Title: Peer acceptance rejection, loneliness and psychological distress in University Students.

Introduction

Acceptance in relationships, from friends, even from strangers is absolutely

fundamental to humans ( DeWall ,2007) Basically “If you turn on the television set, and

watch any reality TV program, most of them are about rejection and acceptance,” The urge

for optimistic and durable connections with others is among the most fundamental of

psychological well-being. What happens when people experience peer rejection? This

research would explore how acceptance peer and rejection influences loneliness, aggression,

pro-social behavior, and self-regulation, emotional responses such as empathy, and physical

sensitivity to pain. In addition to peer acceptance/rejection, having friends, and friendship

quality, another important predictor of loneliness is the degree to which youth are actively

victimized or picked on by peers. Peer victimization takes many different forms, including

physical victimization (e.g., being hit or punched), verbal victimization (e.g., being called

mean names), and relational or social victimization (e.g., being gossiped about, being

excluded). Regardless of its form, it is clear that youth who are victimized by peers

experience a greater degree of loneliness (Ladd et al., 1997). Also, being the victim of

multiple forms of victimization (e.g., being both physically and relationally/socially

victimized) contributes additively to the experience of loneliness in youth (Vernberg, 2001),

although research on this issue has not yet been conducted using “pure” loneliness

assessments.

Researchers investigating the associations among peer rejection, peer victimization, and

loneliness in youth have found that peer victimization tends to act as a moderator between

peer rejection and loneliness, such that peer rejection is linked to loneliness especially

strongly for those who are victimized by peers (Boivin et al., 1995; Buhs & Ladd, 2001).
1.1 Peer Acceptance and rejection:

Acceptance can be powerful (Landy, 2002). Children, who were accepted, were admired

and respected by peers (Landy, 2002). Children, especially children who were well liked by

others, used peers as a resource (Landy, 2002). According to Landy (2002), children learned

from peers by asking questions, observing, and modeling behaviors as well as actions.

Studies discovered children who were highly accepted were seen to use leadership skills and

positive social skills. Because of these characteristics, peers approached “popular” children

more frequently than other classmates did. (Coie, 1990; Coie & Dodge, 1983; Coie et al.,

1982; Coie et al., 1990; Dodge, 1983).

Rejection happens daily, whether a child has been told he or she cannot play with a

friend or a child did not want to share a toy, or a sibling said, “Go away;” or a parent has

been too busy to give attention to a needy child. For a young child, rejection can be tough. It

is hurtful, and it can be damaging to a child’s development (Dodge et al., 2003). It is natural

to want to be accepted, to feel part of the group, or to just be included.

Rejection occurs when a child has been excluded by another individual or by a group

(Coie & Dodge, 1983; Coie, Dodge, & Coppotelli, 1982; Denham & Holt, 1993; Johnson,

Ironsmith, Snow, & Poteat, 2000). Rejection has been an ever-evolving issue in schools, a

child who was rejected by peers can show signs of loneliness, low self-esteem, aggression,

and depression (Dodge et al., 2003).

The term peer acceptance is defined as “the degree a child is socially accepted or

rejected by his or her peer group” (Slaughter, Dennis, & Pritchard, 2002). Coie et al. (1990)

and Mostow et al. (2002) declared socially accepted children were friendly, cooperative,

helpful, sociable, and able to initiate and maintain social interactions. According to Braza et

al. (2009), peer acceptance was important to children’s social development. Peer acceptance
provided a wide range of learning and developmental opportunities for children. Through

peer acceptance, children were able to learn about social skills, peer problem solving,

cooperation, and being part of a group (Denham, McKinley, Couchoud, & Holt, 1990;

Mostow et al., 2002). Parents, teachers, and other adults were good sources of social support

for children; but children learned best from playing and interacting with one another (Ladd,

1990; Sebanc, 2003). When children spent time with other children by playing, interacting,

and conversing, children were usually included and accepted among peers.

Ladd (1983) observed first-throughsixth graders on the playground. Ladd found that

children who participated in constant play with peers were favorably accepted by others.

However, when children spent his or her playtime alone, wandering around, isolated, or

engaged with an adult, these children were seen as unpopular playmates (Ladd, 1983). With

this study in mind, it is important to encourage preschoolers to play and continue to engage

and interact with his or her peers in order to build positive peer relationships.

Positive or negative adjustment to school hinged on peer relationships for children,

especially young children. Beginning school can be stressful (Landy, 2002), and it was more

stressful if a child was excluded or did not feel part of a group (Dodge et al., 2003).

Therefore, if children started school being accepted or were able to be accepted earlier on,

then school was a more appealing place. When children enjoy themselves, school

performance improved due to the exciting environment. Ladd (1990) pointed out that the

children who had friends at the start of school liked school better than children who did not

have friends in the first two months of school. Ladd (1990) also found that if children made a

new friend within the first two months of school, then performance rose. However, if peer

rejection occurred, children avoided school, performance declined, and children had a poor

perception of school (Ladd, 1990).

