To Befriend or Not: Naturally Developing Friendships Amongst a Clinical Group of Adolescents with Chronic Pain.

Adolescents with chronic pain frequently perceive a lack of support from friends. Support from a peer with a shared experience has been found to provide emotional, informational, and appraisal support. We sought to quantify the frequency with which adolescents with chronic pain want to befriend other adolescents with chronic pain, and to describe the features of these friendships. Adolescents with chronic pain who had attended a 10-week structured self-management program from 3 sites were invited to complete an online survey. Forty teens participated, 95% (n = 38) were girls; 32% (n = 13) befriended another; 52% (n = 21) were interested in befriending another but did not; 15% (n = 6) were not interested in befriending anyone. Over half (62%) of the friendships lasted at least 1 year (n = 8), but only 2 intermingled these with their regular friendships. Pain was discussed frequently during interactions. The most common reasons for not forming friendships were no time to exchange contact information during group and not having things in common. Reasons for not being interested in forming a friendship also included not having anything in common apart from pain. The majority of participants were interested in befriending another. Emotional support, by feeling understood and discussing pain without fear that the other is disinterested, was the main peer support provided. Without common interests, this form of friendship may not last and is at risk for being overly solicitous by focusing on pain. It remains unclear whether the benefits of peer support translate into improved function.

Nerve resection, crush and re-location relieve complex regional pain syndrome type II: a case report.

This case report describes the remarkable recovery of a patient with very long-standing, medically intractable and disabling, lower-limb, complex regional pain syndrome type II following the resection, crushing, and relocation of sensory nerves.

Social information processing in adolescents with chronic pain: my friends don't really understand me.

Adolescents with chronic pain are at risk for impairment in their friendships. They miss out on leisure activities, have increased school absence, may have fewer friends, are at an increased risk for victimization, and may be perceived by peers as less likeable. To help determine the source of these problems, the Social Information Processing Model (SIP) was adapted using narrative vignettes to determine if adolescents with chronic pain interpret friendship interactions differently in terms of supportive and nonsupportive behaviors compared to healthy peers. One hundred seven adolescents, 45 with chronic pain, completed the vignette questionnaire and a battery of measures. The vignette questionnaire included 12 vignettes to capture 3 steps in SIP processing: interpretation of cues, response construction, and response decision. Participants with chronic pain rated nonsupportive vignettes more negatively than healthy controls and indicated they would enact supportive behaviors towards the chronic pain character more often if they had been the healthy character. Age, sex, and internalizing measures did not significantly contribute to the findings. Chronic pain explained 6.5% of variance in the ratings of nonsupportive vignettes and 10.1% of the variance in supportive behavior selection. Adolescents with chronic pain may interpret nonsupportive social situations with close friends as more distressing. The endorsement of more supportive behaviors may indicate a need for, and expectation of, supportive behaviors from friends. When adolescents with chronic pain do not perceive friends as providing support, they may avoid these social situations.