Adolescent social development and chronic pain

Adolescents with chronic pain report disability, distress and reduced social functioning. A clinical sample of 110 adolescents, with a mean four year history of pain, was investigated for the psychosocial impact of pain on social development. All participants completed a range of self-report measures of pain intensity, disability, distress, social and family functioning. Also completed was the Bath Adolescent Pain Questionnaire, including its development subscale. The development subscale measures the extent to which adolescents perceive themselves to be ahead or behind their peers on 11 aspects of social development. Three related analyses were undertaken. First, over 50% of adolescents reported themselves to be less developed than their peers on four or more aspects. The item with the highest endorsement of being ahead compared with peers was “dealing with problems”. Second, factor analyses revealed three factors of adolescent social development labelled 'independence', 'emotional adjustment' and 'identity formation'. Third, regression analyses revealed that peer support had a positive effect on all three factors, disability and anxiety had a negative effect on perceptions of independence, greater family dysfunction had a negative effect on emotional adjustment, and depressive mood had a negative effect on identity formation. Pain intensity had a negative effect on all three factors. Findings suggest that adolescents with chronic pain judge themselves to be less developed than their peers. Pain intensity has a negative effect on this perception, but peer relations may play a protective role: strong peer relationships are associated with positive social comparisons of the level of social development.