Peer Relations of Youth with Pediatric Conditions and Health Risks: Promoting Social Support and Healthy Lifestyles

ABSTRACT. Peer relations and close friendships play important roles in youngsters’ emotional development and take on special significance when a child or adolescent has a chronic disease. This article reviews the key ways that peer relations have been examined in youth with chronic pediatric conditions and specifically focuses on (1) the role of peers and close friends as a source of support, (2) friends’ influence on treatment adherence, and (3) peers’ and friends’ impact on health-promoting and health-risk behaviors. In general, youngsters with chronic conditions do not have more problems in their peer relations than other youth, although children with medical conditions that are stigmatizing or that involve the central nervous system (CNS) may encounter peer difficulties. Social support from friends and classmates appears to facilitate youngsters’ disease adaptation and may help with the lifestyle aspects of treatment regimens. Adolescent peer-crowd affiliations (e.g., “brains,” “jocks”) that are linked with health-promoting behaviors may prove beneficial to youngsters’ disease management and health. The findings underscore the need for helping children and adolescents disclose their medical condition to peers in positive ways and for including youngsters’ close friends in the treatment process and in school-reentry programs after extended medical care. Additional research is needed to develop strategies for incorporating youngsters’ peers and friends into the medical management of youth with chronic pediatric conditions.

[1]  B. B. Brown,et al.  The importance of peer group ("crowd") affiliation in adolescence. , 1986, Journal of adolescence.

[2]  G. Huon,et al.  Social influences and female adolescent dieting. , 2000, Journal of adolescence.

[3]  S J Paxton,et al.  Friendship clique and peer influences on body image concerns, dietary restraint, extreme weight-loss behaviors, and binge eating in adolescent girls. , 1999, Journal of abnormal psychology.

[4]  E B Fisher,et al.  I get by with a little help from my family and friends: adolescents' support for diabetes care. , 1995, Journal of pediatric psychology.

[5]  P. Thomas.  Weighing the Options: Criteria for Evaluating Weight-Management Programs , 1995 .

[6]  A. La Greca,et al.  Assessing friend support of adolescents' diabetes care: the diabetes social support questionnaire-friends version. , 2002, Journal of pediatric psychology.

[7]  S. Shiloh,et al.  Attitudes of Asthmatic and Nonasthmatic Adolescents Toward Cigarettes and Smoking , 1993, Clinical pediatrics.

[8]  E. Stice,et al.  The relation between adolescent alcohol use and peer alcohol use: a longitudinal random coefficients model. , 1997, Journal of consulting and clinical psychology.

[9]  K. Berndt.  Cognitive Aspects of Chronic Illness in Children , 2000 .

[10]  P Greco,et al.  A peer group intervention for adolescents with type 1 diabetes and their best friends. , 2001, Journal of pediatric psychology.

[11]  Vessey Ja,et al.  Teasing: who says names can never hurt you? , 1995 .

[12]  W. Bukowski,et al.  Social, Emotional, and Behavioral Functioning of Children With Cancer , 1999, Pediatrics.

[13]  W. Bukowski,et al.  Peer relationships and emotional well-being of youngsters with sickle cell disease. , 1996, Child development.

[14]  R. Forehand,et al.  Social factors associated with adolescent obesity. , 1984, Journal of pediatric psychology.

[15]  W. Bukowski,et al.  Peer relationships and adjustment in children with cancer. , 1991, Journal of pediatric psychology.

[16]  J. Goedert.  What is safe sex? Suggested standards linked to testing for human immunodeficiency virus. , 1987, The New England journal of medicine.

[17]  J. Varni,et al.  Teacher, parent, and child evaluative ratings of a school reintegration intervention for children with newly diagnosed cancer. , 1992, Children's health care : journal of the Association for the Care of Children's Health.

[18]  R. Blum,et al.  Emotional well-being among adolescents with and without chronic conditions. , 1994, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[19]  C. Perry,et al.  Do friendships change behaviors, or do behaviors change friendships? Examining paths of influence in young adolescents' alcohol use. , 2000, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[20]  C. Fairburn,et al.  Binge eating and bulimia nervosa: Distribution and determinants. , 1993 .

[21]  C. A. Smith,et al.  Children's perceptions of peers with somatic symptoms: the impact of gender, stress, and illness. , 2000, Journal of pediatric psychology.

[22]  A. Biglan,et al.  Social and behavioral factors associated with high-risk sexual behavior among adolescents , 1990, Journal of Behavioral Medicine.

[23]  P. Sloper,et al.  Supporting pupils in mainstream school with an illness or disability: young people's views. , 1999, Child: care, health and development.

[24]  W. Bukowski,et al.  Social Interactions between Children with Cancer or Sickle Cell Disease and Their Peers: Teacher Ratings , 1992, Journal of developmental and behavioral pediatrics : JDBP.

[25]  G. Chiari,et al.  Management of insulin-dependent diabetes mellitus in adolescents. , 1997, Hormone research.

