{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:26:20Z","timestamp":1788449180441,"version":"build-2803163510"},"reference-count":52,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic pain in adolescents is associated with loneliness and increases in stress, which in turn elevate the risk of worse pain\u2010related outcomes. Positive peer\u2010related social factors mediate the relationship between stress and loneliness amongst those without pain, but it is not known if this holds in the presence of pain characteristics. It is also unknown if peer\u2010related social factors (e.g., social support) mediate the relationship between pain characteristics and loneliness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional survey using validated measures was completed by 128 adolescents with chronic pain. Mediation with moderation analysis using Hayes Process Macro was conducted to explore if peer\u2010related social factors mediated the relationship between pain intensity and pain\u2010related interference on loneliness and stress as well as stress on loneliness. Demographic variables were assessed as moderators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One's perceived social competence and social support from friends mediated the relationship between pain characteristics and loneliness, pain characteristics and stress, and stress and loneliness for males and females. The number of friends did not mediate these relationships. Socioeconomic status moderated the relationship between pain characteristics and stress, with those in higher income families experiencing significant increases in stress as pain characteristics increased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Strengthening peer\u2010related social factors is a promising avenue for chronic pain management for adolescents as these factors explain why some adolescents with chronic pain experience less loneliness. Examining the effectiveness of evidenced\u2010based interventions found to decrease loneliness in adolescents without pain is warranted in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>Adolescents with chronic pain are at risk for increases in loneliness and stress, both of which are associated with worse pain\u2010related outcomes. Using validated measures, findings indicate that peer\u2010related social factors meditated the effect of pain intensity and pain\u2010related interference on loneliness and stress. Peer\u2010related social factors were also significant in mediating the relationship between stress and loneliness. Peer\u2010related social factors contribute to resiliency amongst adolescents with chronic pain and offer a promising avenue to improve pain\u2010related outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70322","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T11:51:08Z","timestamp":1783165868000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the Power of Peer\u2010Related Social Factors in Mediating the Effects of Pain on Loneliness and Stress in Adolescents"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4686-9698","authenticated-orcid":false,"given":"Paula","family":"Forgeron","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, School of Nursing University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Dick","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Pain Medicine University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pam","family":"Qualter","sequence":"additional","affiliation":[{"name":"Manchester Institute of Education University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Birinie","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine, and Department of Community Health Sciences University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. A.","family":"Finley","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Pain Management &amp; Perioperative Medicine, Faculty of Medicine Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbie","family":"Jordan","sequence":"additional","affiliation":[{"name":"Department of Psychology and Centre for Pain Research University of Bath  Bath UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassidy","family":"Bradley","sequence":"additional","affiliation":[{"name":"Person with Lived Experience Partner  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delane","family":"Linkiewich","sequence":"additional","affiliation":[{"name":"Person with Lived Experience Partner  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trinity","family":"Lowthian","sequence":"additional","affiliation":[{"name":"Person with Lived Experience Partner  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"McNally","sequence":"additional","affiliation":[{"name":"Person with Lived Experience Partner  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Trehan","sequence":"additional","affiliation":[{"name":"Person with Lived Experience Partner  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Lamont","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, School of Nursing University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ligyana","family":"Candido","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, School of Nursing University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Stinson","sequence":"additional","affiliation":[{"name":"Child Health Evaluative Sciences (CHES) in Research Institute, SickKids Pain Centre The Hospital for Sick Children  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14404"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(00)00065-4"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.15266"},{"key":"e_1_2_8_5_1","first-page":"127","volume-title":"Advances in Experimental Social Psychology","author":"Cacioppo J. 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