Are They Still Friends? Friendship Stability of Adolescents With Chronic Pain: 1-Year Follow-Up.

Paula A Forgeron,Christine Chambers,Christine Lamontagne,Gordon Allen Finley,Janice Cohen,Bruce D Dick

doi:10.3389/fpain.2021.767236

Abstract

Most adolescents identify their best friend as their main source of social support. Adolescents with chronic pain (ACP) report the loss of friendships due to pain. Friendships protect against loneliness and depression, yet adolescents with pain experience increased levels of loneliness and depression compared to peers. This longitudinal study examines the friendship stability of dyads that included an adolescent with chronic pain compared to non-pain friendship dyads as well as the factors contributing to a friendship breakup. Eighty-three participants from 61 same-sex friendship dyads across 3 sites participated in a 1-year follow-up survey designed to capture friendship features, indices of social-emotional well-being, pain characteristics, and friendship stability. Chi-square, repeated measures ANOVA, and logistic regression were used to analyze the data. Dyads that included an ACP experienced higher rates of friendship breakup. The shorter length of friendship and having chronic pain predicted a friendship breakup at time 2. ACP continues to experience worse scores on indices of social-emotional well-being that are not predicted with a friendship breakup. Understanding what contributes to positive long-term friendships for those with pain may inform strategies to maintain and improve friendships for those with pain and who experience social challenges.

Highlights

Chronic pain negatively impacts all aspects of an adolescent’s health, including their social health
There was a variation in the degree of pain-related disability among these participants with chronic pain with a T1 PedMIDAS mean score of 87.74 (SD 73.71) for all the Adolescents with chronic pain (ACP), indicating that most of the participants experienced significant pain-related disability
On a more positive note, there was an improvement in the degree of pain-related disability among the ACP over the year, but this was independent of friendship stability

Summary

Introduction

Chronic pain negatively impacts all aspects of an adolescent’s health, including their social health. Teens With Pain Friendship Stability developing persistent low back pain [5], indicating that social functioning in adolescents with chronic pain (ACP) has long-term effects. Not all ACPs report difficulty in making close friends and self-rate their ability equal to normative data [11] It is not known if they are able to maintain these friendships similar to non-pain peers. Adolescent friendships provide one with reliable alliance and companionship, and they can buffer negative effects of peer victimization [15, 16]. They protect against loneliness and depression [17], indicating that strong friendships are necessary for healthy adolescent development. Since ACP score being higher on loneliness, depression, and anxiety measures compared to controls and being lower on self-esteemed measures in cross-sectional studies [18, 19], it is critical to understand if and how friendship stability impacts these factors over time

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