Loneliness is associated with a variety of negative consequences, such as depressive symptoms (Qualter, Brown, Munn, & Rotenberg, 2010), and the manner in which people express and cope with loneliness experiences is significantly related to cultural orientation (i.e., collectivist or individualist; Rokach, 2008). For example, collectivist cultural norms and values cause Chinese adolescents to experience a different trajectory of loneliness from their individualistic Western peers (Chen, Fu, & Leng, 2014). However, to our knowledge, no one has explored possible differences in the relationships among attachment, social anxiety, and loneliness between deaf and hearing adolescents in a Chinese cultural context. Thus, we examined these interrelationships with the aim of extending the current understanding in this regard.

Theoretical Background and Hypotheses Development

Relationships Among Attachment, Social Anxiety, and Loneliness

Researchers have consistently associated attachment with loneliness, such that secure and insecure attachment styles have been found to predict, respectively, lower and higher levels of loneliness (e.g., Bernardon, Babb, Hakim-Larson, & Gragg, 2011; Erozkan, 2011). Western scholars have also shown that socially anxious, compared to socially nonanxious, individuals usually experience a higher level of loneliness (e.g., Beidel et al., 2007), and that there is a strong association between social anxiety and attachment styles (e.g., Brown & Whiteside, 2008). Further, the quality of the attachment bond in childhood may serve as a contributing factor to later development of social anxiety problems (Bernardon et al., 2011). Although social anxiety has been found to be associated with both attachment and loneliness, to our knowledge, no researcher has examined the effect of social anxiety on the relationship between attachment and loneliness. Therefore, we investigated the role of social anxiety in this association.

Attachment, Social Anxiety, and Loneliness Among People With Hearing Impairment

Anxiety disorders may be more common in the deaf population compared to the hearing population because of language barriers. For example, Sisia (2012) found that deaf adolescents reported more frequent feelings of loneliness and mild depression, experienced greater anxiety, and had slightly weaker social networks and support systems. However, other findings are inconsistent, with some scholars suggesting that attachment is not more insecure, and that social anxiety and loneliness are not higher in the deaf population. For example, McKinnon, Moran, and Pederson (2004) did not find significant differences between the attachment style of 50 deaf students who had mostly attended residential schools and a similar group of hearing students. Bossaert, Colpin, Pijl, and Petry (2012) also suggested that there are no significant differences in loneliness between typically developing adolescents and those with sensory disabilities. Some researchers have even found that the deaf population had lower social anxiety than their hearing counterparts (e.g., Vogel-Walcutt, Schatschneider, & Bowers, 2011). However, the focus in most of the latter studies was on deaf participants who were educated in special education schools or who had cochlear implants. Thus, the inconsistent results may be because of the variation in study samples.

In addition, psychological development can be viewed as a process that reflects individual, familial, and cultural influences. Triandis (1989) emphasized the need to understand multiple contexts, highlighting the reciprocal and dynamic influences of contextual factors on individual development. From this perspective, loneliness, social anxiety, and attachment vary across development and are influenced by cultural context. Accordingly, we examined potential differences in relationships among attachment (with mother, father, and peers), social anxiety, and loneliness, between deaf and hearing Chinese adolescents. Our hypotheses were as follows:
Hypothesis 1: The mediating effect of social anxiety on the relationship between attachment and loneliness among deaf and hearing Chinese adolescents will vary across a) father, b) mother, and c) peer attachment types.
Hypothesis 2: The relationships among attachment, social anxiety, and loneliness will vary between deaf adolescents in special schools and hearing peers.

Method

Participants

Hearing sample. Participants in the hearing sample were 152 fifth to eighth graders at a parochial school in an inner-city neighborhood in Panyu, Guangzhou, China. They comprised 82 boys and 70 girls, ranging in age from 10 to 15 years (M_age = 12.86 years, SD = 1.10). By grade level, there were 18 fifth, 22 sixth, 59 seventh, and 51 eighth graders, and two who did not specify their grade.

Deaf sample. Participants in the deaf sample were 120 sixth to ninth graders who were pupils at one of five special education schools in inner-city neighborhoods in five cities in China (i.e., Guangzhou, Zhongshan, Jiangmen, Taishan, and Dongguan). They comprised 68 boys and 52 girls, ranging in age from 10 to 19 years (M_age = 15.05 years, SD = 2.19). By grade level, there were 39 sixth, 25 seventh, 27 eighth, and 29 ninth graders.

All participants were matched according to socioeconomic status and intelligence, as reported by school administrators, and were children of hearing parents. All deaf participants had had a hearing deficit from birth. The Institutional Review Board of South China Normal University approved this study.

