Peer Relationship Difficulties Research Articles

Collaborative conversations: adolescent girls' own strategies for managing conflict within their friendship groups

Adolescent girls' friendships are often disrupted by conflict and aggressive behaviour. Solving these difficulties is challenging as girls claim that adult intervention can make things worse. What advice would girls themselves give their friends if they were experiencing peer relationship difficulties? This study addressed this question using a narrative perspective, and a participatory action research approach. Seventy-five 14–15-year-old adolescent girls engaged in a series of interactive focus group sessions. A cyclical process of group interviews, discussions and data analysis saw the refinement of the girls' knowledge and the development of 10 key strategies for managing peer conflict. The most highly ranked strategies included: developing a wide circle of friends, having a voice, walking away from conflict, talking individually to peers, and avoiding participating in hurtful behaviours. Acknowledging adolescent girls' knowledge, creativity, and abilities creates an alternative story, enabling them to better manage peer conflict.

A Review of Peer Relationships and Friendships in Youth With ADHD

Objective: The purpose of this essay is to examine peer relationships in youth with ADHD and to review current peer functioning interventions. Method: The studies included in this review were identified using the following search terms: “attention-deficit/hyperactivity disorder,” “ADHD,” “peer relationships,” “friendships,” “social skills,” “intervention,” and “treatment.” Other than a few seminal studies published prior to 2000, studies included were published between 2000 and 2012. Results/Discussion: Background information regarding peer relationship difficulties and specific social skills deficits of youth with ADHD is reviewed and current social skills and friendship intervention programs are examined. Future directions also are provided.

Are children with obsessive–compulsive disorder at risk for problematic peer relationships?

The current study examined social functioning and peer relationships among pre-adolescent children with obsessive–compulsive disorder (OCD) and a non-psychiatric control group. The sample included 23 children with a primary diagnosis of OCD and 30 children with no psychiatric disorders. All children were diagnosed using the Anxiety Disorders Interview Schedule-Child Version (ADIS-CV) and assessed on social functioning (Pediatric Quality of Life Inventory – Child Report), fear of negative evaluation (Brief Fear of Negative Evaluation Scale), peer victimization, bullying behavior, and pro-social behavior (Peer Relations Questionnaire), and several aspects of their friendships (ADIS-CV Interpersonal Relationships). Children with OCD were also assessed on symptom severity (Children's Yale–Brown Obsessive–Compulsive Scale Severity Ratings). Children with OCD reported significantly worse social functioning, more fear of negative evaluation, more peer victimization, less bullying behavior, and less pro-social behavior compared to controls. Additionally, children with OCD were significantly more likely than controls to endorse difficulties in peer relationships, including having fewer friends than most kids, wanting more friends, and having trouble making friends. Findings suggest that OCD interferes with social functioning among pre-adolescent children. Parents and teachers are encouraged to facilitate social interactions for children with OCD, and treatment providers are encouraged to attend to peer difficulties.

Evidence of gene–environment correlation for peer difficulties: Disruptive behaviors predict early peer relation difficulties in school through genetic effects

Early disruptive behaviors, such as aggressive and hyperactive behaviors, known to be influenced by genetic factors, have been found to predict early school peer relation difficulties, such as peer rejection and victimization. However, there is no consensus regarding the developmental processes underlying this predictive association. Genetically informative designs, such as twin studies, are well suited for investigating the underlying genetic and environmental etiology of this association. The main goal of the present study was to examine the possible establishment of an emerging gene-environment correlation linking disruptive behaviors to peer relationship difficulties during the first years of school. Participants were drawn from an ongoing longitudinal study of twins who were assessed with respect to their social behaviors and their peer relation difficulties in kindergarten and in Grade 1 through peer nominations measures and teacher ratings. As predicted, disruptive behaviors were concurrently and predictively associated with peer relation difficulties. Multivariate analyses of these associations indicate that they were mainly accounted for by genetic factors. These results emphasize the need to adopt an early and persistent prevention framework targeting both the child and the peer context to alleviate the establishment of a negative coercive process and its consequences.

