The Association Between Social Exclusion and Depression Characteristics in Adolescents with Congenital Mild Limb Disability: A Longitudinal Analysis Based on Generative and Reflective Models

doi:10.12139/j.1672-0628.2025.02.010

Abstract

Abstract:

To explore the longitudinal association between social exclusion and depression characteristics of adolescents with congenital mild limb disability and to identify intervention targets, two repeated follow-up measurements were conducted on 1040 adolescents with congenital mild limb disability using a questionnaire method. The results showed that: 1) Both the generative model and the reflective model revealed an interaction between social exclusion and depression among adolescents with congenital mild limb disability. 2) Time-specific characteristics of the connection between social exclusion and depression were observed at Time Point 1 (T1) and Time Point 2 (T2). 3) Suicide ideation, a sub-characteristic of depression, was identified as the activation node within the network of social exclusion and depression characteristics. Meanwhile, certain sub-characteristics of social exclusion, such as “It seems that others often don’t see me”, “Others are always cold to me”, “Others often block important information from me”, and “Others always exclude me”, were highlighted as important intervention targets for addressing depression-interpersonal vulnerability.

Key words: adolescents with congenital mild limb disabilities, social exclusion, depression, cross-lagged panel model, cross-lagged panel network model

摘要：

为探讨先天轻度肢残青少年社会排斥与抑郁特征的纵向关联及其干预靶点，采用问卷法对1040名先天轻度肢残青少年进行了两次重复追踪测量，结果表明：(1)生成性模型与反映性模型结果均表明先天轻度肢残青少年社会排斥与抑郁相互影响。(2) T1与T2时点社会排斥与抑郁特征症候群之间存在联结桥梁的时间特异性特点。(3)抑郁子特征自杀意念是社会排斥与抑郁特征网络的活化节点，而社会排斥子特征“别人好像经常看不到我似的”、“别人总是对我很冷淡”、“别人常常对我封锁很重要的信息”以及“别人总是将我排除在外”是抑郁−人际脆弱性的重要影响靶点。

关键词: 肢体残疾青少年, 社会排斥, 抑郁, 交叉滞后面板模型, 交叉滞后面板网络模型

Linxin LU, Zaihua LIU, Shuang YANG, Zhengkai JIANG, Weiqiang DANG, Jing TAN, Yongfei BAN, Ji SUN, Xiuyun LIN. The Association Between Social Exclusion and Depression Characteristics in Adolescents with Congenital Mild Limb Disability: A Longitudinal Analysis Based on Generative and Reflective Models[J]. Studies of Psychology and Behavior, 2025, 23(2): 216-225.

卢林鑫, 刘在花, 杨爽, 蒋政凯, 党韦强, 谭婧, 班永飞, 孙霁, 蔺秀云. 社会排斥与先天轻度肢残青少年抑郁特征的关联性：基于生成性模型与反映性模型的纵向分析[J]. 心理与行为研究, 2025, 23(2): 216-225.

