Role of Friends in Adolescent Interpersonal Relations

(BFFs Trial)

Overseen By Michelle P Brown, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of South Carolina

Disqualifiers: Age, No caregiver, No friend, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

120 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to investigate how the friendship experiences of maltreated (i.e., abused and/or neglected) and non-maltreated adolescents differentially influence their risk for adverse outcomes. The main questions it aims to answer are: 1. How do the friendships of maltreated adolescents differ from those of non-maltreated adolescents? 2. Which friendship experiences influence the associations between maltreatment and ability to regulate stress, as well as future mental health difficulties and revictimization? Participants will: * Attend the initial study visit on the campus of the University of South Carolina with their primary caregiver and a best friend during which they will: * Complete study questionnaires * Be connected to a device that records their physical ability to manage stress * Complete a task during which they will be audio and video recorded and complete a brief assessment rating how they are feeling at different times during task completion * Depending on which research group they are placed in, be assigned to discuss their experience doing this task with their friend (intervention group) or sit quietly in a room for 5 minutes (comparison group) * The follow-up study visit will involve completion of study questionnaires online or via mail 6 months later Additionally, the participant's caregiver and friend will complete study questionnaires. Researchers will compare the intervention group (debriefs with a friend) and comparison group (sits quietly for 5 minutes) to see if the presence of and discussion with the friend influences their physical ability to regulate stress and future outcomes.

Do I need to stop taking my current medications to join the trial?

The trial protocol does not specify whether you need to stop taking your current medications. It seems unlikely that you would need to stop, as the study focuses on friendships and stress regulation, not medication use.

What data supports the idea that Role of Friends in Adolescent Interpersonal Relations (also known as: Debrief) is an effective treatment?

The available research shows that friendships play a crucial role in adolescent development, helping with personal adjustment and social skills. For example, studies indicate that the quality of friendships, such as trust and communication, is linked to better coping mechanisms and social skills. Additionally, having a stable friendship network is associated with greater social satisfaction and school belonging. These findings suggest that focusing on friendships, as in the Role of Friends in Adolescent Interpersonal Relations treatment, can be beneficial for adolescents' social and emotional development. ^{1 2 3 4 5}

What safety data exists for the treatment 'Role of Friends in Adolescent Interpersonal Relations'?

The provided research does not directly address safety data for the treatment 'Role of Friends in Adolescent Interpersonal Relations' or 'Debrief.' The studies focus on the influence of friendship networks on adolescent risk behaviors, peer influence on sexual risk behavior, and social influences on alcohol use. They highlight the importance of understanding peer relationships and social networks in shaping adolescent behaviors, which could inform the development of interventions. However, specific safety data or evaluations of the treatment itself are not mentioned in the research provided. ^{6 7 8 9 10}

Is the treatment in the trial 'Role of Friends in Adolescent Interpersonal Relations' a promising treatment?

Yes, the treatment is promising because friendships play a crucial role in adolescent development. They help with emotional support, problem-solving, and building social skills. Friendships can also be used as a therapeutic tool to help troubled adolescents improve their mental health and social interactions. ^{1 2 11 12 13}

Eligibility Criteria

This trial is for adolescents aged 13-17 who have experienced maltreatment or not, with a non-offending caregiver and a best friend (not sibling/romantic partner) to participate. They must all be fluent in English. It excludes those without a non-offending caregiver, no best friend available, or not fluent in English.

Inclusion Criteria

I am between 13 and 17 years old.

Qualify as either maltreated (endorses history of maltreatment - physical abuse, sexual abuse, emotional maltreatment, or neglect and/or has substantiated record of child maltreatment per Department of Social Services [DSS] records) or non-maltreated (denies history of maltreatment and/or no substantiated record of child maltreatment per DSS records)

Parent participating in the study visit is a non-offending caregiver (no record of substantiated maltreatment against the adolescent participant)

Exclusion Criteria

I am either younger than 13 or older than 17 at my first study visit.

No available non-offending parent or guardian/caregiver to participate in the study

I do not have a best friend to come with me to the study.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Study Visit

Participants attend an initial study visit with their caregiver and friend, complete questionnaires, undergo stress management assessment, and participate in a task with either a debrief or quiet sitting period.

1 day

1 visit (in-person)

Follow-up

Participants are monitored for changes in friendship, psychopathology, and revictimization experiences through questionnaires completed online or via mail.

6 months

1 visit (virtual or mail)

Treatment Details

Interventions

• Debrief

Trial Overview The study examines how friendships affect stress regulation and future mental health in maltreated versus non-maltreated teens. Participants will complete questionnaires, stress tests, and either discuss an experience with their friend or sit quietly afterward. Outcomes are compared after six months.

Participant Groups

Group I: Debrief Experimental Treatment 1 Intervention

Following exposure to a laboratory stressor, participants in this arm will debrief their experience with a friend for 5 minutes while their psychophysiological reactivity is recorded using an electrocardiogram (ECG). Their interaction will be audio and video recorded for later observational coding of their friend's validating and invalidating behaviors during the conversation.

Group II: No Debrief Active Control 1 Intervention

Following exposure to a laboratory stressor, participants in this arm will sit by themselves while their psychophysiological reactivity is recorded using an electrocardiogram (ECG).

