249: Distinct social pathways linking interference and psychological function in youth with chronic pain

Topic: Clinical Science
Subtopic: Non-specific to any diagnosis, Psychology, Epidemiology, Pain in Special Populations

Background and Aims: Evidence suggests that pain interference is linked to depression and anxiety in youth with chronic pain, but the specific contribution of the social environment to these associations remains unclear. Guided by the Stress-Buffering Model of Social Support, this study tested theory-driven mediation and moderation models to examine whether peer relationships and bullying contribute to or modify concurrent and short-term longitudinal associations between pain interference and psychological function.

Methods: A concurrent sample of 744 youth with chronic pain (61% girls; mean age = 11.9 years, SD = 2.6) completed measures of pain characteristics, pain interference, peer relationship quality, bullying (past and current), and psychological function (depressive and anxiety symptoms). A short-term longitudinal subsample of 357 youth who reported chronic pain 12 months later completed measures at both assessments.

Results: Peer relationships significantly mediated the association between pain interference and depressive symptoms in both samples. No mediating effects were observed for anxiety symptoms or for being bullied. In the concurrent sample, being bullied in the past significantly moderated the association between pain interference and depressive symptoms; in the longitudinal sample, this effect was moderated by peer relationship quality. For anxiety, only concurrent moderation was observed, with past bullying amplifying its association with pain interference.

Conclusions: These findings extend theoretical models by demonstrating that supportive and adverse peer experiences influence psychological adjustment through distinct contextual pathways. They highlight the importance of assessing the social environment in clinical evaluations and suggest that strengthening peer support may be a valuable target for intervention in youth with chronic pain.

References: Dudeney J, Aaron R V., Hathway T, Bhattiprolu K, Bisby MA, McGill LS, Gandy M, Harte N, Dear BF. Anxiety and depression in youth with chronic pain: A systematic review and meta-analysis. JAMA Pediatr 2024;178:1114–1123.

Solé E, Roman-Juan J, Sánchez-Rodríguez E, Castarlenas E, Jensen MP, Miró J. School bullying and peer relationships in children with chronic pain. Pain 2024;165:1169–1176.

Wolock ER, Sinisterra M, Fedele DA, Bishop MD, Boissoneault J, Janicke DM. A systematic review of social functioning and peer relationships in adolescents with chronic pain. J Pediatr Psychol 2025;50:354–376.

Presenting Author: Juan P. Sanabria-Mazo
Submitting Author: Juan P. Sanabria-Mazo

Senior Author: Jordi Miró

IASP 2026 Global Year theme of Neuropathic Pain: No

• Juan P. Sanabria-Mazo: PhD - Universitat Rovira i Virgili
• Josep Roman-Juan: PhD - University of Calgary
• Mark P. Jensen: PhD - University of Washington
• Jordi Miró: PhD - Universitat Rovira i Virgili