[26]  W. Bukowski,et al.  Social interactions between children with cancer and their peers: teacher ratings. , 1990, Journal of pediatric psychology.

[27]  Brian R. Flay,et al.  Reviewing Theories of Adolescent Substance Use: Organizing Pieces in the Puzzle , 1995 .

[28]  H. Leventhal,et al.  Peer group identification and smoking: implications for intervention. , 1988, Journal of abnormal psychology.

[29]  I. Newman.  Capturing the energy of peer pressure: insights from a longitudinal study of adolescent cigarette smoking. , 1984, The Journal of school health.

[30]  S. Paxton.  Prevention implications of peer influences on body image dissatisfaction and disturbed eating in adolescent girls , 1996 .

[31]  B Stanton,et al.  Social influences on the sexual behavior of youth at risk for HIV exposure. , 1994, American journal of public health.

[32]  B. B. Brown,et al.  Parenting practices and peer group affiliation in adolescence. , 1993, Child development.

[33]  J. Pennebaker,et al.  Confronting a traumatic event: toward an understanding of inhibition and disease. , 1986, Journal of abnormal psychology.

[34]  S. Sexson,et al.  The Chronically Ill Child in the School. , 1995 .

[35]  H. Levy,et al.  PKU in adolescents: rationale and psychosocial factors in diet continuation , 1994, Acta paediatrica (Oslo, Norway : 1992). Supplement.

[36]  M. Rapoff,et al.  Adherence to Pediatric Medical Regimens , 1999, Issues in Clinical Child Psychology.

[37]  A. Bauman,et al.  Asthma, health behaviors, social adjustment, and psychosomatic symptoms in adolescence. , 1996, The Journal of asthma : official journal of the Association for the Care of Asthma.

[38]  S. Affenito,et al.  Are eating disorders more prevalent in females with type 1 diabetes mellitus when the impact of insulin omission is considered? , 2001, Nutrition reviews.

[39]  N. Onetto,et al.  Adolescents with chronic disease. Are they receiving comprehensive health care? , 1983, Journal of adolescent health care : official publication of the Society for Adolescent Medicine.

[40]  J. D'Auria,et al.  The child's eye: memories of growing up with cystic fibrosis. , 1997, Journal of pediatric nursing.

[41]  W. Tamborlane,et al.  Prevalence of Eating Disorder Symptoms in Preadolescent and Adolescent Girls With IDDM , 1992, Diabetes Care.

[42]  Alan L. Smith.  Perceptions of Peer Relationships and Physical Activity Participation in Early Adolescence , 1999 .

[43]  P. J. Byard,et al.  Recreational use of psychoactive drugs by patients with cystic fibrosis. , 1987, The Journal of pediatrics.

[44]  R C Peveler,et al.  Eating habits, body weight, and insulin misuse. A longitudinal study of teenagers and young adults with type 1 diabetes. , 1999, Diabetes care.

[45]  J. Pennebaker,et al.  Disclosure of traumas and immune function: health implications for psychotherapy. , 1988, Journal of consulting and clinical psychology.

[46]  G. Bonanno,et al.  When Children Tell Their Friends They Have AIDS: Possible Consequences for Psychological Well-Being and Disease Progression , 2000, Psychosomatic medicine.

[47]  K. Bauman,et al.  The contribution of influence and selection to adolescent peer group homogeneity: the case of adolescent cigarette smoking. , 1994, Journal of personality and social psychology.

[48]  R. M. Schultz,et al.  Children with Diabetes , 1983, Behavior modification.

[49]  L. Ricciardelli,et al.  Body image and body change methods in adolescent boys. Role of parents, friends and the media. , 2000, Journal of psychosomatic research.

[50]  J. Varni,et al.  Social Support and Self-Esteem Effects on Psychological Adjustment in Children and Adolescents with Insulin-Dependent Diabetes Mellitus , 1989 .

[51]  J. Rodrigue,et al.  Brief report: perceptions of young adolescents about a hypothetical new peer with cancer: an analog study. , 2001, Journal of pediatric psychology.

[52]  K. Urberg,et al.  Locus of peer influence: Social crowd and best friend , 1992, Journal of youth and adolescence.

[53]  M. Resnick,et al.  Family and peer issues among adolescents with spina bifida and cerebral palsy. , 1991, Pediatrics.

[54]  T. Ollendick,et al.  Developmental Issues in the Clinical Treatment of Children , 1998 .

[55]  M. Prinstein,et al.  Adolescent peer crowd affiliation: linkages with health-risk behaviors and close friendships. , 2001, Journal of pediatric psychology.

[56]  S. Sanders,et al.  Developmental changes in children's cognition to stressful and painful situations. , 1986, Journal of pediatric psychology.

[57]  R. Blum,et al.  Sexual behavior of adolescents with chronic disease and disability. , 1996, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[58]  D. Neumark-Sztainer,et al.  Body dissatisfaction and unhealthy weight-control practices among adolescents with and without chronic illness: a population-based study. , 1995, Archives of pediatrics & adolescent medicine.

