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Home » Child and Adolescent Psychiatry

Psychiatric Times. Vol. 29 No. 11
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CHILD & ADOLESCENT PSYCHIATRY 

The Importance of Friends

By Karen Dineen Wagner, MD, PhD | November 6, 2012
Dr Wagner is the Marie B. Gale Centennial Professor and Vice Chair in the department of psychiatry and behavioral sciences and Director of Child and Adolescent Psychiatry at the University of Texas Medical Branch at Galveston. Dr Wagner has been a consultant and/or has received research support from manufacturers of antidepressants.

The researchers found that a best friend buffered the effects of negative experiences. When a best friend was present, there was little change in cortisol level as the student’s experience increased in negativity. However when a best friend was absent, there was an increase in cortisol as the negativity of the experience increased. Similarly, when a best friend was present, there was no change in the student’s global self-worth in the face of very negative experiences. However, when the best friend was absent, the student’s global self-worth rating was lower in the face of very negative experiences. The researchers concluded that the presence of a best friend during negative experiences protects against decreased global self-worth and activation of the hypothalamic-pituitary-adrenocortical axis.

An important issue is whether lack of friends is a precipitant or a consequence of a psychiatric disorder such as depression. Alternatively, there may be an interaction over time between depression and lack of friends. In a recent study, Kochel and colleagues3 examined 3 models for the predictive association between depressive symptoms and poor peer relationships. The interpersonal model predicts that poor peer relationships precipitate depressive symptoms. The symptoms-driven model predicts that depressive symptoms contribute to poor peer relationships. The transactional model predicts that depressive symptoms and poor peer relationships are reciprocally associated over time.

This longitudinal study was made up of 486 youths who were in grade 4 at baseline. Follow-up assessments were conducted in grades 5 and 6. Data were obtained from study participants, their classmates, teachers, and parents. Depressive symptoms were evaluated using parent and teacher reports. Peer victimization was assessed using student, peer, and teacher reports. Low peer acceptance was assessed by peer report.

The symptoms-driven model best explained the relationship between depressive symptoms and poor peer relations. Depressive symptoms in fourth grade predicted peer victimization in fifth grade, which predicted low peer acceptance in sixth grade. These investigators concluded that depressive symptoms lead to future difficulties with peer interactions.

The finding from this study provides optimism that adequate treatment of a child’s depression will improve peer relationships. However, many children have been depressed for a significant period before treatment, which can exacerbate adverse effects on peer relations.

It is important for clinicians to address the issue of friendships when evaluating and treating children. Parents should be apprised about the critical need for a best friend or friends for their children. If a child is having difficulty in making friends in school, extracurricular activities may provide a setting for interaction with children who have similar interests. Psychotherapy can also promote skills aimed at positive peer interactions.

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by Balasubramanian N | December 01, 2012 10:03 PM EST

ofcourse, many children without friends may develop some neurological and personality problems

by sharon A | November 15, 2012 1:03 AM EST

This does not take into account bullying. I would hope that it's not suggested a child be pushed to stick out a situation that is damaging to them in the hopes that they'll develop better peer relationships with support. A parent may not even be aware to the extent of bullying because the child is afraid or too embarrassed to say anything. Driving them into extracurricular activities, at that point, can further exacerbate things. That doesn't mean not encouraging other types of socialization. It's about finding out their interests and connecting with peers who appreciate them for same. That might mean making friends unconnected to school.

Further, this is a good place to add that there are far too many situations of more introverted kids being pushed hard to socialize to the effect of dishonoring their own gifts and need for more than average space.

by Michele Meltzer | November 14, 2012 6:15 PM EST

Prof Wagner hasn't mentioned a couple of other possibilities that may account for lack of friendships. One is that the child may be on the Asperger / high functioning autistic spectrum, and have genuine difficulty with social relationships. Another possibility is that the child may be significantly gifted, and has been unable to find like-minded peers amongst his or her classmates.

Dr Michele Meltzer





References

1. Sullivan HS. The Interpersonal Theory of Psychiatry: A Systematic Presentation of the Later Thinking of One of the Great Leaders in Modern Psychiatry. New York: WW Norton & Company Inc; 1953.

2. Adams RE, Santo JB, Bukowski WM. The presence of a best friend buffers the effects of negative experiences. Dev Psychol. 2011;47:1786-1791.

3. Kochel KP, Ladd GW, Rudolph KD. Longitudinal associations among youth depressive symptoms, peer victimization, and low peer acceptance: an interpersonal process perspective. Child Dev. 2012;83:637-650.


 
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