Strong Genetic Contribution to Peer Relationship Difficulties at School Entry: Findings From a Longitudinal Twin Study

This study assessed the genetic and environmental contributions to peer difficulties in the early school years. Twins' peer difficulties were assessed longitudinally in kindergarten (796 twins, Mage = 6.1 years), Grade 1 (948 twins, Mage = 7.1 years), and Grade 4 (868 twins, Mage = 10 years) through multiple informants. The multivariate results revealed that genetic factors accounted for a strong part of both yearly and stable peer difficulties. At the univariate level, the genetic contributions emerged progressively, as did a growing consensus among informants with respect to those who experienced peer difficulties. These results underline the need to intervene early and persistently, and to target the child and the peer context to prevent peer difficulties and their consequences.

Body esteem, peer difficulties and perceptions of physical health in overweight and obese urban children aged 5 to 7 years

To determine whether there is an association between body mass index (BMI) and body esteem in young overweight and obese urban children, and to test peer relationship difficulties and perceived physical health as mediators of this relationship. Child self-reported body esteem, and parent-reported child peer relationship difficulties (being bullied by peers and peer rejection) and physical health perceptions were obtained from 218 overweight and obese children aged 5-7 years (81% racial/ethnic minority, M BMI = 25.3) and their primary caregivers. Higher BMI was associated with lower body esteem for both girls and boys. This relation was mediated by poor physical health for boys but not for girls. Peer relationship difficulties did not mediate the observed association between BMI and body esteem in either group; however, girls with higher BMI experienced more bullying and being bullied by peers was associated with lower body esteem in girls. Intervening with perceptions of physical health may buffer overweight and obese boys from developing low body esteem in early childhood.

Associations Between Fifth Graders’ Gender Atypical Problem Behavior and Peer Relationships: A Short-Term Longitudinal Study

An accruing body of evidence supports associations between self-perceived gender typicality and peer relationship difficulties; however, researchers have yet to evaluate peers' perceptions of problem behaviors to gain insight into the social correlates of gender typicality. A short-term longitudinal study was conducted to evaluate associations between gender atypical problem behavior and subsequent peer relational difficulties for 2,076 fifth graders (M age= 10.27; 53% female). Peer nomination methodology was used to assess participants' classroom peer relationships, problem behaviors, and social-emotional characteristics. Findings showed that youth characterized by gender atypical, compared to gender typical, problem behavior (withdrawn boys/aggressive girls vs. withdrawn girls/aggressive boys, respectively) evidenced higher levels of subsequent peer difficulties; moreover, participation in a mutual friendship was associated with decreased risk for peer relationship maladjustment, particularly among youth characterized by gender atypical problem behavior. Results further revealed that, compared to friendless youth, friended youth earned higher prosocial and peer liking scores and, for withdrawn youth, lower emotional sensitivity scores. The present research contributes to our understanding of the potential short-term consequences of youth's gender atypical problem behavior. Findings underscore the need for supplemental conceptualizations of gender typicality as well as multifaceted interventions designed to promote the acceptance of gender nonnormativity, support the development of adaptive peer relationships, and reduce the occurrence of problem behaviors.

Gender and Conduct Problems Predict Peer Functioning Among Children with Attention-Deficit/Hyperactivity Disorder

Children with attention-deficit/hyperactivity disorder (ADHD) often have poor relationships with peers. However, research on this topic has predominantly focused on boys. This study considered child gender, ADHD status, and dimensionally assessed conduct problems as predictors of peer relationship difficulties. Participants were 125 children (ages 6–10; 67% male), 63 with clinical diagnoses of ADHD and 62 non-ADHD comparison youth. Conduct problems were reported by teachers and observed in a lab playgroup. Peer relationships were assessed by parent report, teacher report, and peer sociometric nominations in the playgroup. Results suggested that children with ADHD, as well as those with high conduct problems, displayed more impaired peer relationships than did comparison children and those with low conduct problems, but overall there were no gender differences in social functioning. However, statistical interactions appeared such that the negative impact of conduct problems on peer relationships was stronger for girls than for boys.