 Peer rejection is defined as a child being excluded or not accepted by his or her peers

(Coie, Dodge, & Coppotelli, 1982; Denham & Holt, 1993; Johnson et al., 2000). Children

who experienced rejection at a young age had a difficult time being included and in forming

relationships with their peers (Johnson et al., 2000). Researchers studied peer rejection in

order to determine why children were excluded. While focusing on rejection, researchers

tested assumptions of how children could be accepted by peers (Coie, 1990). Johnson et al.

(2000) proposed that by teaching young children to accept others, children were then able to

acquire a healthy social development.

Mostow et al. (2002) found when children began formal schooling, peer relationships

become prominent. During the preschool period, children started to experience the peer group

and to feel its importance in their lives (Denham & Holt, 1993; Denham et al., 1990).

Johnson et al. (2000) stated preschool was the perfect time period for children to develop

social skills and friendships in order to be accepted by their peers. Since children are able to

develop friendships at this age and have the ability to verbalize who they like to play with,

preschool was a good age to implement a sociometric status task.

Studies showed rejected children potentially suffer in academics, suspensions, and

dropping out of school (Johnson et al., 2000). According to Coie and Dodge (1983),

individuals who experienced rejection as children tended to show an increased amount of

psychological damage and delayed social development as they continued to develop (Dodge

et al., 2003).

These individuals were more likely to have antisocial behavior or to be involved in

criminal behaviors later in life (Dodge et al., 2003; Johnson et al., 2000). Due to these

findings, preschool was an excellent time to teach children about accepting their peers

(Johnson et al., 2000; Landy, 2002; Mostow, Izard, Fine, & Trentacosta, 2002).
 Landy (2002) declared, teachers encourage children’s social development when they

are of preschool age by forming relationships with others. Hanish, Ryan, Martin, and Fabes

(2005) stated preschool children, generally between the ages of three and five, were

developing at an extremely rapid pace as they learned how to build and maintain friendships,

discovered which peers were disliked and liked, established steady play partners, acquired

reputations, and developed social skills. Mize, Ladd, and Price (1985) found promoting peer

acceptance was a preferred choice instead of treating rejected children later on in their lives.

1.2 Psychological Distress

Psychological distress is a general term used to describe unpleasant feelings or emotions

that affect your level of functioning. In other words, psychological discomfort interferes with

your activities of daily living. Psychological distress can result in negative views of the

environment, others, and the self. Sadness, anxiety, distraction, and symptoms of mental

illness are manifestations of psychological distress. So, no two people experience one event

the exact same way. Psychological distress is a subjective experience. That is, the severity of

psychological distress is dependent upon the situation and how we perceive it. We can think

of psychological distress as a continuum with 'mental health' and 'mental illness' at opposing

ends. As we continue to experience different things, we travel back and forth on the

continuum at different times throughout our lives.

Traumatic experiences, such as the death of a loved one, are causes of psychological

distress. Psychological distress can be thought of as a maladaptive response to a stressful

situation. Psychological distress occurs when external events or stressors place demands upon

us that we are unable to cope with. For example, we may struggle to accept that a loved one

is no longer with us. As a result, we become sad and have trouble getting out of bed, we are

unable to focus at work, and we lose interest in social activities.

 Major life transitions, i.e. moving to a new state or graduating from college, can be a

source of psychological stress if you are unable to cope with the demands that these

transitions place on you or are having difficulty adjusting to the new situation. Sudden

unexpected events, such as a loved one's death of a heart attack or being fired from a job, can

also cause psychological distress.Interest in the area of psychological well-being and positive

mental health seems to have peaked between the late 1950’s and 1970’s. Psychological well-

being is a multi-dimensional concept. After factor analysis, it was revealed that cheerfulness,

optimism, playfulness, self-control, a sense of detachment and freedom from frustration,

anxiety and loneliness are indicators of psychological well-being. (Tellegen, 1979; Sinha and

Verma, 1992)

1.2.1 Anger

Anger is defined as a subjective and a negative state which includes emotional

experiences, behavioral patterns, and cognitive phenomena (Sukhodolsky, Kasinove, &

Gorman, 2004). The role of parental rearing behaviors on occurrence of anger and hostility

was explored by several research studies. Houston and Vavak (1991) asked adults to describe

their parents’ behavior. It was found that individuals who were less accepted, more harshly

controlled, and more interfered were more likely to experience high level of hostility.

Furthermore, Meester, Muris and Esselink (1995) investigated perceived parental rearing

style and individual differences in hostility. They revealed that highly hostile individuals

perceived more rejection and control while they perceived less emotional warmth from their

parents than low hostile individuals did.

Clay, Anderson, and Dixon, (1993) investigated the relationship between anger

expression and depression. It was revealed that depression has been very much related to

suppressing anger but not to outward anger. In addition to that, anger expression and anger
experience of clinical sample were compared with normal sample by Riley, Treiner, and

Woods (1989). They found that depressed people reported high level of anger experience and

suppressed anger more than the normal sample. These findings indicate that when individuals

suppress their anger rather than expressing it outwardly, anger turned inward- the dynamic

explanation for depression- and these individuals are more likely to experience depression.

Considering gender difference in experience of anger, it is claimed that anger is more related

to a masculine expressive style. Therefore, males are expected to express their anger

outwardly. On the other hand, expressing anger is not appropriate for female gender role.

