Bidirectional associations between peer exclusion and depressive symptoms in children and adolescents: A meta-analysis of longitudinal studies

Abstract: The causal relationship between peer exclusion and depressive symptoms in children and adolescents remains controversial. To systematically examine this dynamic relationship and its boundary conditions, we conducted a one-stage meta-analytic structural equation modeling analysis based on 23 longitudinal studies (26 independent samples, N = 20,676) identified from eight databases. Results showed that peer exclusion significantly predicted subsequent depressive symptoms (β = 0.06), and depressive symptoms likewise predicted subsequent peer exclusion (β = 0.09). Moderator analyses indicated that the path from peer exclusion to depressive symptoms was not moderated by any examined variable, whereas the path from depressive symptoms to peer exclusion was significantly moderated by peer exclusion reporting method, individualism scores, and publication year. The autoregressive paths of peer exclusion and depressive symptoms were moderated by time interval and cultural background, respectively. These findings support the transactional model, confirming a bidirectional vicious cycle between peer exclusion and depressive symptoms. The results provide meta-analytic evidence for refining interpersonal theories of depression in children and adolescents and for developing dual-track intervention strategies. Future school mental health practices should aim both to reduce the psychological harm of peer exclusion and to improve the social interaction patterns of depressed adolescents, thereby preventing them from falling into persistent exclusion.