Introduction

According to the second China National Sample Survey on Disability (CNSSD), it is estimated that by the end of 2010, the total number of people with disabilities in China had reached 8.52 million(Zhao, 2012). At the final stage of the “13th Five-Year Plan” on building a moderately prosperous society in all respects (Zhou, 2017), whether people with disabilities are physically and mentally healthy, whether their families are happy, and whether their lives are generally decent, are important indicators for measuring whether China can build a moderately prosperous society in all respects. Furthermore, the Central Committee of the Communist Party of China and the State Council issued the Healthy China 2030 Plan Outline, which states that health is a must for promoting well-rounded personal development and a prerequisite for social and economic development, which proposes that the gaps in health services and conditions between different localities and between different groups should be narrowed, and which requires that China should formulate and implement the health intervention plan for special groups including people with disabilities (Zhao, 2012). With the continuous development of contemporary medicine and positive psychology, people no longer only focus on physical health, but they have begun to pay more attention to mental health. People with disabilities are a social group with special difficulties due to their physical disabilities and functional impairment (Zheng, 2008), and their mental health issues have gradually become a spotlight of researchers’ attention. According to the data of the 2013 Monitoring Report on the Status and Progress towards a Comfortable Life of Persons with Disabilities in China, people with disabilities rarely participated in community cultural and sporting activities, and nearly two-thirds of people with disabilities had not really gone out of their homes and integrated into society (Chen et al., 2014). It can be seen from this that social avoidance is a common problem currently faced by people with disabilities in China, and it may even gradually affect their physical and mental health.

Social interaction is an essential part of people’s social activities. “Social avoidance” refers to an individual’s tendency to avoid participating in social activities, which is manifested as refusing to be with others, refusing to talk, or even avoiding everyone for certain reasons; social distress refers to the absence of positive emotional experiences experienced in social interaction(Wright et al., 2012). Previous studies have shown that most people with disabilities tend to self-impose isolation and avoid socializing with others in their behaviors (Ye & Zhang, 2010). Compared with healthy people, people with disabilities generally have poor mental health, they are plagued by emotional problems such as loneliness, social anxiety, and inferiority, and some of them whose mental health are severely challenged even have the idea of committing suicide (Yan, 2013). Social avoidance and distress frequently haunt people with disabilities, and gradually cause them to separate from mainstream social groups and become marginalized when interacting with peers, which have affected their normal socializing, learning, rehabilitation, and development (Liao & Zhang, 2013). Based on this, it is extremely important to explore the impacting factors and the mechanism of social avoidance and distress among people with disabilities, with the goal of hel** the social reintegration of people with disabilities.

Impacts of family functioning on social avoidance and distress

Unlike healthy people, people with disabilities are limited by their own functions, and the family is the main place of their daily life. In addition, under the social conditions that China’s social welfare system is not yet perfect, the life stress of people with disabilities is mainly borne by their family members, and their dependence on the family is stronger than that of healthy people. Previous studies have also shown that: firstly, in terms of economy, only 27.42% of the 34 million people with disabilities of working age in China have the ability to work, while the employment rate of people with disabilities who with the ability to work is only about 40% (Huang, 2006), so the most important source of income for most people with disabilities is the support from their family members; secondly, in terms of medical rehabilitation, due to reasons such as the current imperfect social welfare system in China, most people with disabilities cannot have access to adequate medical rehabilitation services and life care from the society, which they can only obtain from their families; thirdly, in terms of mental health, the family is the main place for people with disabilities to live their daily life and communicate with the outside world. The attitudes of family members would directly affect the emotional state and happiness of people with disabilities(Zhao, 2014). The functions of family played in the physical and mental development of people with disabilities have gradually become a spotlight of researchers’ attention.

The concept “Family Functioning” was first proposed in the 1970s. At that time, McMaster proposed a model based on systems theory, the crucial assumptions of systems theory which underlie the model are as follows: (1) All parts of the family are interrelated; (2) One part of the family cannot be understood in isolation from the rest of the family system; (3) Family functioning cannot be fully understood by simply understanding each of the individual family members or subgroups; (4) A family’s structure and organization are important factors that strongly influence and determine the behaviour of family members; (5) The transactional patterns of the family system strongly shape the behaviour of family members(Miller et al., 2010). Currently, the concepts on family functioning are mainly divided into two orientations: one is to pay attention to the results of family functions, such as Beavers, Olson, and Sheik et al., while the other is to emphasize the process of develo** family functions, such as Epstein and Skinner et al. Beavers focuses on describing family functioning from the aspects of intimacy, connection quality, and family adaptability among family members(Beavers & Hampson, 2000). On this basis, connecting with Chinese local culture, Sheik proposes to define family functioning by the lifestyle and quality on the two-way relationships between husband and wife and between parents and children within the family system (Sheik, 2002). Olson argues that family functioning is the effectiveness reflected in the communication, emotional connection, family rules and co** with external stressful events among members within the family system(Olson, 2002). Skinner propose that families fulfill their functions by meeting the physical and mental growth and self-development needs of members within the system (Skinner & Stein Auer, 2000). From the perspective of either the results-oriented or process-oriented family functioning theory, relevant empirical studies have shown that the better the family functions are played, the higher the level of individual mental health is. Family functioning can effectively reduce the level of social avoidance and distress (** should be more detailed, to examine the possible impact of age on people with disabilities.

Furthermore, most existing studies on the psychological and behavioral characteristics of people with disabilities are still superficial, and the studies on the psychological mechanism that affects people with disabilities’ social avoidance and distress are still relatively weak. This study selected 406 people with disabilities for investigation, but did not classify their disability categories and levels of disability. Therefore, follow-up research can focus on examining the differences in psychological characteristics of the individuals with congenital and acquired disabilities, and early and late disability, as well as the individuals with different disability categories and levels of disability.

Finally, in order to better validate research hypotheses, this study only selected the total scores of family functioning, social avoidance and distress, perceived social support, happiness, and self-esteem for analysis, without exploring the subscales. In the future, various subscales can be considered for analysis to examine the potential effects of different dimensions.

Conclusions

Perceived social support and happiness have multiple mediating effects on the relationship between family functioning and social avoidance and distress among people with disabilities;

The mediating effect of perceived social support is moderated by self-esteem, and self-esteem moderates the latter half path of the mediating process of family functioning - perceived social support - social avoidance and distress.

The findings from the study are of theoretical and practical significance for promoting people with disabilities’ participation in social activities and improving the level of their physical and mental health.