Therefore, females are expected to repress their feelings of anger and express it in the form of

depressive symptoms (Sharkin, 1993).

Newman, Gray, and Fuqua (1999) found no gender differences in terms of

experiencing anger. Therefore, it was concluded that males and females get angry to similar

things in the same intensity and express their anger in similar ways. The only difference is

that although both males and females experience anger in the same level, internalized anger

plays a prominent role among women than man.

1.2.2 Depression and Anxiety

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, American Psychiatric

Association [APA], 1994) describes major depression as loss of pleasure or depressed mood

and reduction in daily life activities. In addition to that, at least four of the following

symptoms must occur: a significant weight loss or weight gain, insomnia or hypersomnia,

psychomotor retardation or agitation, loss of energy or fatigue, feeling guilty and

worthlessness, problems associated with concentration and indecisiveness, and suicidal

ideation. These symptoms must be present at least for a two weeks period in order to be

diagnosed as depressed According to Beck, Rush, Shaw, and Emery (1979), depressive
people have a tendency to perceive themselves as defective, the world as offering difficulties,

and the future as pessimistic and hopeless.

Depressive feelings become more prevalent in adolescence since it is the transitional

period involving major changes in physical development, cognitive abilities, emotional

adjustment, and self-esteem (Weissman & Shaffer, 1998). Adolescents grown up in a

conflicting and rejecting home environment are more vulnerable to feelings of depression

(Nilzon & Palmerus, 1997). Lau and Kwok (2000) investigated the relationship between

family environment and depression of adolescents in Hong-Kong. It was concluded that

adolescent’s depression was related to perceived family environment. However, the

retrospective reports can be confusing since it is possible that depressive mood negatively

affect recall of parenting behaviors (Lewinsohn & Rosenbaum, 1987). Burge and Hammen

(1991) provided convincing evidence for the relationship between parenting behavior and

depression. They videotyped interactions of mothers and their children while discussing a

topic of discord. It was found that the affective quality of interaction between mother and

child during this discussion predicted depressive symptoms of the child 6 months later.

Anxiety was described as perception of uncertainty and threat concerning future events

and increased autonomic activity (Feldman, 1993). Watson and Kendall (1989) indicate that

comorbidity rate of depression and anxiety is very high. That is, people having high level of

depression are more likely to experience anxiety. Similarly, individuals experiencing anxiety

have a tendency to experience depression (Foa & Foa, 1982). However, anxious people tend

to perceive ambiguous situations as more threatening than depressed people. On the other

hand, depressed people are more likely to experience failure (Butler & Matthews, 1983).

According to a two factor model of Watson and Tellegen (1985), both depression and anxiety

involve a negative affect factor referring to feelings of upset and unpleasant arousal (e.g.
being distressed, fearful, hostile). However, depressive people seem to experience positive

affect, defined as pleasurable experiences (e.g. being excited, enthusiastic, elated) less than

anxious people. Similarly, Clark and Watson (1991) stated that both positive affect and

negative affect were able to discriminate depression and anxiety. That is, while negative

affect is the shared component of anxiety and depression, low positive affect is relatively

specific to depression. Gencoz (2002) investigated the effects of low positive affect on

depression symptoms. It was revealed that low positive affect predicted changes in

depression symptoms but not changes in anxiety.

Vulic-Prtoric and Macuka (2006) stated that both anxiety and depression are strongly

correlated with perceived parental rejection, but it appears that depressive children perceive

their families less pleasant to live with, and particularly, their parents to be less accepting,

supporting, and approving, and more rejecting and controlling than anxious children.

Through a meta-analytical study, Gerlsma, Emmelkamp, and Arrindell (1990) investigated

perceived parental rearing practices in depressed and anxious patients. The psychometric and

validational properties of questionnaires measuring perceptions of parental rearing styles

were examined and only studies using satisfactory measures were included in this meta-

analysis. It was concluded that different types of anxiety disorders were related to parental

rearing style of less affection and more control. However, findings of this study related to

depression were not consistent which may be explained by different diagnostic criteria.

Similarly, Rohner and Britner (2002) reported that depression and anxiety are inversely

related to the level of support and approval provided by the family environment.

1.3 Loneliness:

Loneliness is a part of the human condition that affects all ages. It is a subjective

negative feeling related to the person’s own experience of deficient social relations. A sense
of loneliness is associated with an individual’s evaluation of their overall level of social

interaction and describes as a deficit between the actual and desired quality and quantity of

social engagement. Loneliness can be a reaction to the lack of social relations one needs or

even though one has the social relations but they are not intimate or satisfying according to

the needs or they lack sincerity and emotions in them. Human beings are said to actively

engage each other and the universe as they communicate, and loneliness is merely the feeling

of being cut off from this process.

The most broadly accepted definition of loneliness is the distress that results from

discrepancies between ideal and perceived social relationships. While common definitions of

loneliness describe it as a state of solitude or being alone, loneliness is actually a state of

mind. It causes people to feel empty, alone and unwanted. People who are lonely often crave

human contact, but their state of mind makes it more difficult to form connections with other

people.

Loneliness has always been considered as a common problem among the older

people, but today it is becoming more of a concern amongst the young people. (Mental health

Foundation, 2010).Loneliness is a subjective experience. That means that if one thinks that

they are lonely then they will feel lonely. Not everybody who is alone is necessarily lonely.

