxiety and anxiety-related defensive behavior (Greenberg,2008;Pyszczynski,Greenberg,Solomon,Arndt,& Schimel,2004).

Quality of life was inversely associated with social interaction anxiety (Olatunji,Cisler,& Tolin,2007).Eng,Coles,Heimberg,and Safren (2005) also showed that levels of life satisfaction were significantly related to severity of social anxiety.Similarly,Beutel et al.(2010) found that life satisfaction was strongly associated with the absence of social anxiety.That is,the absence of anxiety is of crucial importance for the maintenance of life satisfaction.Additionally,people diagnosed with generalized social anxiety disorder found less meaning in life and put less effort towards a purpose in life (Kashdan,Weeks,& Savostyanova,2011;Weeks,Heimberg,Rodebaugh,Goldin,& Gross,2012).

Adolescence is a special period that involves considerable social,cognitive and physical changes.The social relationships of adolescents play a critical role in their comprehensive development.They have an expansion of peer networks,pay more attention to close friendships,and even expect the emergence of romantic relationships (La Greca,& Harrison,2005).As the interaction with others increases,social anxiety may become a severe problem during adolescence,and have a long-term effect on adolescents’ life satisfaction (Hebert,Fales,Nangle,Papadakis,& Grover,2013;Khandagale & Dumbray,2017).

Blind adolescents may have more difficulty in their social relationships.Researchers have suggested that the youth who were visually impaired were more socially immature,more egocentric,and often had difficulty in observing and imitating peers,making them unpopular in local school (Rosenblum,2000;Tuttle & Tuttle,2004).Blind adolescents cannot communicate through eye contact,which is a useful form of nonverbal communication and is thought to have a large influence on social behavior.Adolescents who are blind may have more difficulty communicating with others.Partially,this difficulty stems from their self-abasement and the stereotypes they face,which further impinges on their feelings of happiness and psychosocial adjustment.Thus,it is not surprising that blind adolescents were found to be lonelier and have fewer friends than their sighted peers (Huurre & Aro,2000).Kef and Bos (2006) found that blind adolescents had less experiences in intimate relationships.

In reviewing the literature,most of the previous studies primarily focus on the pairwise links between self-esteem,life satisfaction and social anxiety among sighted adolescents.The present study sought to examine the structural relationships among self-esteem,social anxiety,and life satisfaction among blind adolescents and their sighted peers.Specifically,we focused on the mediating role of social anxiety in the association between self-esteem and life satisfaction as well as the moderating role of being blind or not Answers to these questions are crucial for a better understanding of blind adolescents’ self-evaluated life satisfaction as well as the development of targeted intervention programs.

1.3 Hypotheses

Overall,the present study aimed to test the following hypotheses:

Hypothesis 1:According to the empirical evidence that blind individuals showed lower self-esteem and life satisfaction but higher social anxiety compared with their sighted peers,similar results will be expected in the current study.

Hypothesis 2:Given the strong effect of self-esteem on life satisfaction found in previous studies,it is hypothesized that life satisfaction will be significantly predicted by self-esteem in blind and sighted adolescents.Additionally,life experience of blind and sighted adolescents will moderate the relationship between self-esteem and life satisfaction.

Hypothesis 3:Based on the findings of the pairwise associations between self-esteem,social anxiety,and life satisfaction,as well as the particularly important role of social anxiety among adolescents,it is hypothesized that social anxiety will mediate the moderation of life experience on the relationship between self-esteem and life satisfaction.

2 Method

2.1 Participants

Sighted adolescents.The sample consisted of 149 sighted adolescents aged 10 to 15 years old who were selected from an elementary school and a middle school in Guangdong,China.There were 72 boys and 77 girls with a mean age of 13.04 years (SD=1.11).Regarding grade,there were 17 fifth graders,17 sixth graders,52 seventh graders,and 63 eighth graders.All of the sighted participants are native Chinese speakers and all of them have normal or corrected-to-normal vision.

Blind adolescents.The sample consisted of 66 blind adolescents enrolled in fifth to ninth grades in a special educational school in Guangdong,China.35 of the participants were boys and 31 were girls,with a mean age of 14.02 years (SD=1.97) and a range from 11 to 20 years.Regarding grade,there were 16 fifth graders,14 sixth graders,11 seventh graders,10 eighth graders,and 15 ninth graders.45 of the participants were congenitally blind and 21 were blind before the age of four.All blind participants are native Chinese speakers and use Chinese Braille.

Parental consent was obtained and only students with written consent forms participated in this study.The blind and sighted participants were matched according to socio-economic status (e.g.,Hanscombe,Trzaskowski,Haworth,Davis,Dale,& Plomin,2012) and intelligence (e.g.,Hackman,Farah,& Meaney,2010) as reported by school administrations.Participants (blind and sighted) were children of sighted parents.

