Peer Relationship Difficulties Research Articles

Adolescent Peer Relationship Difficulties, Prosociality, and Parental Emotion Socialization: Moderating Roles of Adolescent Gender

The present study examined longitudinal, transactional associations between youth social adjustment (prosociality, peer relationship difficulties) and parental emotion socialization in early adolescence. Adolescent gender was considered as a potential moderator. Eighty-seven adolescent-parent dyads (50 girls, 37 boys) participated in 8th grade, with follow-up waves in 9th and 10th grade. Adolescents reported their experiences of peer victimization and their parents’ emotion socialization responses, and parents reported youth prosocial behavior and peer relation problems. Hierarchical linear modeling results indicated transactional associations between parent supportive/unsupportive responses and adolescent peer relations and prosociality over time, some of which were moderated by adolescent gender. Increases in parental supportive emotion socialization corresponded to decreased experiences of peer victimization over time for girls, but not boys. When peer victimization increased over time, girls reported less parental supportive responses and all adolescents reported receiving more unsupportive responses from parents. For all adolescents, parents’ increased supportive responses also corresponded to decreased peer problems and increased prosocial behavior. As prosocial behavior increased, so did parental supportive responses. Increases in parents’ unsupportive responses related to decreased prosocial behavior, and increases in adolescent prosocial behavior related to decreases in parents’ unsupportive responses. Results suggest that there is mutual influence between parent emotion socialization and adolescent social adjustment. Adolescent girls appear to uniquely benefit from parents’ supportive emotional socialization in relation to their experiences of peer victimization. Potential mechanisms and implications are discussed.

The association between early regulatory problems and adult peer relationship quality is mediated by the brain's allostatic-interoceptive system.

Early regulatory problems (RPs), i.e., problems with crying, sleeping, and/or feeding during the first years, increase the risk for avoidant personality traits in adulthood, associated with social withdrawal and anxiety. Even more, RPs are linked with functional alterations in the adult default mode and salience networks, comprising the brain's allostatic-interoceptive system (AIS) and playing a role in social interactions. We investigated whether RPs assessed in infancy are associated with difficulties in adult peer relationships mediated by functional alterations of the AIS. As part of a large case-controlled prospective study, 42 adults with previous RPs and 70 matched controls (mean age = 28.48, SD = 2.65, 51% male) underwent fMRI during rest. The analysis focused on the intrinsic functional connectivity (iFC) of key nodes of the AIS. Peer relationship quality was assessed via a semi-structured Life Course Interview and the YASR scale. In these same individuals, RPs were assessed at ages 5, 20 and 56 months. RPs in infancy were associated with lower-quality peer relationships and enhanced functional connectivity of the AIS nodes in adulthood, with a stronger effect for multiple and persistent RPs compared with transient-multiple or single-persistent RPs. Importantly, iFC changes of the dorsal mid insula, a primary interoceptive cortex with frontal and temporal regions, mediated the relationship between early RPs and adult peer relationship quality. Results indicate long-lasting social and neural changes associated with early RPs. Our findings further implicate the AIS in both interoceptive and social processes, while indicating the need for early screening of early RPs.

A Single Case Study of Sports Psychological Counseling Based on Rational Emotional Behavior Therapy (REBT) for Modern Triathlon Adolescent Athletes Experiencing Peer Relationship Difficulties

A Single Case Study of Sports Psychological Counseling Based on Rational Emotional Behavior Therapy (REBT) for Modern Triathlon Adolescent Athletes Experiencing Peer Relationship Difficulties

Gifted Students’ Special Educational Programs in France: An Analysis of Students’ Needs as Perceived by Headmasters — A Secondary Publication

Some French public middle schools offer gifted students the opportunity to pursue their education in general classes, while benefiting from specific facilities within the framework of a dedicated educational program. In this study, we sought to identify and analyze the needs of these students as perceived by the headmaster of each middle school involved. The results highlight two main student needs, common to all these programs (uneasiness and difficulties in peer relationships) as well as needs specifically mentioned by some headmasters (non-adaptive behavior).