Some people enjoy solitude. Tillich (1959) has stated, “Solitude expresses the glory

of being alone, whereas, Loneliness expresses the pain of feeling alone.” Larson (1997) in his

description of the differences between loneliness and solitude has explained that ‘solitude’ is

to be segregated from others easily, while, ‘loneliness’ is choosing to be alone.

Theoretical Background

Parental Acceptance and Rejection Theory

 Rohner (1986) developed Parental Acceptance-Rejection Theory (PARTheory), which

was an evidence-based theory of socialization and lifespan development. PARTheory aims to

predict and explain major antecedents and consequences of parental acceptance-rejection all

over the world. Within this perspective PARTheory is divided into three sub-theories. The

first is personality sub-theory which tries to answer the questions of whether children

everywhere give same reactions when they perceive that their parents reject them, to what

degree do the effects of childhood rejection extend into adulthood and old age. The second is

coping sub-theory, attempting to find answers to questions of what gives some children and

adults the resilience to emotionally cope more effectively than most others, with the

experience of childhood rejection and why some parents are warmer than others. The third

and the last one is socio-cultural systems sub-theory, investigating how parental acceptance

and rejection affect preferences of children in the future (Rohner, 1986, 2004).

Ecological theory

Bronfenbrenner’s Ecological Systems Theoretical perspective used a process, person,

context, and time model to observe continuity and change in the biophysical characteristics of

human beings (Bronfenbrenner & Morris, 2006). The first proposition of the theoretical

model incorporated the child’s development in various contexts — family, school, and peer

groups — with relationships and interactions that took place over time (Bronfenbrenner &

Morris, 2006). In this study, Bronfenbrenner’s Ecological Systems Theoretical perspective

was discussed as related to peer acceptance in preschool children. According to

Bronfenbrenner’s Ecological Systems Theory (Bronfenbrenner, 1979), children were

influenced by a number of different environments, as well as adult behavior. Various

environments can have profound effects on children’s lives (Bronfenbrenner, 1979). Three of

these settings include family, school, and peer group interaction. In a family environment,
children had daily interactions with family members. They were usually closest to the child

because the child saw them on a day-to-day basis and, as a result, had the most influence on

the child. Therefore, if parents only accepted people who are the same age, same gender,

same ethnicity, and pretty appearance, then the child would probably do the same. On the

other hand, if a child was not accepted by their parents, then it was likely the child would

have difficulties developing relationships with a teacher or peers; thus making acceptance

hard for a child to develop. School was another important environment in a child’s life

(Bronfenbrenner, 1979). Children have face-to-face contact with teachers and children saw

these individuals usually in more formal settings and interacted with them closely. Teachers

served as models in order to help children develop social skills and behaviors. Thus, if the

child’s teacher or peers only accepted others based on age, gender, ethnicity, and appearance,

then the child would pick others based on these characteristics to play with as well.

Peers were a part of a child’s environment within family and schools (Bronfenbrenner,

1979). Peers provided a direct connection for children to interact without adults, usually

within formal settings. With the absence of close adult supervision, children were able to gain

and experience independence. Independence allowed children to get a sense of who they were

and what they could do. Peers provided companionship and support, as well as learning

experiences in cooperation and role taking. As a result, children who were accepted by their

peer group gained a positive social development.

Strengths-based approach.

Research has a long history of focusing on children’s deficits and problem behaviors.

Within the last decade, researchers within the fields of education, mental health, psychology,

social work, and child welfare have begun to question the deficit-based approach and move

toward a more holistic model of development (Trout, Ryan, La Vigne, & Epstein, 2003).
Instead of focusing on individual and family weaknesses, strength-based professionals and

researchers collaborate with families and children to determine individual and family

strengths (Laursen, 2000). At the base of the strength-based approach is the belief that

children and families have unique talents, skills, and life events (Olson, Whitebeck, &

Robinson, 1991).

A reliable tool used to assess strengths and competencies, strength-based assessment

provides professionals with a positive way to approach intervention with children and

families. “Over time we have learned that asking the right question often has more impact on

the client than having the correct answer” (Miller, 1994, as cited in Clark, 1997, p. 98).

Professionals working from a strength-based approach emphasize the importance of asking

youth and families the “right questions”.

Several validated assessments for children have relied on a deficit-oriented assessment

model. For example, validated assessment tools, such as the Child Behavior Checklist

(Achenbach, 1991), document children’s deficits and problems. While these tools have

proven useful for understanding what is wrong with children, they provide little insight to the

strengths children may have in overcoming some of their problem behaviors. Researchers

working from a strength-based approach suggest that using assessments that focus on

strengths allow professionals to develop partnerships with families and children and that may

contribute to the child’s enhanced performance and motivation. When applied to peer

acceptance, the strengths-based framework in the present study used a definition of peer

acceptance that focused on the positive nature of children’s relationships, rather than the

identification of unsatisfactory relationships (peer rejection). Strengths-based approach drew

on studies of rejected children to inform professionals and teachers about how accepted

children could be affected when rejection took place (McLoyd, 1990, 2006). Acknowledging
the problems created by rejection, while at the same time highlighting factors that contributed

to acceptance, created a positive approach for sorting out the negative issues (McLoyd, 1990,

2006). When observing the behavior of the most selected children, it was thought that the

characteristics of accepted children would be discovered by their peers’ selection through the

sociometric task. Therefore, this study focused on what was working when children accepted

others, and it used what worked to stop children from being rejected in peer groups.