The relationship between motor performance and peer relations in 9- to 12-year-old children

Poor motor skills have been associated with peer relationship difficulties, with lower peer preference and greater likelihood of suffering from withdrawal and low self-worth. Most research into these relationships has focused upon children with motor problems and on activities involving physical skills (play/sport). The current study examined the link between motor performance and peer relations in 9- to 12-year-old children in both physical and non-physical (schoolwork) settings using a community sample. Participants were 192 school children whose motor performance was tested using the Movement Assessment Battery for Children. Peer acceptance was assessed using the Peer Rating Scale and teachers completed the Peer Exclusion subscale of the Child Behaviour Scale to indicate each child's peer status. Children were also asked to indicate their level of physical activity and their perceived freedom in leisure using self-report questionnaires. Children with poor motor performance had lower levels of physical activity, and freedom in leisure and were less preferred by their peers in both play and classroom settings. These effects were stronger for boys than for girls. Teacher indicated that children with poorer motor skills experienced higher levels of peer rejection in the classroom setting. When motor performance was separated into fine- and gross-motor performance it was found that only the latter was significantly correlated with peer acceptance in the play context but that fine-motor skills contributed significantly to variance in teacher ratings of peer exclusion in the classroom setting. The results support and extend earlier findings that children with poor motor performance are less accepted by their peers in play settings and provide some support for this extending to settings involving low levels of physical activity (classroom settings). The results similarly support previous findings that motor performance is associated with perceived freedom in leisure and with the likelihood of participating in active pursuits.

Peer-relationship difficulties in children with brain injuries: Comparisons with children in mental health services and healthy controls

Positive peer relationships are essential in healthy development. The prevalence of peer-relationship problems in children after acquired brain injury (ABI) has yet to be explored, although ABI does inevitably impact upon peer interactions. We aimed to explore how peer-relationships and emotional distress after ABI may differ from the levels reported by healthy children or mental health controls. Parents of 214 children (137 “healthy” children, 27 children using mental health services and 40 children with ABI) aged 9–15 years participated. A questionnaire measure of peer-relationship functioning and emotional distress was completed. Children with ABI experienced a greater degree of peer-relationship difficulties and emotional distress than healthy controls. No difference was found in reported peer relationship difficulties or emotional distress between ABI children and the children accessing mental health services. We conclude that emotional distress and co-occurring peer-relationship difficulties are as prevalent in a population of children after ABI as may be expected in a population of children under the care of mental health services, yet, unlike the latter group, appropriate intervention services are not commonly available. Interventions that aim to enhance peer relationships after childhood ABI may provide an essential resource to the benefit of outcome.

An Initial Evaluation of a Culturally Adapted Social Problem-Solving and Relational Aggression Prevention Program for Urban African-American Relationally Aggressive Girls

Recent research demonstrating that relational aggression is associated with peer relationship difficulties, internalizing and externalizing behaviors, social processing deficits, and possibly later mental health disorders among girls has emphasized the need to address the unique expression of aggression among females. Despite these findings, almost all aggression interventions have been directed toward physically aggressive boys. In the current article, the authors describe the acceptability and initial effectiveness of a culturally adapted social problem-solving/social skills intervention for inner-city 3rd- to 5th-grade urban, African American, relationally aggressive girls called the Friend to Friend Program. The authors partnered with youth, teachers, parents, and playground supervisors to design the program, and the current study presents preliminary data suggesting that the intervention is viewed as highly acceptable by participating girls and teachers. Further, the intervention appears to have promise for decreasing at-risk girls' levels of relationally and physically aggressive behaviors, hostile attributions, and loneliness.

Self-Reported Peer Victimization and Child Mental Health: Results of a Cross-Sectional Survey Among French Primary School Children