2.2 Procedures

Participants completed questionnaires including the Rosenberg self-esteem scale (RSES;Rosenberg,1965),the multidimensional students’ life satisfaction scale (MSLSS;Huebner,1994),and the social anxiety scale for children (SASC;La Greca,Dandes,Wick,Shaw,& Stone,1988).The Chinese versions of RSES (Ji & Yu,1993),MSLSS (Zhang,He,& Zheng,2004) and SASC (Ma,1999) are standardized for mainland Chinese participants.They were translated into Chinese Braille,and a back-translation procedure was adopted to ensure the consistency between Chinese version and Chinese Braille version.Thus,sighted participants completed the measures in Chinese and the blind participants in Chinese Braille.

To ensure that the blind participants were linguistically able to understand the written measures,two teachers fluent in Chinese Braille and experienced at teaching blind adolescent Chinese students adapted the Chinese versions of the scales by minimizing difficult vocabulary.The participants completed the questionnaires individually,raising their hands for assistance from a language interpreter who explained the questions in Chinese if there was a problem.The order of the questionnaires in the survey package was randomized for each of the participants.

2.3 Measures

2.3.1 Self-esteem

The RSES is a 10-item scale that measures global self-esteem by measuring both positive and negative feelings about the self.Respondents are requested to rate on a 4-point scale (ranging from 1=strongly disagree to 4=strongly agree).Examples from the RSES include “I take a positive attitude toward myself’’ and “I feel that I have a number of good qualities”.In the present study,the Cronbach’s alpha reliability coefficient was.88 for sighted adolescents and.80 for blind adolescents.

2.3.2 Life satisfaction

The MSLSS is a self-report scale that is used to assess a multidimensional profile of students’ life satisfaction.The Chinese version comprises 36 items and 6 subscales:(i) family,“I enjoy talking with my parents”;(ii) school,“I look forward to going to school”;(iii) friendship,“I have many friends”;(iv) study,“I am satisfied with my academic achievement”;(v) freedom,“I can do what I love to do in my spare time”;and (vi) environment,“I like where I live”).All items are answered using a 6-point Likert scale format ranging from strongly disagree to strongly agree.In the current study,the Cronbach’s alpha reliability coefficient of the global,family,school,friendship,study,freedom and environment satisfaction were 0.93,0.86,0.90,0.72,0.82,0.66,and 0.72 for sighted adolescents and 0.93,0.86,0.85,0.75,0.64,0.67,and 0.72 for blind adolescents.In the current study,only global life satisfaction instead of each specific domain of life satisfaction was further analyzed for simplicity and clarity.

2.3.3 Social anxiety

The SASC is a 10-item measure,tapping two factors:(i) children’s fear of negative evaluation;and (ii) their level of social avoidance/social distress.Participants were asked to indicate on a 3-point continuum how often each of 10 statements is true for them (0=never,1=sometimes,2=always).Examples from the SASC include,“I worry about what other kids think of me”.In the current study,the Cronbach’s alpha reliability coefficient was 0.79 for sighted adolescents and 0.66 for blind adolescents.

2.4 Data analysis

In order to test Hypothesis 1,T test and Pearson correlations were conducted.The Hypothese 2 and 3 in this study taken together formed a mediated moderation model.To test this model,the analytic procedures proposed by Muller et al.(2005) were used with three multiple regression analyses using self-esteem,social anxiety,group (coding:0=sighted;1=blind),and their two-way interactions.To increase the interpretability of the model parameters that include interaction terms,we centered all variables according to their means:

(1) Equation 1:Y=a1X +b1Mo +c1XMo

(2) Equation 2:Me=a2X +b2Mo +c2XMo

(3) Equation 3:Y=a3X +b3Mo +c3XMo +dMe +eMoMe

where X is the independent variable (self-esteem);Mo is the moderator (group:1=sighted adolescents;0=blind adolescents);Me is the mediator (social anxiety);and Y is the dependent variable (life satisfaction).Four criteria need to be met to indicate a statistically significant mediated moderation effect (Muller et al.,2005):(a) Equation 1 shows a significant effect of self-esteem × group on life satisfaction,(b) Equation 2 shows a significant effect of self-esteem on social anxiety,(c) Equation 3 shows a significant effect of social anxiety×group on life satisfaction,and (d) the magnitude of the regression coefficient for the self-esteem×group in Equation 3 is reduced (or becomes insignificant) in comparison to the same coefficient in Equation 1.

