title: Social functioning and peer relationships in children and adolescents with chronic pain: A systematic review.
abstract: BACKGROUND
  Peer relationships during childhood and adolescence are acknowledged to be negatively impacted by chronic pain; however, to date there has been no synthesis of this literature.
  
  
  OBJECTIVE
  To systematically review existing literature describing the social functioning and peer relationships in children and adolescents with recurrent or continuous chronic pain.
  
  
  METHODS
  Articles on peer relationship factors studied in samples of children and adolescents with chronic pain published in English or French were identified using EMBASE, Medline, CINAHL and PsycINFO. Two independent reviewers performed initial screenings using study titles and abstracts, and reviewed each eligible article in full.
  
  
  RESULTS
  Of 1740 published papers yielded by the search, 42 articles met the inclusion criteria and were included in the present review. Nine studies had peer relationship investigation as the primary purpose of the study; the remaining 33 examined peer relationships as part of a broader study. A range of specific and more general measures was used to examine peer relationships. Across studies, children and adolescents with chronic pain were reported to have fewer friends, be subjected to more peer victimization, and were viewed as more isolated and less likeable than healthy peers.
  
  
  CONCLUSIONS
  Children and adolescents with chronic pain have peer relationship deficiencies. However, the majority of studies to date measure peer relationships as part of a broader study and, thus, little attention has been paid specifically to peer relationships in this group. Additional research examining the quality of peer relationships of children and adolescents with chronic pain, as well as development of measures specifically designed to assess these relationships, is needed.
authors.affiliation: Dalhousie University and IWK Health Centre, Halifax, Nova Scotia. pforgero@dal.ca
authors.forename: Paula A
authors.initials: PA
authors.lastname: Forgeron
authors.forename: Sara
authors.initials: S
authors.lastname: King
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Stinson
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: McGrath
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: MacDonald
authors.forename: Christine T
authors.initials: CT
authors.lastname: Chambers
mesh_terms: D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology / Q000523:psychology; D002908:Chronic Disease; D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D007398:Interpersonal Relations; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000523:psychology*; D010379:Peer Group; D011569:Psychiatric Status Rating Scales; D012917:Social Adjustment