Attachment theory

Establishing a basis of loneliness from a developmental viewpoint, John Bowlby’s

1973 book further explaining attachment and its implications for later life he discusses the

development of two internal working models, one of the self and another of others. Bowlby

claimed that these models are formed from an individual’s early life experiences with their

primary caregiver. He theorised that as an infant, each individual forms an attachment type

based on this relationship with their mother in most cases. He believed that these models

were formed and retained in the memory from an early age and served as a template for what

the individual will expect their future experiences and relationships to amount to. The impact

on romantic relationships is emphasised however all social experiences are believed to be

effected. Bowlby theorises that the attachment type that an infant forms at the early stage of

life will likely correspond to an individual’s concept of others and adds that an avoidant or

insecure attachment type is associated with poor development of social skills and could result

in social and emotional underdevelopment. He believed that these individuals would

experience less social interaction and have fewer partners and close relationships throughout

life. He links this to loneliness as an individual may desire a close, loving and secure

relationship with a significant other but lack the social skills and security within themselves

to obtain and maintain such a relationship therefore fostering the discrepancy between the
relationships that the individual has and the relationships that they want to have. (Waters et

al., 2002). This association between preconceived relationship expectations inconsistent with

reality and feelings of loneliness is the foundation on which many widely accepted

definitions rest (Peplau & Perlman, 1982).

The aspect of Bowlby’s theory focusing on the outcome of insecure attachment styles

being associated with an inability to manage relationships successfully is supported in the

literature with links being found between insecure attachment and a number of dysfunctional

behaviour in the context of social relationships, some even finding a relationship with

stalking behaviour (MacKenzie et al., 2008). Further support for the theory is evident from

studies where associations between secure adult attachment styles and fewer feelings of

loneliness have also been found (Larose, Guay and Boivin, 2002; Kafetsios & Sideridis,

2006). Theories that view loneliness as a general term for different ‘types of loneliness’ and

claim it is multifaceted will now be described in order to provide the reader with an overview

of how theories of loneliness have progressed with time and approach the concept in

alternative manners.

A multidimensional view of loneliness begins with the work of Robert Weiss (1973).

Weiss claimed that loneliness is not a single vague construct but is multidimensional and

derived social loneliness and emotional loneliness from the original construct. Weiss

specified that social loneliness is concerned with a scarcity of social connections with friends

and colleagues whereas emotional loneliness refers to the absence of a significant other or

intimate partner with whom to share thoughts and everyday experiences. This approach also

receives support in the literature and is respected for its new and alternative view of the

concept (DiTommaso & Spinner, 1997; Dahlberg & McKay, 2013). This new outlook seems
to inspire researchers and theorists alike to explore the concept of loneliness and form new

ideas and theories to be investigated and compared.

 Literature Review:

The review of literature and this study could benefit parents, teachers, and

professionals. The literature informed readers about factors and reasons that may be

associated with peer acceptance.

Research has been conducted on peer rejection through intervention techniques for

teachers, parent surveys, and from child sociometric tasks (Coie, 1990). Research has studied

characteristics regarding age, gender, ethnicity, and appearance individually (Coie, 1990;

Coie & Dodge, 1983, Dodge et al., 2003; Dion & Berscheid, 1974; Mize et al., 1985).

However, little research existed on preschool aged children and these characteristics,

all in one study. The literature review and research project may help the reader understand the

reasoning behind how preschool children relate to their peers.

Peer acceptance has been the subject of many investigations in the area of inclusive

education. The study of Nikolaraizi et al. (2005), which was about children’s attitudes

towards individuals with special needs, indicated that children in Greece and in the United

States were more accepting of individuals with special needs. Also children attending

inclusive kindergartens held more positive attitudes when compared with children attending

non-inclusive kindergartens.

Yu, Zhang, and Yan’s (2005) study indicated that ‘children with disabilities reported

higher degree of loneliness, but lower levels of peer acceptance; significant correlations

existed between peer acceptance and loneliness, and between peer acceptance and family

functioning’. For peer interaction, strategic and communicative skills are important which the

role of pragmatic skills in attaining acceptance was shown in hearing students (Place and

Becker, 1991; Schimer, 2001; Nearland, 2011). Another factor that contributes to acceptance
and popularity is social behaviour. Prosocial behaviour positively predicts acceptance in

hearing children. Deaf children show less age-appropriate behavior than their hearing peers

(Kluwin, Stinson, and Colarossi 2002). They show less ageappropriate or socially adjusted

behaviour in separate classes than the mainstreamed deaf children do (Musselman, Mootilal,

and MacKay 1996; Stinson and Kluwin, 2011).

