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Dyadic Differences in Friendships of Adolescents with Chronic Pain Compared to Pain Free Peers

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Forgeron, P. A.; Chambers, C. T.; Cohen, J.; Dick, B. D.; Finley, G. A.; Lamontagne, C.

A multisite cross sectional study was conducted to examine dyadic friendship features between adolescents with chronic pain and their friends compared to 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, 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 to 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 to 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 adolescents with chronic pain. Further research is needed to understand if pain-related social support improves loneliness and depressive symptoms for adolescents with chronic pain. Furthermore, a more nuanced understanding of loneliness in this population is warranted. Strategies to help adolescents with chronic pain garner needed social support from friends is needed to decrease rates of loneliness to improve long term outcomes.

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