Through the Parent’s Eyes: Exploring the Relationship Between Parental Perceptions of Difficulties and SDQ Scale Results in Children and Adolescents

IntroductionThe Strengths and Difficulties Questionnaire (SDQ) is a widely used assessment tool for measuring the psychological well-being of children and adolescents. It consists of 25 items that assess emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship difficulties, and prosocial behavior.ObjectivesThe present study aimed to investigate the relationship between parental perceptions of difficulties and the results obtained from the SDQ.MethodsParticipants were recruited from the initial consultation of Child and Adolescent Psychiatry (N=132). Parents completed a questionnaire assessing their subjective perceptions of their child’s difficulties in various domains (home, school, learning activities, relations with friends) on a 4-point scale ranging from “no notion of difficulties” to “very severe difficulties”. They also completed the SDQ scale. Data were analyzed using SPSS software.Results In this study, 74% of participants had scores on the SDQ indicating potential psychological difficulties. Additionally, 17.4% of participants had scores on the borderline between normal and abnormal results. 47% of patients scored above the cut-line for problems on the hyperactivity/inattention subscale, indicating higher levels of difficulties in this area. Conversely, only 3% of participants scored problematic scores on the peer relationship difficulties subscale. There was no statistical difference between sexes in terms of SDQ scores. A correlation analysis revealed a significant positive correlation (p < 0.01) between parental perceptions of difficulties and higher SDQ scores and the mean score on the SDQ scale was found to be significantly higher in patients who were rescheduled for another consultation following the evaluation by doctors, compared to those patients who received clinical discharge from the initial consultation (p-value 0,040).ConclusionsThis study provides valuable insights into the concordance between parental perceptions and objective assessments of difficulties in children and adolescents. Parents who perceived their child to have more difficulties also reported higher levels of psychological difficulties on the SDQ. This study highlights the importance of using tools like the SDQ to assess psychological well-being in children and adolescents. It also emphasizes the practical utility of the SDQ as a time-efficient assessment tool for use during initial consultations in child and adolescent psychiatry.Disclosure of InterestNone Declared

The importance of social relationships in depression in autistic adolescents: a narrative-review.

The impact of social relationships on autistic adolescents has been recently studied. However, the link between social relationships and depression in autistic adolescents seem underrepresented in the scientific literature. Especially no specific assessment tool has been developed to evaluate depression in autistic adolescents. The aim of this narrative review is to raise the impact of social relationships on depression in autistic adolescents. We aim to propose lines of thought on the creation of a sensitive tool for identifying depression in this population. We conducted two types of searches for articles and reviews on PubMed, Embase, and Cochrane. First, regarding social relationships, we searched the following terms: [("adolesc*" OR "youth") AND ("ASD" OR "autis*") AND ("social communication" OR "peer relationship") AND ("depress*")]. Secondly, regarding assessment tool, we searched the following terms: [("tool" OR "assess*") AND ("depress*") AND ("ASD" OR "Autis*)"]. Social impact, verbal skills, and good social motivation are risk factors of depression in autistic adolescents. Social impairment during childhood is related to peer victimization and is a risk factor for depression. There is no specific tool to measure depression in autistic adolescents. No specific tool based on social relationships was developed to evaluate depression in autistic adolescents. Depression in autistic adolescents needs to be assessed considering the social and pragmatic specificities of autism. Social communication and difficulties in peer relationships may be evaluated in specific assessment tools based on social relationships for depression in autistic adolescents.

Exploring concepts of friendship formation in children with language disorder using a qualitative framework analysis.

Sociometric studies and adult reports have established that children with Language Disorder (LD) are at risk of peer relationship difficulties. However, we have limited knowledge of how children with LD understand friendship, whom they deem as a good or bad friend, and what role their friendship concepts play in their relationships with peers. This exploratory study aimed to conduct a qualitative investigation into the friendship concepts that children with LD hold and to explore their strategies for making friends. We conducted multiple, art-informed interviews on the topic of friendship with 14 children with LD at the age of 6-8 years. Participating children were based in the United Kingdom and Republic of Ireland. They attended enhanced provision, specific speech and language classes and mainstream classrooms. We used framework analysis to map children's responses to Selman's (1979) developmental model of interpersonal understanding, which espouses a theory of children's social development within the context of peer relationships. The understanding of friendship formation in children with LD varied from physical presence to mutual support and sharing. Children's ideas about a good/bad friend represented the lowest developmental stage. Participants from the mainstream classroom demonstrated the highest stages of interpersonal understanding. Children with LD did not mention their language abilities as a barrier to making friends. There are limited studies exploring friendship directly from children with LD, and this study provides insights into this gap, by utilising art-informed interviews. Children's immature understanding of a good/bad friend points towards a potential susceptibility to false friends, which we suggest needs further empirical validation. We also found that children with LD did not pay attention to their language difficulties when making friends, which raises questions about the ways diagnoses are shared with children. What is already known on the subject Children with Language Disorder (LD) are at risk of peer relationship difficulties. Studies to date are based on sociometrics and adult reports. Only a few studies employ participatory approaches to research with children, directly engaging children with LD when exploring their friendships What this paper adds This paper directly asks children with LD about their understanding of friendship and strategies for making friends. Physical proximity and play are important to children.s understanding of friendship especially in recognising good and bad friends. This indicates potential reasons for children with LD being susceptible to false friends Additionally, children with LD do not perceive language and communication as a barrier to making friends. What are the potential or actual clinical implications of this work? Concepts around friendship and good/bad friends should be routinely assessed and targeted (if appropriate) in interventions. The study highlights the need to continue discussing practices around sharing diagnoses with children with LD.