To estimate the prevalence of peer victimization among primary school-aged children, to identify mental health and social correlates, and to assess health care services use. One hundred schools and 25 children (6-11 years old) per school were randomly selected in a large French region. Data were collected using standardized self-administered questionnaires to parents (Strengths and Difficulties Questionnaire) and children (Dominic Interactive). Three drawings depicting situations of victimization were added to the 91 standard questions of the Dominic Interactive. The categories of victimization considered were as follows: bullied, assaulted not scared, and scared not assaulted (categories mutually exclusive). Complete data were available for 1,274 children (54.4%). The prevalence of bullied children, assaulted not scared, and scared not assaulted was 21.0%, 19.6%, and 19.7%, respectively. Bullied children were characterized by their vulnerability: young age (6-8 yr) and chronic illness. The main correlates were self-reported symptoms of anxiety, major depressive disorder, and parent-reported peer relationship difficulties. Victimization was not associated with higher access to mental health services (odds ratio = 1.0; 95% confidence interval = 0.5-2.1). Except for children who suffered chronic illness, access to physicians was less frequent for bullied children (odds ratio = 0.3; 95% confidence interval = 0.2-0.7). Peer victimization was frequent in schools, even in primary schools. Our findings highlight the need for public health interventions in schools and the role of physicians in detecting children at risk.

Effects of a Social Skills Intervention Administered in Mixed Diagnostic Groups for Children with Peer Relationship Problems

Research on social skills interventions has been mixed. This study evaluates a group-administered, manualized social skills intervention program. Twenty-three boys and 9 girls between the ages of 7 and 13 participated. Participants were included in the groups based on peer relationship difficulties rather than diagnostic status, resulting in a diagnostically heterogeneous sample. As a group, children who were symptomatic at pretest made statistically significant and, in some cases, clinically significant improvements on socially relevant constructs. The results provide modest support for this intervention. Implications for future research, clinical work, and younger children are discussed.

Health Status and Peer Relationships in Early Adolescence: The Role of Peer Contact, Self-esteem, and Social Anxiety

We examined associations between children’s health status and the quality of their peer relationships, as well as factors that may account for individual variation in the quality of chronically ill and healthy children’s peer relationships. Our sample included 268 children (138 boys; 130 girls) with 149 European-Americans and 119 African-Americans. There were 91 children with a chronic illness; 35 with asthma, 26 with diabetes, and 30 with obesity. Chronically ill children were characterized by teachers as displaying less prosocial behavior, less overt aggression, and less relational aggression with peers than healthy children. Chronically ill children reported lower levels of peer contact and higher levels of social anxiety than healthy children. Among chronically ill children those with high self-esteem were more prosocial and less aggressive than those with low self-esteem. Our findings suggest that chronically ill children are at risk for peer relationship difficulties, but that self-esteem may serve as a protective factor against poor peer relationships for some chronically ill children.

Social functioning and adjustment in Canadian-born children with Chinese and European backgrounds.

The purpose of the study was to examine social functioning and adjustment in peer context in Chinese Canadian and European Canadian children. A sample of elementary school children participated in the study. Data on social functioning, peer acceptance and rejection, and victimization were collected from peer assessments and sociometric nominations. The results indicated that Chinese Canadian children were viewed by peers as less aggressive-disruptive than European Canadian children. Chinese Canadian girls, but not boys, were more shy-sensitive than their European Canadian counterparts. Sociability was associated with peer acceptance, whereas aggression was associated with peer rejection and victimization. Shyness was associated with peer relationship difficulties more evidently in European Canadian children than in Chinese Canadian children. These results indicate the relevance of ethnic background to children's peer social experiences.

Perfectionism and Peer Relations Among Children with Obsessive-compulsive Disorder

The study examined perfectionism, symptoms of obsessive-compulsive disorder (OCD) and depression, and peer relationships among a clinical sample of 31 youth (age range 7-18 years) diagnosed with OCD. Using a correlational design, perfectionistic beliefs accounted for significant variance in OCD symptoms, depressive symptoms, and difficulties in peer relationships for children with OCD. One dimension of perfectionism, sensitivity to mistakes, was the most salient maladaptive aspect of perfectionism for this sample whereas another dimension, contingent self-esteem, emerged as the most salient adaptive dimension. Implications are discussed regarding the diagnosis, treatment, and developmental course of OCD among children and adolescents.