[59]  J. Vessey,et al.  Teasing: who says names can never hurt you? , 1995, Pediatric nursing.

[60]  W. Bukowski,et al.  Adjustment in the peer system of adolescents with cancer: a two-year study. , 1993, Journal of pediatric psychology.

[61]  A. La Greca.  Peer influences in pediatric chronic illness: an update. , 1992, Journal of pediatric psychology.

[62]  T. Burroughs,et al.  Research on Social Support In Adolescents With IDDM: A Critical Review , 1997, The Diabetes educator.

[63]  S. Sawyer,et al.  Reproductive health in young women with cystic fibrosis: knowledge, behavior and attitudes. , 1995, Journal of Adolescent Health.

[64]  A. La Greca.  Social consequences of pediatric conditions: fertile area for future investigation and intervention. , 1990, Journal of pediatric psychology.

[65]  M. Gartstein,et al.  A controlled study of peer relationships of children surviving brain tumors: teacher, peer, and self ratings. , 1998, Journal of pediatric psychology.

[66]  J. S. St. Lawrence,et al.  Social Support as a Factor in African-American Adolescents' Sexual Risk Behavior , 1994 .

[67]  A. La Greca,et al.  Children with pediatric conditions: can peers' impressions be managed? And what about their friends? , 2000, Journal of pediatric psychology.

[68]  J. Varni,et al.  The impact of social skills training on the adjustment of children with newly diagnosed cancer. , 1993, Journal of pediatric psychology.

[69]  A. Biglan,et al.  Longitudinal changes in adolescent cigarette smoking behavior: Onset and cessation , 1988, Journal of Behavioral Medicine.

[70]  B. B. Brown,et al.  The multidimensionality of peer pressure in adolescence , 1985, Journal of youth and adolescence.

[71]  J. Garrett,et al.  Risky behavior in teens with cystic fibrosis or sickle cell disease: a multicenter study. , 1998, Pediatrics.

[72]  J. Ward.  Integration of Mildly Handicapped Cerebral Palsied Children into Regular Schools. , 1984 .

[73]  N. Adler,et al.  Perceived competencies, peer group affiliation, and risk behavior among early adolescents. , 1994, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[74]  J. Skyler,et al.  Developmental and Behavioral Aspects of Diabetes Management in Youngsters , 1990 .

[75]  B. Flay,et al.  Reviewing theories of adolescent substance use: organizing pieces in the puzzle. , 1995, Psychological bulletin.

[76]  H. Pollack,et al.  Epidemic increase in childhood overweight, 1986-1998. , 2001, JAMA.

[77]  D. Drotar,et al.  Social competence among children with central nervous system-related chronic health conditions: a review. , 1997, Journal of pediatric psychology.

[78]  D. Kandel.  Homophily, Selection, and Socialization in Adolescent Friendships , 1978, American Journal of Sociology.

[79]  S. Morgan,et al.  Children's attitudes and behavioral intentions toward a peer with Tourette syndrome. , 1996, Journal of pediatric psychology.

[80]  M. Wang.  Social Influences on Adolescents' Smoking Progress: A Longitudinal Analysis. , 1997 .

[81]  J. Varni,et al.  Perceived Social Support and Adjustment of Children with Newly Diagnosed Cancer , 1994, Journal of developmental and behavioral pediatrics : JDBP.

[82]  W. Hartup.  The company they keep: friendships and their developmental significance. , 1996, Child development.

[83]  T. Wills,et al.  Peer and adolescent substance use among 6th-9th graders: latent growth analyses of influence versus selection mechanisms. , 1999, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[84]  B. Compas,et al.  Stress and life events during childhood and adolescence , 1987 .

[85]  J. Varni,et al.  Psychological adjustment and perceived social support in children with congenital/acquired limb deficiencies , 1992, Journal of Behavioral Medicine.

[86]  B. Cromer,et al.  Sexual activity and other high-risk behaviors in adolescents with chronic illness: a review. , 2000, Journal of pediatric and adolescent gynecology.

[87]  G. Elliott,et al.  At the Threshold: The Developing Adolescent , 1990 .

[88]  S. Morgan,et al.  Children's attitudes and behavioral intentions toward a peer presented as obese: does a medical explanation for the obesity make a difference? , 2000, Journal of pediatric psychology.

[89]  J. Varni,et al.  Social support and adjustment in chronically ill and handicapped children , 1989, American journal of community psychology.

[90]  P. Potter,et al.  Children's perceptions of chronic illness: the roles of disease symptoms, cognitive development, and information. , 1984, Journal of pediatric psychology.

[91]  K. Urberg,et al.  Similarity between Adolescent Best Friends , 1993 .

[92]  G. Huon,et al.  Initiation of dieting among adolescent females. , 2000, The International journal of eating disorders.

[93]  M. Gold,et al.  Substance use among adolescents with diabetes mellitus: preliminary findings. , 1993, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[94]  L. Brown,et al.  The Impact of Secrets in Hemophilia and HIV Disorders , 1993 .