3 Results

3.1 Preliminary Analyses

Table 1 presents the means,standard deviations,and the Pearson correlations of the variables in both blind and sighted adolescents.Social anxiety was significantly higher in blind adolescents than in sighted adolescents (t=7.12,p<0.001),while self-esteem (t=-2.17,p<0.05) and life satisfaction (t=-2.38,p<0.05) were lower in blind adolescents than in sighted adolescents.Thus,Hypothesis 1 was supported.Furthermore,significant correlations were observed between self-esteem,social anxiety and life satisfaction in both blind and sighted samples (ps<0.001).

Table 1 Mean scores,standard deviations,and correlations of self-esteem,social anxiety andlife satisfaction of blind and sighted participants

Note.Correlations for blind adolescents appear above the diagonal,n=66.Correlations for sighted adolescents appear below the diagonal,n=149.***p<0.001.

3.2 Mediated moderation analysis

Participants’ age and gender were included in the regression equations as control variables.Table 2 summarizes the statistical results of the regression models.Equation 1 showed that self-esteem significantly predicted life satisfaction (t=6.97,p<0.001).Moreover,the interaction effect of self-esteem × group was statistically significant (t=2.00,p<0.05).To better interpret this interaction effect,life satisfaction was plotted as a function of self-esteem and group in Figure 1,suggesting that for both blind and sighted adolescents,higher self-esteem was significantly associated with higher life satisfaction (blind:bsimple=0.76,p<0.001;sighted:bsimple=0.50,p<0.001) with the linkage being stronger in blind adolescents.Thus,Hypthesis 3 was supported.

Furthermore,Equation 2 suggested that social anxiety was significantly predicted by the main effects of self-esteem (t=-2.76,p<0.01) and group (t=-7.09,p<0.001).The control variable,participants’ age (t=-3.40,p<0.01) appeared to be significant predictor in this model,too.

Finally,to compare Equation 3 to Equation 1,it was found that life satisfaction was significantly predicted by the self-esteem (t=4.93,p<0.001),social anxiety (t=-4.09,p<0.001),and the interaction between social anxiety and group (t=2.80,p<0.01).Meanwhile,the interaction effect of self-esteem×group became insignificant (p>0.05).Since all four criteria for a mediated moderation model were met (Muller et al.,2005),it was concluded that social anxiety mediated the moderating effect of group on the relationship between self-esteem and life satisfaction,supporting Hypothesis 4.

Table 2 Regression results for the model of mediated moderation

Note.Co=control variables;X=independent variable;Mo= moderator;XMo=interaction between independent variable and moderator;Me=mediator;MoMe=interaction between mediator and moderator.*p<0.05;**p<0.01;***p<0.001.

The study untangles the relationships between self-esteem,life experience of being blind or not (group),social anxiety,and life satisfaction.In general,the results suggest that life experience of being blind or not negatively affects the effect of self-esteem on life satisfaction,and that social anxiety mediates the impact of life experience on the relationship between self-esteem and life satisfaction.Our results also indicate that the effect of self-esteem on life satisfaction is stronger in blind adolescents than that in sighted adolescents.

4.1 The effect of self-esteem on life satisfaction

As expected,the current result shows that self-esteem is a significant predictor of life satisfaction in both blind and sighted adolescents,which is consistent with previous research (Frank & Enkawa,2009;Kap?k?ran,2013;Moksnes & Espnes,2013).For example,Derdikman-Eiron et al.(2011) found that self-esteem and life satisfaction were associated with each other,which together changed and varied sharply during adolescence due to the impact of developmental shifts,transitions,and challenges in this period.It was reported that individuals with high self-esteem had good coping resources (e.g.,seeking and receiving social support from others) so they were more likely to show better adjustment and higher life satisfaction.Meanwhile,those with low self-esteem felt unworthy,incapable,and incompetent,leading to their continued low self-esteem and dissatisfaction with their lives (Boden,Fergusson,& Horwood,2008;Proctor,Linley,& Maltby,2009).

The present study found that the levels of self-esteem and life satisfaction were lower in blind adolescents than those in sighted adolescents.Previous studies evaluating self-esteem and life satisfaction observed inconsistent results on whether they were comparable or not between blind and sighted samples.For example,Pinquart and Pfeiffer (2012) showed that there was no significant difference in body-self image between blind and sighted adolescents,and the significant difference between the two groups was only drawn from female adolescents.Similarly,some studies also found no significant difference in the level of self-esteem between blind and sighted adolescents (Bernarás,2009),as well as between blind and sighted preadolescents (Griffin-Shirley & Nes,2005).Alternatively,there are other studies that indicate people with visual disabilities have lower self-esteem and social skills than sighted people (e.g.,Salehi,Azarbayejani,Shafiei,Ziaei,& Shayegh,2015;Stelmack,2001;Tuttle & Tuttle,2004).The current study is consistent with these findings and argues that visual impairment is not just a physical problem but a psychological one which further leads to lower self-esteem and life satisfaction,depression and social isolation in blind adolescents.