Bridges over troubled waters: a relational approach to fatherless boys and a male therapist

Many children in need of psychotherapy are latency-age boys who have little or no contact with their fathers. Their problems typically include low self-esteem, identity problems, depression, difficulties in peer relationships, and aggression. Clinical material illustrates that the consequences for the child of fatherlessness depend on many factors, among them the mother's attitude to the father and other mature males. If the mother devalues all men, her son has little space to grow into a healthy adult. The male therapist may be experienced as a threat to the mother-son union, which may render his efforts to help the boy fruitless. If, in contrast, the mother's experiences of her own father and other men are more positive, her pride in her son's masculinity may strengthen his need to find support for his male development. These observations are discussed as affecting the capacity for triadic object representations in mothers and sons.

Les garçons agressifs : l'angoisse et ses défenses

In this study we tried to establish a relation between the results obtained from the Rorschach test of 20 Brazilian aggressive boys with those obtained in a French research with “caracteriels”. The groups show similarities as aggressive behaviour and peer relationship difficulties at school. The Rorschach shows a predominance of good form quality of G%, but the F+% is bellow the norms. There is an increase in kinesthetic responses compared to colour responses and the popular responses do not reach 4. The main defence mechanism, “le recours à la fantaisie”, aims to reduce the fear of annihilation. The French research enhanced the understanding of the psychodynamic processes and the decision to recommend a play therapy to the Brazilian group.

Which factors impact on clinician-rated impairment in children with ADHD?

To describe the associations between a range of demographic, family and clinical factors and clinician-rated measures of global impairment in children with ADHD symptoms obtained at the baseline assessment in the ADHD Observational Research in Europe (ADORE) study. Global impairment was measured by clinicians using the Clinical Global Impression-Severity (CGI-S) scale and the Children's Global Assessment Scale (CGAS). Associations with independent variables were investigated using forward-stepwise regression models. For the CGI-S and CGAS analyses, complete data sets were available for 1,265 and 985 children, respectively. The baseline mean CGI-S score in this population was 4.4 (SD 0.9) and the mean CGAS score was 55.0 (SD 10.6). Factors significantly associated with increased impairment on both outcome measures were: increased severity of ADHD symptoms, increased peer relationship problems and presence of oppositional defiant disorder and/or conduct disorder. Also, the presence of anxiety and/or depression and the presence of somatic symptoms were associated with increased impairment on CGI-S,while family health problems and premature birth were associated with increased impairment on CGAS. The severity of clinician-rated impairment in the ADORE sample is increased by the presence of disruptive behaviour problems and emotional problems, somatic symptoms, peer relationship difficulties, family health problems and premature birth.

HEALTH-RELATED QUALITY OF LIFE (HRQOL) AFTER PEDIATRIC LIVER TRANSPLANTATION

Background: Long-term survival after liver transplantation (LT) is now the rule rather than the exception. Better understanding of the broader determinants of health after pediatric LT will support the eventual transition of adolescents to adult programs. We examined health concerns of adolescent survivors of pediatric LT. Methods: Data were gathered via semi-structured 1:1 interviews with 14 (50% male) adolescent patients and 15 parents (87% mothers) at ambulatory LT follow-up at two Canadian pediatric tertiary care institutions. All interviews were audio taped, transcribed verbatim, subjected to content analysis utilizing QSR NVivo 2.0 software for qualitative research and subsequent identification of HRQOL related themes. Results: Mean recipient age at LT was 6.5 (range, 0.5 to 12 years). Mean patient age at time of interview was 15.5 (range, 14 to 18) years, all >1 year post LT. Identified HRQOL themes included impact of a permanent scar, medications, interpersonal functioning, school, physical activities,and coping with life after LT. Adolescents and parents concurred on issues regarding i) compliance with immune suppression medications; ii) school attendance and functioning; iii) parent worries exceeding recipient worries; and iv) impact of living with a surgical scar. Adolescent patients were discordant with their parents in self-reporting i) no memory of health before LT; ii) no worries about future health; and iii) normal peer relationships. In contrast, parents of adolescent LT survivors focused on i) severity of illness at time of LT; ii) child worries about need for re-LT; and iii) difficulties in peer and family relationships. Conclusions: Perceived HRQOL and well-being by adolescent survivors of LT appear excellent and more positive than their care-providing parent. These issues underscore the importance and need for further study and development of measures to assess HRQOL after pediatric LT.