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.