Sleeping soundly? Testing the links between sleep quality and neurodevelopmental characteristics

Sleep plays a major role in child development and sleep problems have been implicated in several neurodevelopmental conditions. However, its exact role in these conditions remains unknown. Co-occurrence is a core challenge of the existing diagnostic framework, with many advocating for a transdiagnostic approach to studying neurodevelopment. In this exploratory investigation, we look at a transdiagnostic sample of 299 children to (1) identify and compare data-driven sleep profiles and explore their links to behaviour, cognition and learning and (2) use a network approach to simultaneously characterise the relationship between sleep and symptoms of behaviour, communication and mental health. Cluster analysis identified two sleep profiles – regular sleepers and poor sleepers. Between-group comparisons showed that poor sleepers disproportionately experienced poorer emotion regulation, peer relationships and structural language. The network analysis suggested that after statistically accounting for the overlap between symptoms of behaviour, communication and mental health, sleep remained directly linked to multiple symptoms, with a particularly strong relationship with emotion regulation. These findings advance our knowledge of the role of sleep in neurodevelopmental conditions, highlighting its importance as a transdiagnostic process and priority in neurodevelopmental research. Lay abstract Sleep quality and quantity are essential in children’s development. Children diagnosed with neurodevelopmental conditions tend to present more sleep problems. However, the exact interaction between sleep and these conditions is still under discussion. Here, novel statistical approaches were used to explore the relationship between sleep and aspects of children’s behaviour, communication, and mental health. These methods identified two groups of children based on their sleep quality: poor sleepers and regular sleepers. The two groups were compared across a broad set of measures including neurodevelopmental difficulties, learning outcomes and mental health. The regular sleepers performed better than those with sleep problems on all measures, with poor sleepers presenting crucial difficulties in emotion regulation, peer relationships and structural language. Using network models, an explorative global analysis of all the participants together reiterated the influence of structural language on other behaviours and uncovered a strong connection between sleep and emotion regulation. Overall, this study improves our knowledge of the role of sleep in conditions affecting brain development and its relationship with behaviour, communication and mental health.