In Spain, Cambra (2002) studied the acceptance of hearing impaired students by their

regular classmates in inclusive classrooms. The findings indicated that socially these students

were well accepted by their peers. Overall, regular students believed that hearing impaired

students should be looked upon more positively when entering an inclusive setting from a

previous special education programme. More specifically, female peers believed that

inclusive settings offer more learning opportunities for classmates with hearing impairment.

Wolters et al. (2011) studied the acceptance and popularity in adolescence as a

function of hearing status, gender and educational settings and found that deaf boys in

mainstream education were less accepted and popular than their hearing classmates and their

peers in special schools. The deaf girls were less popular but not less accepted in mainstream

education.

Wauters and Knoors (2008) express that deaf and hearing children were found to be

similar in their peer acceptance and friendship relations but differences occurred in social

competence. Structural equation modelling showed peer acceptance, social competence and

friendship relations to be stable over time.

Tavakoli (1999) made a comparative study of hearing impaired students’ academic

achievement in inclusive and special education settings. She found that the regular students’

acceptance of their hearing impaired peer in inclusive schools was a significant contributing

factor to his/her academic success. Tavakoli argued that the interaction between the hearing
impaired and the non-hearing impaired students makes the inclusive setting a significantly

more suitable context for development of realistic attitudes and encouragement of peer

acceptance which further leads to enhancement of academic achievement.

Bowen (2008) worked on the friendship patterns and social interactions of students

with hearing impairment and suggests that hearing students in the coenrolled classroom had

better sign language skills, a more positive attitude towards deafness, and awareness of some

aspects of speech such as amplification. Deaf and hard of hearing students’ social acceptance

was similar to that of their hearing peers.

With regard to physical disabilities, Diamond and Hong (2010) mentioned that

children are likely to include a child in their activities who have few motor skills. Some other

studies have shown that physical attractiveness is a strong indicator in attitudes towards the

disabled.

Doubt and McCall (2003) had a research on youth with physical disabilities who

study in regular schools. They identified both external and internal factors as facilitators and

or limitations to integration. They found that some external factors such as peer and staff

support to be important. Analysis of the findings indicated that regardless of the integration

experience, subjects with physical disabilities felt they had a secondary status in school.

Dawkins (1996) mentioned that young people with visible physical disabilities are at

greater risk of bulling if they don’t have any friends, and Blunt-Bugental (2003) expressed

that friends can support children with visible physical disabilities in the same as they do for

other children.
 Other studies, such as Appleton et al. (1994), have shown that these students usually

have a lower feeling of self-adequacy than their peers in those experiences where physical

factors and appearance play a role (e.g. physical education classes).

Findings from studies, which have examined the social relationships of the students

with physical disabilities, shed more light on the subject of peer acceptance in integrated

settings. Investigators such as Lord et al. (1990) stated that adolescents in combined classes

reported the least loneliness, and even among students with relatively good social skills,

mainstream placement is associated with greater subjective experience of loneliness than is

combined placement. Mulcahey (1992) documented four adolescents’ experiences when they

returned to school after a spinal cord injury and found that returning to school environments

and peer groups were difficult for them. Blum et al. (1991) and Stevens et al. (1996) have,

however, reported evidence indicating the existence of positive peer relationship in similar

settings. Relationships, which they identify, do not extend beyond the school setting.

Studies have examined loneliness in adolescence (Goossens & Marcoen, 1999;

Koenig & Abrams, 1999; Kupersmidt, Sigda, Sedikides, & Voegler, 1999; Larson, 1999;

Sippola & Bukowski, 1999), few studies have focused on adolescent loneliness in the context

of peer relations, and these studies have focused on individual components of peer relations,

such as social acceptance, friendship, or behavior. For example, studies have linked

adolescent loneliness to friendship and peer acceptance (e.g., Brendgen, Vitaro, & Bukowski,

2000), and to victimization by peers (Storch & Masia-Warner, 2004). The goal of the present

study was to extend previous research by examining links between adolescent loneliness and

peer relations in a more comprehensive way than had been done previously—that is, through

inclusion of a number of components of peer relations within the same study.

 Previous research has found that negative social behaviors tend to be associated with

lower social acceptance (Cillessen & Mayeux, 2004), and that lower social acceptance tends

to be linked to greater loneliness (e.g., Boivin & Hymel, 1997), we decided to explicitly test

such mediational models. Although shyness is not necessarily a negative behavior, we

include it because of the possibility that shy behavior could adversely affect social

acceptance, which would in turn contribute to adolescents’ degree of loneliness (Crozier,

2000).

Rezan and Fulya (2007) conducted a research on 268 university students to determine

how university students’ loneliness is predicted by their high level of psychological well-

being. The result that they derived from the analysis was that psychological well-being was

one of the main factors of predicting loneliness. There is close relationship between

loneliness and positive relations with other people. In this particular literature, emphasis was

laid on linking loneliness with poorer social skills, introversion and lack of social support.

The second predictor that they found of loneliness was the ‘purpose on life’ dimension of

psychological well-being. Being clear about one’s purpose in life brings harmony and peace

of mind in one’s life. They derived that persons suffering from loneliness were not happy

with life due to different kinds of psychological problems they go through, like, anxiety,

depression, social isolation, loneliness etc. The people who had failed to determine their

purpose in past or in the present go through high levels of loneliness. Out of the six

dimension of psychological well-being, ‘purpose in life’ contributed as an important predictor

of loneliness.

