A multisite cross-sectional study was conducted to examine dyadic friendship features between adolescents with chronic pain (ACP) and their friends compared with non-pain adolescent friendship dyads and the association of these friendship features with loneliness and depressive symptoms. Participants completed a battery of standardized measures to capture friendship features (friendship quality, closeness, and perceived social support from friends) and indices of social–emotional well-being. Sixty-one same sex friendship dyads (122 adolescents) participated; 30 friendship dyads included an adolescent with chronic pain and 52 dyads were female. Adolescents with chronic pain scored significantly higher on measures of loneliness and depressive symptoms compared with all other participants. Hierarchical Multiple Regression analysis revealed that friendship features predicted loneliness and depressive symptoms. Chronic pain predicted loneliness and depressive symptoms above and beyond friendship features. Actor Partner Interdependence Modeling found perceived social support from friends had differing associations on loneliness and depressive symptoms for dyads with a chronic pain member compared with pain-free control dyads. Friendship features were associated with loneliness and depressive symptoms for adolescents, but friendship features alone did not explain loneliness and depressive symptoms for ACP. Further research is needed to understand whether pain-related social support improves loneliness and depressive symptoms for ACP. Furthermore, a more nuanced understanding of loneliness in this population is warranted. Strategies to help ACP garner needed social support from friends are needed to decrease rates of loneliness to improve long-term outcomes.
Friendship features within adolescent dyads were associated with loneliness and depression, but friendship features alone did not explain these outcomes for adolescents with chronic pain.
aSchool of Nursing, Faculty of Health Sciences, Unversity of Ottawa; Children's Hospital of Eastern Ontario Research Insitute, Ottawa, Canada,
Departments of bAnesthesia
dPsychology and Neuroscience, Dalhousie University
eCentre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada,
fBehavioural Neurosciences and Consultation Liaison Service, Mental Health, Children's Hospital of Eastern Ontario, Ottawa, Canada,
gSchool of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada,
hDepartment of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Canada,
iAnesthesia and Psychology, Dalhousie University, Halifax, Canada,
jDr. Stewart Wenning Chair in Pediatric Pain, IWK Health Centre, Halifax, Canada,
kChildren's Hospital for Eastern Ontario, Ottawa, Canada
*Corresponding author. Address: School of Nursing, Faculty of Health Sciences, University of Ottawa, Children's Hospital of Eastern Ontario Research Institute, 451 Smyth Rd, Room 3251B, Ottawa, ON K1H 8M5, Canada. Tel.: (613) 562-5800; fax: 613-562-5443. E-mail address: firstname.lastname@example.org (P.A. Forgeron).
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