57 Executive Functioning Correlates with Adaptive Behaviors in Wiedemann-Steiner Syndrome

Objective:Wiedemann-Steiner syndrome (WSS) is a rare Mendelian disorder of epigenetic machinery caused by a mutation in KMT2A, with hallmark features that include intellectual disability and developmental delay. Animal models have helped identify the critical roles KMT2A plays in prefrontal neuron maturation and executive function (i.e. working memory) development. However, the neurobehavioral phenotype of individuals with WSS, including executive functioning, remains poorly characterized. Accordingly, this study aimed to 1.) examine the neurobehavioral profile (adaptive, psychosocial, and executive functioning) associated with WSS and 2.) the correlations between executive functioning and these domains.Participants and Methods:A total of 25 mothers of individuals with WSS (13 females, Mean age=12.78 years, SD=7.88) completed a combination of parent-informant questionnaires. The caregivers completed the Adaptive Behavior Assessment System 3rd Edition (ABAS-3), the Strengths and Difficulties Questionnaire (SDQ), and a version of the Behavior Rating Inventory of Executive Function (BRIEF). Descriptive analyses were conducted to examine proportion of the sample with clinically significant concerns on the BRIEF and SDQ, and low to very low adaptive skills based on ratings on the ABAS-3. Partial correlations were computed to examine the relationships between overall executive functioning (BRIEF General Executive Composite, GEC) with adaptive domains (ABAS-3 Conceptual, Practical, Social), and psychosocial functioning (SDQ Emotional Problems, Conduct Problems, Hyperactivity, Peer Relations, Prosocial Behaviors) while accounting for age. Associations that survived Benjamin Hochberg correction are reported.Results:Of our sample, 64% were rated in the very elevated range for executive functioning problems (BRIEF GEC), with a greater proportion endorsing clinically significant concerns with behavior regulation (68%) relative to cognitive regulation (48%). Majority of participants was rated in the low or very low range for ABAS-3 General Adaptive Composite (72%), with a greater proportion showing problems in Practical (64%) and Conceptual Domains (64%) relative to Social Domain (44%). Among those who completed the SDQ, caregiver ratings implicate elevated Total Problems (90%) with greater concerns observed in Emotional Problems (62%), Hyperactivity (81%) and Peer Relationship difficulties (95%). After controlling for age, executive functioning difficulties were associated with weaker skills in the Conceptual (r=-0.56, p=0.003), Social (r=-0.44, p=0.028) and Practical domains (r=-0.51, p=0.009); as well as more Hyperactivity (r=0.49, p=0.025) and Conduct problems (r=0.58, p=0.007). Specifically, day-to-day challenges with executive functions were related to weaker adaptive skills in Self-Care (r=-0.54, p=0.006), Self-Direction (r=-0.53, p=0.007), and Communication (r=-0.49, p=0.01).Conclusions:Individuals with WSS are at risk for executive functioning deficits, which in turn may impact the development of and/or day-today application of adaptive skills and behavior regulation. Future clinical research should further explore the development and neurophysiology of executive functions among those with WSS with multidisciplinary methods, including behavioral, cognitive and neurobiological metrics. Those working with individuals with WSS may consider executive functioning interventions, which may yield indirect benefits to self-regulation and daily use of life skills.

The moderating effect of classroom status hierarchy on the associations between shyness and peer relationship difficulties in Chinese children

The goal of the present study was to examine the moderating effect of classroom status hierarchy on the relations between shyness and peer relationship difficulties in Chinese children. Participants were N = 1,275 children in Grade 3–7 (Mage = 10.78 years, SD = 1.55 years) from Shanghai, People’s Republic of China. Participants completed a self-reported measure of shyness, while peer nominations were used to assess peer victimization and social preference. We analyzed data by method of multilevel regression. Regarding main effects, shyness was positively associated with peer victimization and negatively associated with social preference. Regarding moderating effects, the relations between shyness and peer victimization as well as shyness and social preference were both moderated by classroom status hierarchy, in that, shyness was only positively associated with peer victimization and negatively associated with social preference in high hierarchy classrooms. The findings suggest that classroom status hierarchy plays an important role in shy children’s social adjustment.

Multimedia Art Therapy as a Psychological Support for Ukrainian Students in Polish Primary Schools Who Experience Difficulties in Peer Relationships

Multimedia Art Therapy as a Psychological Support for Ukrainian Students in Polish Primary Schools Who Experience Difficulties in Peer Relationships

Can the “Current View” show that autistic young people referred to mental health services have more comorbidities and complex needs?

PurposeAutistic young people have health and care needs that may benefit from a multi-agency intervention. The “Current View” tool is routinely used in England to profile the needs of young people referred to mental health services. This study aims to examine associations between comorbidities and complex needs in autistic and non-autistic young people to assess the multifaceted needs of autistic young people.Design/methodology/approachA cohort study was conducted using data from the electronic patient record, comparing autistic and non-autistic young people to see which items in the four “Current View” tool categories were associated with autistic young people.FindingsIssues associated with autistic young people were: “community issues”, “attainment issues” and “deemed child in need” (all p < 0.001). Autistic young people scored significantly more items (p < 0.05) in the categories complexity/contextual/educational factors. Comorbidities associated with autistic young people included anxiety, “behavioural difficulties”, “peer relationship difficulties” and “self-care issues” (all p < 0.001). There was an association with increased comorbidities and complexity factors in autistic young people which suggests increased support from agencies may be beneficial.Originality/valueFew studies have used data in the “Current View” tool to assess young people referred to services. More use could be made of this data for planning and delivering services.

Risk of new onset and persistent psychopathology in children with long-term physical health conditions: a population-based cohort study.

