Mental health disorders and adolescent peer relationships.

Emily Long,Mark Tranmer,Laurence Moore,Maria Gardani,Helen Sweeting,Mark Mccann

doi:10.1016/j.socscimed.2020.112973

Abstract

RationaleMental health disorders often arise during adolescence, with disruptive behavior disorders and anxiety disorders among the most common. Given the salience of peer relationships during adolescence, and research suggesting that mental health disorders negatively impact social functioning, this study uses novel methodology from social network analysis to uncover the social processes linking disruptive behavior disorders and anxiety disorders with adolescent friendships. In particular, the study focuses on peer withdrawal, peer popularity, and peer homophily in relation to both disorders.MethodsData come from 15-year old students in four Scottish secondary schools (N = 602). Diagnoses of disruptive behavior disorders and anxiety disorders were produced using the Diagnostic Interview Schedule for Children, and peer relationship data were obtained through a friendship nomination survey. Exponential random graph models were used to estimate the probability of peer withdrawal, peer popularity, and peer homophily based on each disorder.ResultsResults demonstrated that adolescents with disruptive behavior disorders were more popular than their peers without disruptive behavior disorders (OR: 1.47, CI: 1.20, 1.87). Friendship was also more likely between two adolescents both with or both without disruptive behavior disorders (OR: 1.26, CI: 1.07, 1.47), demonstrating peer homophily. There was no evidence that anxiety disorders were related to adolescent peer relationships.ConclusionsFindings from this study suggest that disruptive behavior disorders may be socially rewarded (e.g., peer popularity) and socially clustered (e.g., homophily), whereas anxiety disorders show no such trends. Thus, intervention efforts must account for the peer social status that may be gained from engaging in disruptive behavior during this developmental period. Further, given that similarity in DBD status is associated with an increased likelihood of friendship, adolescents are likely to be surrounded by peers who reinforce their behaviors.

Highlights

Adolescence marks a vulnerable period for the onset of poor mental health
Given the unique ability of social network methods to objectively quantify adolescent friendship patterns, the current study extends previous research by using these methods to determine the extent to which disruptive behavior disorders (DBD) and anxiety disorders (AD) are associated with adolescent peer popularity, withdrawal, and homophily
Substance use was associated with friendship, such that adolescents who smoked had a lower probability of friendship ties, and adolescents who drank alcohol had a higher probability of friendship ties

Summary

Introduction

Adolescence marks a vulnerable period for the onset of poor mental health. DBD and AD are linked with continued poor mental health in adulthood (Kessler et al, 2007), and associated with deficits in multiple domains during adolescence, including social functioning (Kingery et al, 2010; Milledge et al, 2019; Mrug et al, 2012). This is problematic in that adolescence is characterized by a heightened salience of relationships with peers (Crosnoe and Johnson, 2011; Rubin et al, 2006), and a lack of friends is associated with increased depression and decreased self-worth (Prinstein and Dodge, 2008; Rubin et al, 2006). In order for research to effectively inform the design of policy programs aimed at enhancing the wellbeing of this vulnerable population, it is critically important to elucidate the interconnections between mental

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Conclusion