Seygin, Akdeniz and Deniz (2015), studied that loneliness affects a person’s well-

being largely. The research-based findings showed that interpersonal problem solving and

loneliness are significant predictors of subjective well-being. One aspect of the finding shows
that when there is lack of interpersonal problem solving skill it lessens the levels of

subjective well-being. It was also seen that self-confidence decreases and negativity

increases. Researchers have found that interpersonal problem solving positively correlates

with well-being in terms of constructive problem solving. Another very important finding

was that loneliness as a predictor of subjective well-being is very significant. This means that

the higher the subjective well-being levels, the lower the loneliness and the lower the

subjective well-being levels, the higher the loneliness. The most important thing that they

derived from their research was that when a person has a good ability of solving interpersonal

problems, he/she becomes happier. Finding solutions to one’s problems lessens the hardships

and increases well-being.

Kalpidou, Costin and Morris, (2011), in their research have shown how social media

affects a person’s well-being. They have shown that social networking sites can be one of the

causes of loneliness. Facebook has reduced interconnectedness with the community among

introverts. Other researchers also studied the relationship between internet usages as a factor

of loneliness. They reported that high level of internet usage resulted in a decrease in social

loneliness i.e., on the social networking sites and it resulted in an increase in emotional

loneliness i.e. intimate relationships (Moody). The findings of this research showed that there

was a relationship between Facebook and a person’s psychological well-being. Spending a lot

of time on Facebook affected self-esteem negatively. Those students who had a low self-

esteem tend to use social networking sites more because that helps him/her in increasing their

social capital (Ellison et.al.). Apart from this, the first year students who had many Facebook

friends reported low levels of adjustment and interpersonal communication in college.

Adjusting well in a new environment shows a person’s strong emotional construct. It is

possible that a person has many friends on facebook in the first year, so that he/she feels a

part of the in-group. It was also found that lack of adjustment also affected the academic
performance of the students. The findings revealed two trends. The first one was that, first

year students who have many friends on Facebook affects their self-esteem negatively,

academic performance becomes poor, adjustment quality becomes poor and interpersonal

communication becomes difficult. The second trend was the amount of time spent online also

affected a person’s well-being.

Doman and Roux in the year (2011), conducted a cross-cultural study on the

relationship between loneliness and psychological well-being. The study was conducted in

South Africa, which is a multicultural developing country. The purpose of this study was to

check the effects of political systems, failed leadership, and high incidence of child abuse,

rape, sexual molestation, incest, violence and crime on young adults. Its aim was to include

these young adults into studies of loneliness and psychological well-being. The target

population was students from different cultures at the University of Free State and the

research was done in a non-experimental method. The non-experimental hypothesis testing

research was used to divide the groups according to criteria. Questionnaire used for loneliness

was a self-designed one i.e. The Le Roux Loneliness Questionnaire and the Psychological

general well-being index. The results that were derived from the research were that,

depression and a sense of positive well-being affect loneliness significantly. They found out

that the relationship between loneliness and psychological well-being is very significant. This

means that students with high psychological well-being experienced lesser degree of

loneliness while students with low psychological well-being experience loneliness to a

greater extent. The most important finding of this research paper was the sub-scale of

psychological well-being i.e. depression and sense of positive well-being resulted as major

causes of loneliness.
Objectives

 The aim is to find positive relationship between Peer rejection with loneliness and

psychological distress.

 The aim is to find negative relationship between Peer with loneliness and

psychological distress.

 The aim is to find predictive role of peer acceptance, rejection and loneliness on

psychological distress.

Hypothesis

 Peer rejection is likely to have a positive relationship with loneliness and

psychological distress.

 Peer rejection is likely to have a negative relationship with loneliness and

psychological distress.

 Peer acceptance, rejection and loneliness are likely to predict psychological distress.

Method
 The present research will consist of a correlational study in which Effect of peer

acceptance rejection on psychological well-being, loneliness and health in university students

will be studied.

3.1 Research design.

Correlational (cross-sectional) research design will be used in the following study.

3.1.1 Sample.

Sample size will consist of 300 students i.e. 150 male and 150 female. Private

University (University of Central Punjab) (n=150) and Government University (Punjab

University) (n=150). The age range of the students included 18 years to 28 years.

Gender

3.1.2 Sampling strategy.

3.2.1.1 Inclusion criteria.

 Students who are at least in their 5th semester of their degree.

 Students who are smokers

3.2.1.2 Exclusion criteria.

 Students with any physical disability.

 Students whom parents are divorced, separated or dead.

 The students with any medical or psychological illness that can have an effect on their

performance.
3.4 Assessment measures.

In the study of the present research, following three measures and demographic

information form will be used for assessment. These measures include:

 Demographic information Form

 Adolescent Peer Relations Instrument

 Emotional and Social Loneliness Scale

 Patient Health Questionnaire-4 (PHQ-4)

 Kessler Psychological Distress Scale (K10)

3.4.1 Demographic information form.

In order to obtain information from the participants a demographic information form was

developed by the researchers. The form included the sex (male/female), age in years (up to

20/21–22/23–24/25 and older), years of education, marital status (married/committed

relationship/single, family system, socio economic status, current semester, residence

(alone/with a partner/shared flat/dormitory or elsewhere), and available money per month

in (up to 550/551–690/690–885/ 886+), Studying in government or private university.