Children and young people (CYP) with long-term physical health conditions (pLTCs) have increased risk of psychopathology compared to physically healthier peers. We explored risk factors for new onset and persistent psychiatric disorders in CYP with pLTCs compared to CYP without pLTCs. This 3-year follow-up study involved a UK representative sample of CYP from the British Child and Adolescent Mental Health Surveys (N = 7804). We examined potential baseline predictors of new onset and persistent psychiatric disorders at follow-up in four groups of children based on the presence of any physical and/or any psychiatric conditions at baseline. Psychiatric disorders were assessed using standardised multi-informant diagnostic assessment. Separate multivariable binary logistic regressions were conducted for each group. In CYP with pLTCs, rented housing (aOR = 1.42, 95% CI 1.01 to 1.99), non-traditional family structure (aOR = 2.08, 95% CI 1.42 to 3.05), increased parental distress (aOR = 1.09, 95% CI 1.04 to 1.14), and greater peer relationship difficulties (aOR = 1.29, 95% CI 1.19 to 1.39) predicted future psychiatric disorder. Only peer relationship difficulties predicted persistent disorder (aOR = 1.27, 95% CI 1.17 to 1.38) in this group. A greater number of factors predicted the onset of psychiatric disorder in CYP with pLTCs compared to physically healthier peers and similarly, a higher number of factors predicted persistent disorder in CYP without pLTCs. CYP with pLTCs might comprise a group with different vulnerabilities, some of which are potentially tractable and may be useful indicators of patients who require preventable or management interventions.

Longitudinal associations between early childhood irritability and adolescent depression symptoms in autistic children are mediated by peer relationships but not educational engagement.

In the general population, irritability is associated with later depression. Despite irritability being more prevalent in autistic children, the long-term sequelae are not well explored. We tested whether irritability in early childhood predicted depression symptoms in autistic adolescents, and whether associations could be explained by difficulties in peer relationships and lower educational engagement. Analyses tested the longitudinal associations between early childhood irritability (ages 3-5) and adolescent depression symptoms (age 14) in a prospective inception cohort of autistic children (N = 390), followed from early in development shortly after they received a clinical diagnosis. Mediators were measured in mid-childhood (age 10) by a combination of measures, from which latent factors for peer relationships and educational engagement were estimated. Results showed early childhood irritability was positively associated with adolescent depression symptoms, and this association remained when adjusting for baseline depression. A significant indirect pathway through peer relationships was found, which accounted for around 13% of the association between early childhood irritability and adolescent depression, suggesting peer problems may partially mediate the association between irritability and later depression. No mediation effects were found for education engagement. Results highlight the importance of early screening and intervention for co-occurring irritability and peer problems in young autistic children.

Getting under the skin: long-term links of adolescent peer relationship difficulties to adult vagal tone.

Understanding whether and how the absence of positive relationships may predict longer-term physical health outcomes is central to building a working conceptual model of the interplay of social and physical development across the lifespan. This study sought to examine the extent to which difficulties establishing positive social relationships from adolescence onward serve as long-term predictors of low adult vagal tone, which in turn has been linked to numerous long-term health problems. A diverse community sample of 141 individuals was followed via multiple methods and reporters from age 13 to 29. Across this span, social relationship quality was assessed via close friend and peer reports, observations of romantic interactions, and self-reported romantic relationship satisfaction. A range of potential personality and functional covariates was also considered. Vagal tone while at rest was assessed at age 29. Adult vagal tone was predicted across periods as long as 16years by: adolescents' difficulty establishing themselves as desirable companions among peers; early adults' inability to establish strong close friendships; and lack of warmth in romantic relationships as an adult. Poor early adult friendship quality statistically mediated the link from adolescent peer difficulties to adult vagal tone. A range of potential confounding factors was examined but was not linked to vagal tone. Within the limits of the correlational design of the study, robust connections between adult vagal tone and social relationship quality from adolescence onward suggest at least a possible mechanism by which relationship difficulties may get 'under the skin' to influence future physiological functioning.

