title: Living with difference: exploring the social self of adolescents with chronic pain.
abstract: BACKGROUND
  Chronic pain negatively affects an adolescent's life; however, little is known about the social impact of chronic pain for adolescents. More is known about the general peer relationships of adolescents with chronic pain than their close friendships. Close friendships begin to take on more importance during adolescence as these relationships facilitate the development of an adolescent's sense of personal identity and increasing independence from family influences. Thus, chronic pain may create friendship challenges for adolescents beyond those typically experienced during this developmental trajectory, which may negatively impact their abilities to secure social support.
  
  
  OBJECTIVE
  To better understand the challenges adolescents with chronic pain face with regard to their friendships.
  
  
  METHODS
  An interpretative phenomenological study using individual interviews was conducted.
  
  
  RESULTS
  Two themes emerged. 'Rethinking the self with pain' describes the intrusive nature of chronic pain, challenging the participants to rethink the way they view themselves and their place within their social network. 'Rethinking friendships' describes the interpretation of their friends' reactions to their chronic pain condition, which led to these adolescents spending more time by themselves, and feeling misunderstood and unsupported.
  
  
  CONCLUSIONS
  The impact of chronic pain on the adolescent as an individual as well as the responses of close friends and others within their social network resulted in the development of new friendship needs. However, the adolescents were not always able to secure these new friendship needs. Their experiences suggest factors within friendships that may be ameliorated by interventions, thus maintaining and strengthening their close friendships.
authors.forename: Paula A
authors.initials: PA
authors.lastname: Forgeron
authors.forename: Joan
authors.initials: J
authors.lastname: Evans
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: McGrath
authors.forename: Bonnie
authors.initials: B
authors.lastname: Stevens
authors.forename: G Allen
authors.initials: GA
authors.lastname: Finley
mesh_terms: D000293:Adolescent; D059350:Chronic Pain / Q000523:psychology*; D005260:Female; D033062:Friends / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010379:Peer Group; D012649:Self Concept; D012944:Social Support