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References 0

	班永飞, 卢林鑫, 陈燕琴, 孙霁, 王庭照. 盲生的歧视知觉与心理健康的关系: 领悟社会支持和自尊的链式中介作用. 中国特殊教育, 2022, (9): 29- 38.
	杜建政, 夏冰丽. 心理学视野中的社会排斥. 心理科学进展, 2008, 16 (6): 981- 986.
	杜亚男, 邱纪方, 邢赛春. 浙江省肢体残疾人生活质量及心理健康状况调查. 预防医学, 2017, 29 (2): 121- 124.
	高丹. (2023). 残疾青少年人际交往困境研究(硕士学位论文). 青海师范大学, 西宁.
	洪伟, 唐勇, 张南平, 陈惠玲. 肢体残疾者心理健康状况研究. 中国民康医学, 2010, 22 (21): 2781- 2782. DOI
	胡星辰, 张迎黎, 梁炜, 张红梅, 杨世昌. 病人健康问卷抑郁量表(PHQ-9)在青少年中应用的信效度检验. 四川精神卫生, 2014, 27 (4): 357- 360.
	贾金玲, 卢林鑫, 班永飞, 孙霁, 蔺秀云. 留守听障学生同伴欺凌对抑郁的影响: 核心自我评价与社交焦虑的链式中介作用. 中国特殊教育, 2023, (6): 37- 46.
	贾金玲, 卢林鑫, 邱天龙, 宋海迎, 周瀚翔, 吕向彬, 蔺秀云. 视障青少年生命意义追寻与生命意义感的相生相克: 基于随机截距交叉滞后模型. 中国特殊教育, 2024, (6): 44- 55.
	李嫱. (2010). 肢体残疾青少年体育锻炼与心理健康的关系研究(硕士学位论文). 陕西师范大学, 西安.
	刘玎, 卢宁, 金莹, 吴幼妹, 李嘉惠. 肢体残疾人社会适应与心理健康的关系: 安全感的中介效应. 心理学进展, 2021, 11 (6): 1402- 1409.
	邵蕾, 董妍, 冯嘉溪, 张登浩. 社会排斥对居民主观幸福感的影响: 社会认同和控制感的链式中介作用. 中国临床心理学杂志, 2020, 28 (2): 234- 238.
	汤丹丹, 温忠麟. 共同方法偏差检验: 问题与建议. 心理科学, 2020, 43 (1): 215- 223.
	Bond, M. H., & Smith, P. B. (1996). Culture and social identity: The role of social identity in intergroup relations. In S. Worchel & W. G. Austin (Eds.), The Psychology of Intergroup Relations (pp. 107–125). Chicago: Nelson-Hall.
	Borsboom, D. A network theory of mental disorders. World Psychiatry, 2017, 16 (1): 5- 13. DOI
	Cheung, G. W., & Rensvold, R. B. Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling: A Multidisciplinary, 2002, 9 (2): 233- 255. DOI
	Epskamp, S., Borsboom, D., & Fried, E. I. Estimating psychological networks and their accuracy: A tutorial paper. Behavior Research Methods, 2018, 50 (1): 195- 212. DOI
	Fried, E. I., Nesse, R. M. Depression sum-scores don’t add up: Why analyzing specific depression symptoms is essential. BMC Medicine, 2015a, 13 (1): 72. DOI
	Fried, E. I., Nesse, R. M. Depression is not a consistent syndrome: An investigation of unique symptom patterns in the STAR*D study. Journal of Affective Disorders, 2015b, 172, 96- 102. DOI
	Fung, H. W., Chung, H. M., & Ross, C. A. Demographic and mental health correlates of childhood emotional abuse and neglect in a Hong Kong sample. Child Abuse & Neglect, 2020, 99, 104288.
	Gijzen, M. W. M., Rasing, S. P. A., Creemers, D. H. M., Smit, F., Engels, R. C. M. E., & De Beurs, D. Suicide ideation as a symptom of adolescent depression: A network analysis. Journal of Affective Disorders, 2021, 278, 68- 77. DOI
	Güner, T. A., & Das Gecim, G. Y. Effects of social exclusion on psychological-well-being and suicidal possibilities among people with physical disabilities. OMEGA - Journal of Death and Dying, 2023, 87 (3): 962- 976. DOI
	Hames, J. L., Hagan, C. R., & Joiner, T. E. Interpersonal processes in depression. Annual Review of Clinical Psychology, 2013, 9, 355- 377. DOI
	Hartgerink, C. H. J., van Beest, I., Wicherts, J. M., & Williams, K. D. The ordinal effects of ostracism: A meta-analysis of 120 Cyberball studies. PLoS One, 2015, 10 (5): e0127002. DOI
	Holme, P. An introduction to temporal networks. Journal of Complex Networks, 2018, 6 (3): 393- 418.
	Joiner, T. E., Wingate, L. R., & Otamendi, A. An interpersonal addendum to the hopelessness theory of depression: Hopelessness as a stress and depression generator. Journal of Social and Clinical Psychology, 2005, 24 (5): 649- 664. DOI
	Juvonen, J., Lessard, L. M., Rastogi, R., Schacter, H. L., & Smith, D. S. Promoting social inclusion in educational settings: Challenges and opportunities. Educational Psychologist, 2019, 54 (4): 250- 270. DOI
	Kitayama, S., & Cohen, D. (2007). Handbook of cultural psychology (pp. 136–173). New York: Guilford Press.
	Kitayama, S., Markus, H. R., & Kurokawa, M. Culture, emotion, and well-being: Good feelings in Japan and the United States. Cognition and Emotion, 2000, 14 (1): 93- 124.
	Li, M. W., Rao, V. D., Gernat, T., & Dankowicz, H. (2018). Lifetime-preserving reference models for characterizing spreading dynamics on temporal networks. Scientific Reports, 8(1), 709.
	Mullarkey, M. C., Marchetti, I., & Beevers, C. G. Using network analysis to identify central symptoms of adolescent depression. Journal of Clinical Child & Adolescent Psychology, 2019, 48 (4): 656- 668.
	Mushtaq, S., & Akhouri, D. Self esteem, anxiety, depression and stress among physically disabled people. The International Journal of Indian Psychology, 2016, 3 (4): 125- 132.
	Parmenter, T. R., & Knox, M. The post-school experiences of young people with a disability. International Journal of Rehabilitation Research, 1991, 14 (4): 281- 292. DOI
	Piškur, B., Beurskens, A. J. H. M., Ketelaar, M., Jongmans, M. J., Casparie, B. M., & Smeets, R. J. E. M. Daily actions, challenges, and needs among Dutch parents while supporting the participation of their child with a physical disability at home, at school, and in the community: A qualitative diary study. BMC Pediatrics, 2017, 17 (1): 12. DOI
	Tajfel, H. Social psychology of intergroup relation. Annual Review of Psychology, 1982, 33 (1): 1- 39. DOI
	Uwimbabazi, M. P., Muziki, J. D., Muhayisa, A., Uwera, T., & Mutabaruka, J. The mediating role of anxiety between negative feelings and depression among students with congenital physical disabilities. PloS ONE, 2023, 18 (3): e0281430. DOI
	van Bork, R., Rhemtulla, M., Waldorp, L. J., Kruis, J., Rezvanifar, S., & Borsboom, D. Latent variable models and networks: Statistical equivalence and testability. Multivariate Behavioral Research, 2019, 56 (2): 175- 198.
	van Borkulo, C. D., van Bork, R., Boschloo, L., Kossakowski, J. J., Tio, P., Schoevers, R. A., … Waldorp, L. J. Comparing network structures on three aspects: A permutation test. Psychological Methods, 2023, 28 (6): 1273- 1285. DOI
	Williams, K. D. Chapter 6 Ostracism: A temporal need-threat model. Advances in Experimental Social Psychology, 2009, 41, 275- 314.
	Zhao, T., Liu, H., Roeder, K., Lafferty, J., & Wasserman, L. The huge package for high-dimensional undirected graph estimation in R. Journal of Machine Learning Research, 2012, 13, 1059- 1062.