Peer Relationship Difficulties among Children with Adhd: A Systematic Review

Peer Relationship Difficulties among Children with Adhd: A Systematic Review

Predicting peer acceptance and peer rejection for autistic children

AbstractAutistic students often experience peer relationship difficulties. As peer acceptance and rejection may be malleable over time, we examined predictors of change in peer acceptance and peer rejection among early elementary‐age autistic students. We followed 166 autistic children (mean age: 6.1 years [range: 4–8], 82.5% boys, grades preK‐2nd) longitudinally across 2 school years. Social skills, internalizing problems, and externalizing behaviors were considered as predictors of change in teacher‐rated peer acceptance and rejection, covarying IQ and autism characteristics. Autistic children experienced high rejection and low acceptance; 51.9% of children were rejected by peers in one or both school years. Results revealed distinct predictors for peer acceptance versus rejection: social skills predicted change in peer acceptance across school years, whereas externalizing problems predicted change in peer rejection. Internalizing problems did not predict change in either construct. Findings can assist school professionals in supporting social acceptance and acceptance for young autistic students.

Mental health and academic performance in a cohort of first year primary school children in Chile

IntroductionPsychiatric disorders are common in children, and academic attainment is lower in children with psychiatric disorders. There are few data about the occurrence of mental health problems and the academic attainment among children in Chile.ObjectivesTo determine the occurrence of mental health problems and its association with academic attainment in first-year students of elementary schools in ChileMethods The study was conducted in 39 urban and rural public elementary schools in Chile in 2019. The academic performance was measured using the Woodcock Muñoz IV Battery and the Corsi Bock-Tapping test. Mental health was assessed using the self-report Dominique Interactive and Strengths in children and Difficulties Questionnaire (SDQ) instruments in their parents and teachers. A triangulation of information was conducted between different informants.Results Overall 610 children were included in the analysis (mean age 7.10 years (SD=0.58), 51% women, 36% from rural area). A higher score in mathematics and reading was negatively correlated to a higher score in emotional symptoms, hyperactivity and peer relationship difficulties, separately, based on both teacher- and parent-reported SDQ. The correlation coefficient between reading scores with Dominique Interactive and Strengths externalizing symptoms was -0.22 (p&lt;0,05). A higher maternal education level was associated with higher education attainment in their children (p &lt;0,05). There was no association between rurality and children’s mental health symptoms.ConclusionsThe current results can inform local stakeholders in Chile about the importance of mental health at a very early age.DisclosureNo significant relationships.

Depressive Symptoms and Negative Experiences in School: A Network Analysis.

Negative experiences in school predict adolescents' depression. However, the dynamic interactions of depressive symptoms with adolescents' negative experiences in school remain unclear. This study aimed to applied network analysis to detect the complex relationships between early adolescents' depressive symptoms and negative experiences in school. We adopted the data from a Chinese national survey conducted in 2018. Eight hundred ninety-seven adolescents from 10 to 15 years old were included. The measurements included an 8-item depression screener scale and a 14-item scale assessing negative experiences in school. The centrality analysis suggested that Chinese early adolescents' core depressive symptoms were negative affections. Regarding "negative experiences in the school," the most central nodes were poor academic performance and peer relationships. The bridge-centrality results showed negative emotions in school and difficulties in peer relationships were significantly linked to depression. Educators should pay attention to adolescents' negative affection and difficulties in peer relationships in school settings because they are potential signs of depression. Relevant peer support intervention aiming for adolescents' social development should be underscored.

Understanding and supporting peer relationships in adolescents with acquired brain injury: A stakeholder engagement study

ABSTRACT Peer relationship difficulties in adolescents with acquired brain injury (ABI) are under-recognized and targets for intervention are unclear. From a social constructionist position, this study aimed to engage with stakeholders to develop a collaborative understanding of peer relationship difficulties in adolescents with ABI and seek consultation on what might be required to improve them. Focus groups and semi-structured interviews were conducted with four stakeholder groups: adolescents with ABI (n = 4); parents of adolescents with ABI (n = 7); adults who sustained an ABI in adolescence (n = 2); and specialist practitioners (n = 3). Qualitative data were analysed using thematic analysis. The analysis yielded 11 themes, grouped into two domains. The first, understanding peer relationship difficulties, included themes from “exclusion and a need to belong”, to “loss of past self”. The second, supporting peer relationships, comprised themes of “building understanding” and “meaningful social connection”, amongst others. A logic model of stakeholder experiences of peer relationship difficulties was constructed. Difficulties with peers can increase vulnerability to feelings of loneliness, shame, and hopelessness for adolescents post-ABI. Stakeholders described that a meaningful intervention would be multi-layered, targeting change within the adolescent's environment and within the adolescent themselves. The presented logic model provides a framework for future intervention development.