Procedure

We initially sent an email and made a phone call to the principals of five special schools and one normal school, all of which are located in an area near Guangzhou, to introduce our study aims and purpose. After receiving the principals’ permission, we asked them to distribute a participant recruitment and consent form. Only students whose parents gave written consent were invited to participate in this study. We then spent 2 weeks collecting the data (one afternoon per week, per school). All 152 of the surveyed hearing students provided complete responses, but 16 of the 136 deaf students returned surveys with missing data; thus, 120 students were included in the final sample.

To ensure that the deaf participants were linguistically able to understand the written measures, two teachers who were fluent in sign language and experienced at teaching deaf adolescents Chinese, adapted the Chinese versions of the scales by minimizing difficult words. The participants completed the measures individually, raising their hands for assistance from a language interpreter who could explain the questions in Chinese (for hearing participants) or Chinese sign language (for deaf participants) if there was a problem. The order of the measures in the survey package was randomized.

Measures

Attachment. We assessed attachment with the Chinese version (Zhang, 2006) of the Inventory of Parent and Peer Attachment-Revised (Armsden & Greenberg, 1987). This scale is used to measure the psychological security that is derived from relationships with parents and peers, and comprises 75 self-report items divided across mother, father, and peer subscales, each of which contain 25 items. Three aspects of attachment are assessed: trust, communication, and alienation, with participants rating the extent to which each item accurately describes their feelings in these close relationships, using a 5-point Likert scale (1 = never to 5 = always). In this study, Cronbach’s alphas for father, mother, and peer attachment subscales were .94, .95, and .92, respectively, for hearing adolescents, and .84, .86, and .86, respectively, for deaf adolescents.

Social anxiety. The Chinese version (Ma, 1999) of the 10-item Social Anxiety Scale for Children (La Greca, Dandes, Wick, Shaw, & Stone, 1988) is used to measure children’s subjective experience of social anxiety, especially in relation to their emotional, cognitive, and behavioral symptoms. Items are rated on a 3-point Likert scale according to how true the item is for the participant (1= not at all, 2 = sometimes, 3 = all the time). In this study, Cronbach’s alpha was .85 for hearing adolescents and .64 for deaf adolescents.

Loneliness. Loneliness and social dissatisfaction were assessed with the Children’s Loneliness Scale (Asher, Hymel, & Renshaw, 1984), which was translated into Chinese by Liu (1999). Respondents indicate the extent to which each statement is true for them on a 5-point Likert scale (1 = always true to 5 = not true at all). In this study, Cronbach’s alpha was .90 for hearing adolescents and .77 for deaf adolescents.

The scores for all measures were computed by averaging items on each subscale after reverse-scoring some negatively phrased items.

Data Analysis

After standardizing all variables, we used SPSS version 19 to perform regression analyses by following the procedures suggested by Muller, Judd, and Yzerbyt (2005). Because it has been found (e.g., Ranta et al., 2007) that age and gender affect our target variables, we controlled for these demographic variables when testing three moderated mediation models with father, mother, and peer attachment types, as the independent variable.

Results

Moderated Mediation Model of Father Attachment

After analyzing the control variables, father attachment, hearing status (0 = hearing adolescents, 1 = deaf adolescents), and the interaction between father attachment and hearing status, we did not observe an overall effect of father attachment on loneliness (b = -.08, p > .05). Thus, the first condition of a moderated mediation model was not fulfilled, which does not support Hypothesis 1a.

Moderated Mediation Model of Mother Attachment

The statistical results of the regression models computed to test mother and peer attachment types as the independent variable, respectively, are summarized in Table 1.

In Model 1, we observed an overall effect of mother attachment on loneliness that was not moderated by hearing status. In Model 2, the main effect of mother attachment on social anxiety was significant, but the interaction between mother attachment and hearing status was not. In Model 3, the effect of social anxiety on loneliness was both significant and significantly moderated by hearing status. Therefore, the moderated mediation model of mother attachment was supported. A simple slopes test revealed that greater social anxiety was significantly correlated with greater loneliness in the hearing sample, but not in the deaf sample. Thus, the mediation effect of social anxiety on the relationship between mother attachment and loneliness existed only in the hearing sample, and Hypothesis 1b was partially supported.

Moderated Mediation Effect of Peer Attachment

With respect to peer attachment as the independent variable, Model 1 showed an overall effect of peer attachment on loneliness that was not moderated by hearing status. In Model 2, the main effect of peer attachment on social anxiety was significant, but the interaction between peer attachment and hearing status was not. In Model 3, the effect of social anxiety on loneliness was both significant and significantly moderated by hearing status. The moderated mediation model of peer attachment was, thus, supported. A simple slopes test revealed that greater social anxiety was significantly correlated with greater loneliness in the hearing sample, but not in the deaf sample. Thus, the mediation effect of social anxiety on the relationship between peer attachment and loneliness existed only in the hearing sample, and Hypotheses 1c and 2 were supported.