	M	SD	1	2	3	4
1. 性别	1.44	0.50
2. T1社会排斥	12.31	5.42	0.06
3. T2社会排斥	13.28	6.61	0.01	0.51^***
4. T1抑郁	6.04	4.90	0.09^*	0.51^***	0.37^***
5. T2抑郁	7.24	5.87	0.03	0.35^***	0.53^***	0.50^***

	M	SD	1	2	3	4
1. 性别	1.44	0.50
2. T1社会排斥	12.31	5.42	0.06
3. T2社会排斥	13.28	6.61	0.01	0.51^***
4. T1抑郁	6.04	4.90	0.09^*	0.51^***	0.37^***
5. T2抑郁	7.24	5.87	0.03	0.35^***	0.53^***	0.50^***

测量工具	模型	S-Bχ²	df	S-Bχ²/df	CFI	TLI	RMSEA(90%CI)	SRMR	∆CFI	∆RMSEA
青少年社会排斥量表	形态等值	480.06	95	5.05	0.927	0.915	0.074[0.068, 0.081]	0.045
	弱等值	517.39	102	5.07	0.930	0.914	0.075[0.068, 0.081]	0.060	0.003	−0.001
	强等值	548.98	109	5.04	0.925	0.915	0.074[0.068, 0.080]	0.059	−0.005	0.001
	严格等值	521.35	117	4.46	0.932	0.920	0.069[0.063, 0.075]	0.068	0.007	−0.005
病人健康问卷抑郁量表	形态等值	371.14	125	2.97	0.932	0.917	0.052[0.046, 0.058]	0.042
	弱等值	373.39	133	2.81	0.933	0.923	0.050[0.044, 0.056]	0.043	0.001	−0.002
	强等值	392.87	141	2.79	0.930	0.924	0.049[0.044, 0.055]	0.043	−0.003	−0.001
	严格等值	408.42	150	2.72	0.929	0.927	0.049[0.043, 0.054]	0.047	−0.001	0.000

测量工具	模型	S-Bχ²	df	S-Bχ²/df	CFI	TLI	RMSEA(90%CI)	SRMR	∆CFI	∆RMSEA
青少年社会排斥量表	形态等值	480.06	95	5.05	0.927	0.915	0.074[0.068, 0.081]	0.045
	弱等值	517.39	102	5.07	0.930	0.914	0.075[0.068, 0.081]	0.060	0.003	−0.001
	强等值	548.98	109	5.04	0.925	0.915	0.074[0.068, 0.080]	0.059	−0.005	0.001
	严格等值	521.35	117	4.46	0.932	0.920	0.069[0.063, 0.075]	0.068	0.007	−0.005
病人健康问卷抑郁量表	形态等值	371.14	125	2.97	0.932	0.917	0.052[0.046, 0.058]	0.042
	弱等值	373.39	133	2.81	0.933	0.923	0.050[0.044, 0.056]	0.043	0.001	−0.002
	强等值	392.87	141	2.79	0.930	0.924	0.049[0.044, 0.055]	0.043	−0.003	−0.001
	严格等值	408.42	150	2.72	0.929	0.927	0.049[0.043, 0.054]	0.047	−0.001	0.000

节点	T1时点		T2时点
节点	桥接预期影响	桥接预期影响Z分数	桥接预期影响	桥接预期影响Z分数
SE1	0.11	1.00	0.07	0.12
SE2	0.08	0.22	0.05	−0.28
SE3	0.01	−1.32	0.03	−0.71
SE4	0.01	−1.21	0.03	−0.76
SE5	0.01	−1.35	0.02	−0.88
SE6	0.04	−0.54	0.03	−0.71
SE7	0.07	0.08	0.05	−0.30
SE8	0.13	1.43	0.07	0.12
DP1	0.03	−0.93	0.03	−0.71
DP2	0.05	−0.40	0.19	2.61
DP3	0.05	−0.40	0.01	−1.15
DP4	0.08	0.31	0.09	0.49
DP5	0.06	−0.13	0.06	−0.24
DP6	0.15	1.89	0.09	0.41
DP7	0.12	1.13	0.04	−0.61
DP8	0.03	−0.73	0.15	1.82
DP9	0.11	0.95	0.10	0.78