Moderating Effects of Peer Relations on the Relationships Between Physical Appearance Concerns, Pain, and Depression in Youth with Chronic Conditions

Date of Submission

2020

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Stephanie Felgoise, PhD, ABPP

First Advisor

Elizabeth A. Gosch, PhD, ABPP

Second Advisor

Michelle Lent, PhD

Third Advisor

Andrea Knight, PhD

Abstract

Adolescents with chronic illnesses are at risk for impairments in social, physical, and emotional functioning. They are vulnerable to peer relation deficits, physical impairments such as pain and appearance changes, and have an increased risk of depression. Peer relations, physical impairments, and depression have been shown to have a multifaceted relationship, such that each has been shown to influence the others. For example, depression symptoms have been linked to both physical and social deficits. Additionally, peer relationship quality has been linked to both physical issues and depression, such that higher quality peer relations may be a protective factor whereas lower quality peer relations may exacerbate negative physical and emotional outcomes. This study evaluated the moderating effects of peer relations on the relationships between 1) physical appearance concern and depression and 2) pain interference and depression for adolescents with chronic conditions as measured by parent proxy reports. Eighty-six caregivers (92% female, Mage = 43.7 years) met the inclusion criteria and completed an anonymous, on-line survey. Children of participants (56% female, 83% Caucasian) ranged in age from 12 to 17 years (Mage = 14). The results of the study demonstrated that lower quality peer relations compounded the effects of physical appearance concern on depression and pain interference on depression, whereas higher quality peer relations had a buffering effect. This finding suggests that higher quality peer relations are a protective factor against elevated symptoms of depression. Clinical implications of the findings include improving peer relationships for adolescents with chronic illness who are at risk for depression.

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