Discussion

We examined attachment and perceived loneliness of deaf and hearing Chinese adolescents in relation to their social anxiety. Overall, the results indicated that the relationship between father attachment and loneliness was not mediated by social anxiety in either the deaf or hearing sample. In contrast, for both mother and peer attachment, the relationship was partially mediated by social anxiety in the hearing sample only. That is, the indirect link for father attachment was comparable between deaf and hearing adolescents, and life experience moderated the link for mother and peer attachment, with this being weaker for deaf adolescents.

In hearing Chinese adolescents, social anxiety mediated the relationships between mother and peer attachment and loneliness, but not between father attachment and loneliness. That is, our results did not show any effect of father attachment on either social anxiety or loneliness in hearing Chinese adolescents. We consider that there are two possible explanations for these findings. First, Grossman and Rhodes (2002) noted that children’s attachment relationships with mothers and fathers are derived from a different set of early social experiences. Mothers often act as a secure base in times of distress, whereas fathers often act as a challenging but reassuring play partner. Moreover, in China, fathers may be primarily an economic provider, and are less involved in children’s affect development (Li & Lamb, 2015). Thus, it is understandable that in China, fathers are less involved than mothers are in children’s socioemotional functioning development.

Second, on the one hand, researchers have found that boys’ and girls’ quality of affect toward their mothers remains stable from early to late adolescence (Nickerson & Nagle, 2005), whereas an increase in negative feelings toward fathers occurs in toddlerhood as parents, especially fathers, begin to assert control over their behavior (e.g., Laible, Panfile, & Makariev, 2008). This has been found to be more common in China than in North America (Ng, Pomerantz, & Deng, 2014). On the other hand, as adolescents experience rapid psychological and physical development, they are heavily influenced by peer and school environments (Kobus, 2003). In this study, we have shown that attachment to mothers and peers has a similar effect on loneliness, in that they both directly and indirectly affect loneliness via the mediator of social anxiety.

In regard to deaf Chinese adolescents, our finding that attachment significantly predicted loneliness, is consistent with previous findings concerning the roles of peer and parent functioning in the development of loneliness (e.g., Bogaerts, Vanheule, & Desmet, 2006). However, we also found that the link between attachment and loneliness was not mediated by social anxiety. We believe that this result is primarily attributable to the weak associations between social anxiety and attachment, and between social anxiety and loneliness in the deaf sample. Recently, Vogel-Walcutt et al. (2011) found that there was no significant correlation between social anxiety and loneliness in a sample of deaf Western children who spent most of their time in a special school. These authors argued that the deaf children’s environment was similar enough to that of their hearing peers that it did not impede adjustment. Moreover, the deaf children’s segregated school setting provided for the children who were deaf formed a sheltered frame of reference that caused a similar perceived socioemotional adjustment. The deaf adolescents in the present study were also educated in special schools, which may be why our results are similar to those of Vogel-Walcutt et al.

Our findings have several practical implications. First, our results suggest that the relationships among attachment, social anxiety, and loneliness vary between deaf and hearing Chinese adolescents. This finding is critical because changes in adolescent students’ social needs (i.e., parent and peer attachment) and loneliness across developmental stages (Jobe-Shields, Cohen, & Parra, 2011) are still an underemphasized aspect in the reform of psychological education in schools in China. Second, our findings can help targeted–intervention practitioners to understand the different pathways through which attachment is associated with loneliness among Chinese adolescents. Third, special schools in China provide deaf students with an environment that is similar to that of their hearing peers, which helps with their socioemotional adjustment. However, our results showed that although deaf students’ social anxiety was reduced in these schools, loneliness was not; thus, different mechanisms may underlie social anxiety and loneliness, and specific targeted interventions are needed for deaf students in regard to both social anxiety and loneliness.

There are several limitations in this study, including our examination of the relationships among attachment, social anxiety, and loneliness being based on cross-sectional data. Future researchers should use longitudinal designs to seek evidence of the dynamic changes that occur in these relationships. In addition, the reliability of the measures used in this study was consistently lower for deaf adolescents than it was for their hearing peers. Longitudinal designs could also be used to assess the test–retest reliability of the measures to ensure that the validity is acceptable for both samples. Finally, the findings regarding our sample of deaf Chinese adolescents who were enrolled in special education schools cannot be generalized to deaf adolescents educated in mainstream schools.

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This work was supported by the National Natural Science Foundation of China (31200762 and 31571141)

the Foundation for Outstanding Young Teachers in Higher Education of Guangdong

China (HS2015001)

the Guangdong Natural Science Foundation (2015A030310517)

and by the Pandeng project of Guangdong

China (pdjh2015a0133).

Aitao Lu, Center for Studies of Psychological Application, South China Normal University, 55 Zhongshan W. Ave., Guangzhou 51063, People’s Republic of China. Email: [email protected] or Wenna Wang, School of Humanities and Management, Guangdong Medical College, Dongguan, People’s Republic of China. Email: [email protected]