Importantly,the predictive role of self-esteem on life satisfaction in blind adolescents was stronger than that in sighted adolescents,indicating that self-esteem may be a more important predictor of a blind adolescent’s life satisfaction.Therefore,it is necessary to investigate the underlying mechanism in the relationship between self-esteem and life satisfaction among blind and sighted adolescents.

4.2 The mediated moderation roles of group and social anxiety in the link between self-esteem and life satisfaction

The results offered support for the moderating role of blindness in the link between self-esteem and life satisfaction.Specifically,we found that the effect of social anxiety was stronger in blind adolescents.That is,blindness heightened the relationship between self-esteem and life satisfaction through the link between social anxiety and life satisfaction.To our knowledge,our study is one of the first that reveals the moderating effect of blindness and the mediating effect of social anxiety on the relationship between self-esteem and life satisfaction.

Teenagers are in a period of great change both physically and psychologically,they long to build social relationships with others.Adolescents with low self-esteem who evaluate themselves in a negative way are prone to show defensive cognitive and emotional reaction.They are always in pursuit of protective goals by performing verbal and non-verbal hostility,which definitely worsens interpersonal relations and causes social anxiety (Laible,Carlo,&,Roesch,2004;Simpson,2007).Additionally,the inability to cope in the social environment and social isolation are significant sources of stress in adolescents’ daily lives which leads to a lower life dissatisfaction.

Huurre’s results indicated that compared to their sighted peers,people with visual disability have lower self-esteem and social skills (Huurre & Aro,1998).Roy and MacKay (2002) also claim that self-evaluation,social comparison,and identity may vary between children and young adults who differ in their visual status.With their age increasing,children have a tendency to involve with friends instead of with their parents or siblings,which could help them to become independent by joining in different activities (Olsen et al.,2008).Due to functional restrictions,especially problems with mobility and orientation,blind children may be less socially mature and more egocentric than sighted children.Thus,they may perceive more stress in their personal and social development compared with sighted children (Tuttle & Tuttle,2004).

Our results showed that the level of social anxiety in blind adolescents is higher than in their sighted peers,which is in line with previous research indicated that adolescents with blindness had more difficulties in social skills (Huurre,& Aro,1998).Visual cues are crucial to the development of social skills.The blind adolescents who can not observe social interactions often have lower levels of social interaction and experience more problems in social adaptation.Therefore,it is not surprising that the link between social anxiety and life satisfaction is much stronger in blind adolescents.Furthermore,the acquisition of social skills will help further develop the supportive social networks of blind adolescents.This aided in effectively coping with daily communication with others,and thus improving their life satisfaction.

Although the current study provides an interesting insight and fills a gap in literatures focused on the relationship of self-esteem and life satisfaction,it is important to note the limitations.Firstly,the measures of the self-esteem,social anxiety,and life satisfaction used in this research consist entirely of questionnaires.In this method,recall error and the desire to provide socially desirable responses have to be considered.Future studies should simultaneously employ data collected from a comprehensive set of measures,such as interviews and experimental methods.The second limitation concerns the cross-sectional nature of the present study.Future studies should consider longitudinal designs.Thirdly,the sample size of our study may not be large enough to provide strong statistical power,and we did not stratify the analyses by gender variables.Thus,future studies should conduct such analysis to better understand whether these results can be applied to different subgroups.Finally,the hypotheses from this study need to be tested using different samples,such as deaf adolescents.

Taken together,despite the aforementioned limitations are,we believe that our findings have important practical implications.First of all,we found that the effect of self-esteem on life satisfaction in blind adolescent was stronger than that in sighted adolescents.Furthermore,the stronger link was accomplished by the mediator,social anxiety,which indicated that it is more useful to improve life satisfaction of blind adolescents by reducing their social anxiety.Secondly,our results that blind adolescents have lower self-esteem and life satisfaction but higher social anxiety than their sighted peers highlights that it is important for the blind adolescents to develop their social skills,particularly in school setting.Opportunities for blind adolescents to take part in leisure activities and other social activities with friends are especially essential (Huurre & Aro,2000).Griffin,Shirley and Nes (2005) claim that an environment with freedom to explore and providing protection from danger helps the development of self-esteem among blind adolescents.The blind adolescents in the current study were from a special education boarding-school in China.Therefore,Chinese special education schools need to further help blind adolescents to find suitable leisure-time activities to improve their social skills and self-esteem,and further improve their life satisfaction.

Acknowledgments

This work was supported by the National Natural Science Foundation of China (31628010),the National Social Science Foundation of China (14ZDB155),the Key Institute of Humanities and Social Sciences (16JJD880025),and the Foundation for Outstanding Young Scholars in Guangzhou (18QNXR11).