# Risk, Resilience, and Recovery: A Longitudinal Mixed-Method Study Examining the Role of Peer Relationships in Pediatric Pain

> **NIH NIH R01** · WASHINGTON STATE UNIVERSITY · 2024 · $581,156

## Abstract

Project Summary/Abstract
Pediatric chronic pain is a critical public health problem, affecting up to a third of adolescents and contributing
to significant emotional distress, poor sleep, and difficulties in social functioning. These difficulties include
social isolation, friendship instability, and high rates of peer victimization both on and offline. Whether peer
relationship problems are a cause, correlate, or consequence of chronic pain is largely unknown. Although
research has long demonstrated links between social pain (e.g., social exclusion, loneliness) and physical
pain—little research has examined the prospective, daily, or chronic impact of peer relationship problems on
pain persistence and pain-related disability in childhood. Further, no research has examined how positive peer
relationship factors (e.g., social connectedness, social support) may promote recovery or protect against the
development of disabling pediatric chronic pain. The objective of the proposed research is to identify specific
peer relationship processes that influence pain persistence, exacerbation, and recovery in a cohort of 450 early
adolescents (ages 11-14) at risk for developing chronic pain (i.e., youth seeking treatment for an acute pain
problem). Longitudinal studies that model the trajectories of peer relationship processes are needed to
establish temporal relationships and disentangle social risk and protective factors from outcomes. If peer
relationship factors contribute to pain persistence and pain-related disability, improving these relationships
should become an immediate goal of both prevention and intervention efforts. Here we combine 1) a large-
scale longitudinal cohort design, 2) comprehensive assessment of peer relationship processes and pain, and
3) a model-based approach to determine whether and how specific peer relationship processes (e.g., social
exclusion, cyber-victimization, social connectedness) contribute to pain outcomes in at-risk youth during the
critical transition from early to middle adolescence (Aims 1 and 2). Electronic daily diary monitoring of peer
victimization experiences and pain, incorporating objective assessment of social media use and sleep, will be
combined with qualitative interview data to characterize the temporal dynamics between peer victimization,
social media use, shared comorbidities, (i.e., poor sleep, low mood) and pain outcomes (Aim 3). Our broad
hypothesis is that peer relationship problems will contribute to pain persistence and disability, directly and
indirectly (through mood and sleep mechanisms)—and that these effects will be mitigated by the presence of
strong social support and social connectedness. The proposed methodologically rigorous mixed-methods
investigation of peer relationship trajectories from early to middle adolescence will advance our understanding
of the specific peer relationship processes that contribute to pain risk and resilience in childhood. Mechanistic
insights regarding the ro...

## Key facts

- **NIH application ID:** 10873485
- **Project number:** 1R01HD111882-01A1
- **Recipient organization:** WASHINGTON STATE UNIVERSITY
- **Principal Investigator:** JESSICA L FALES
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $581,156
- **Award type:** 1
- **Project period:** 2024-08-07 → 2029-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10873485

## Citation

> US National Institutes of Health, RePORTER application 10873485, Risk, Resilience, and Recovery: A Longitudinal Mixed-Method Study Examining the Role of Peer Relationships in Pediatric Pain (1R01HD111882-01A1). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10873485. Licensed CC0.

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