3.4.2 Adolescent Peer Relations Instrument

This six-scale APRI instrument measures three types of behaviors used to bully others

(Physical, Verbal, Social) and three ways of being targeted (Physical, Verbal, and Social). In

total 18 items were used to measure bullying and 18 items used to measure being bullied.

However, two words within the instrument were modified to accommodate for primary

school aged students. These were ‘remark’ modified to ‘comment’, and ‘ridiculed’ modified

to ‘embarrassed’ (refer to Table 1 for items used). All items were measured on a six-point

Likert response scale (1 = Never, 2 = Sometimes, 3 = Once or twice a month, 4 = Once a

week, 5 = Several times a week, 6 = Every day). Responses closer to 1 represented small

amounts of bullying or being bullied, whereas scores closer to 6 represented frequent

amounts of bullying or being bullied.

3.4.3 Emotional and Social Loneliness.

The authors measured emotional loneliness and social loneliness based on the six-

item De Jong Gierveld Loneliness Scale. The six-item scale is a reliable and valid

measurement instrument for overall, emotional, and social loneliness that is suitable for large

surveys. The authors focused on reporting the results of emotional and social loneliness

separately, because previous theoretical and empirical research underlined the importance of

conceptual separation. The scale included three items measuring social loneliness and three

items measuring emotional loneliness. It had three negatively formulated items (“I miss

having people around”, “I experience a general sense of emptiness”, and “I often feel

rejected”) and three positively formulated items (“There are many people I can trust

completely”, “There are plenty of people I can rely on when I have problems”, and “There

are enough people I feel close to”). The items had four response categories: “strongly agree”,

“agree”, “disagree”, and “strongly disagree”. Scale scores were calculated by counting

“strongly agree” and “agree” on negatively formulated items and “disagree” and “strongly

disagree” on positively formulated items. Each loneliness scale ranged from 0 (not

emotionally/not socially lonely) to 3 (emotionally/socially lonely). The general loneliness

scale ranged from 0 to 6 (0–1 = not lonely, 2–4 = moderately lonely, 5–6 severely lonely).

Cronbach’s alpha was 0.681 for emotional loneliness and 0.694 for social loneliness.

3.4.4 Patient Health Questionnaire-4 (PHQ-4)

Drs. Robert L. Spitzer, Janet B.W. Williams, and Kurt Kroenke and colleagues developed the

PHQ scales. It is a four-item measure of depression and anxiety symptoms ranging from 0 to
12. It consists of the PHQ-2 that measures core criteria for depression and the Generalized

Anxiety Disorder-2 GAD-2, which is a two-item measure for anxiety [36]. Both have been

shown to be excellent screening tools. This continuous variable was categorized into four

levels (none/mild/moderate/severe) according to Kroenke et al. The authors included

variables measuring changes in health-related parameters due to the transition from high

school to university. They measured self-reported changes in weight (yes/no/I don’t know),

direction of weight change (weight increase/weight decrease), diet (yes/no/I don’t know), and

physical activity (more activity/less activity/no difference) since the last year at high school.

Furthermore, they assessed perceived stress of transition from high school to university using

a scale ranging from 1 to 10 (1 = non-stressful, 10 = very stressful). They split perceived

stress into three categories using a tertile split (low/medium/high).

3.4.5 Kessler Psychological Distress Scale (K10)

This is a 10-item questionnaire intended to yield a global measure of distress based on

questions about anxiety and depressive symptoms that a person has experienced in the most

recent 4 week period. The use of a consumer self-report measure is a desirable method of

assessment because it is a genuine attempt on the part of the clinician to collect information

on the patient’s current condition and to establish a productive dialogue. When completing

the K10 the consumer should be provided with privacy. As a general rule, patients who rate

most commonly “Some of the time” or “All of the time” categories are in need of a more

detailed assessment. Referral information should be provided to these individuals. Patients

who rate most commonly “A little of the time” or “None of the time” may also benefit from

early intervention and promotional information to assist raising awareness of the conditions

of depression and anxiety as well as strategies to prevent future mental health issues.

Procedure
 Before starting the research, first research topic was approved by competent authority

of the University. Before using the assessment tools for collecting the data, permission was

taken from the respective authors for the use, assessment measures. For impending research-

targeted sample, two universities of Lahore were selected and before collecting data, official

permission was taken from the main department of the universities through the letter by

University of Management and Technology, Lahore. Informed consent and information sheet

was designed to educate the study participants about the purpose of the study, assure them

about the confidentiality, and give them the liberty to leave the study at any stage of the

assessment. The study participants were informed about the purpose of the study. Once they

were aware than questionnaires to the nurses were provided and data was collected.

Ethical Considerations:

 The participants will be given an informed consent.

 All the information about the research will be given to the participants.

 The participants are free to withdraw from the research anytime.

 The given information of the participants will be confidential.

 Their identity will be anonymous.

 The given information will only be used for the research purpose.

 The participants would be informed about the research result if they were willing.