Who Is Running the Clinical Trial?

University of South Carolina

Lead Sponsor

Trials

233

Recruited

122,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Findings from Research

Adolescent friendships are characterized by reciprocity, co-construction, and consensual validation, highlighting their importance in psychological development.

Despite the increasing influence of peers during adolescence, parents continue to play a significant role in socialization, and understanding friendship dynamics requires considering cultural and historical contexts, especially regarding gender differences.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Friendship in adolescence. Youniss, J., Haynie, DL.[2005]

Friendship relations in adolescence are crucial for developmental functions such as independence from parents, starting romantic relationships, and identity formation, characterized by trust, communication, and intimacy.

Quality of friendships, particularly the ability to communicate personal concerns, is more important for developing social skills and coping mechanisms than simply the number of friends, with girls generally valuing these elements more than boys.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Characteristics and functions of friendship in adolescence]. Claes, M., Poirier, L.[2019]

In a study of 349 adolescents aged 12 to 18, girls showed higher expectations and greater levels of attachment and intimacy in friendships compared to boys, indicating gender differences in friendship dynamics.

The quality of friendships, particularly attachment and lack of conflict, plays a significant role in personal adjustment, suggesting that strong, conflict-free friendships can help adolescents develop adaptive behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Friendship and personal adjustment during adolescence. Claes, ME.[2022]

A 32-week intervention aimed at enhancing resilience in 16 adolescents showed promising results, particularly with reductions in mental health problems for all boys in both intervention groups after 12 months.

While the intervention did not show statistically significant differences due to the small sample size, there were mixed results, including a slight increase in substance use problems among boys and girls in the Positive Adolescent Life Skills (PALS) group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effect of Positive Adolescent Life Skills Training on Long Term Outcomes for High-Risk Teens. Campbell-Heider, N., Tuttle, J., Knapp, TR.[2021]

In a study of 430 early adolescents, having new friendships and a larger friendship network was found to be more beneficial for social adjustment than maintaining existing friendships.

While stability in friendships was linked to a greater sense of belonging at school, losing a significant number of friends negatively impacted social adjustment, highlighting the importance of friendship dynamics during early adolescence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The role of school friendship stability, instability, and network size in early adolescents' social adjustment. Ferguson, S., Brass, NR., Medina, MA., et al.[2022]

Friendship networks significantly influence adolescents' engagement in risky behaviors such as alcohol consumption, smoking, sexual activity, and marijuana use, as shown in a systematic review of 15 studies utilizing Social Network Analysis and Add Health data.

The studies reviewed demonstrated good methodological quality, with an average score of 4.6 out of 9, suggesting that health educators can develop more effective programs by targeting friendship dynamics to mitigate risky behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

US adolescents' friendship networks and health risk behaviors: a systematic review of studies using social network analysis and Add Health data. Jeon, KC., Goodson, P.[2022]

In a study involving 1,029 participants from 162 virtual networks, it was found that individuals often over-reported their peers' sexual risk behaviors while under-reporting protective behaviors, indicating a misperception of peer influences.

The research highlighted a significant concordance between perceived and actual behaviors regarding condom use and multiple partners, suggesting that understanding these perceptions is crucial for addressing sexual risk behaviors among youth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Actual versus perceived peer sexual risk behavior in online youth social networks. Black, SR., Schmiege, S., Bull, S.[2021]

Peer relationships significantly influence mental health outcomes, and understanding these dynamics can help identify new psychological processes and health risks in youth.

Future research should explore how peer interactions affect physical health, including stress responses and immune system markers, especially in the context of digital communication.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Future Directions in Peer Relations Research. Prinstein, MJ., Giletta, M.[2020]

A study of 1,439 adolescents found that the frequency of drunkenness increased when their friends and romantic partners' friends also drank more, highlighting the strong influence of social networks on alcohol use.

Positive attitudes towards alcohol from romantic partners were linked to higher drunkenness frequency, and older adolescents were more affected by unstructured socializing compared to younger ones, suggesting targeted interventions may be needed for different age groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sources of Social Influence on Adolescents' Alcohol Use. Wesche, R., Kreager, DA., Lefkowitz, ES.[2020]

Adolescent risk behaviors, such as sexual activity and substance use, are influenced by psychological development and social environments, with significant differences observed based on age and gender.

Effective interventions to change these risk behaviors must consider the developmental stage and social context of adolescents, as evidenced by trends in alcohol consumption and sexual activity among U.S. teens.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioral risks for HIV in adolescents. Moss, N.[2019]

Sociodemographic factors are the strongest determinants of friendship formation among adolescents, with participation in illicit drug use being a significant factor as well.

Peer influence is particularly crucial for initiating marijuana use, while parental influence becomes more important as adolescents transition to using other illicit drugs, highlighting the different roles parents and peers play in adolescent drug involvement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

On processes of peer influences in adolescent drug use: a developmental perspective. Kandel, DB.[2007]

The study identified two types of friendship trajectories among adolescents: interdependent friendships, which are characterized by high perceived closeness and balanced relatedness, and disengaged friendships, which show lower levels of intimacy and problem-solving skills.

Adolescents in disengaged friendships, particularly girls, experienced less improvement in balanced relatedness and higher levels of depression compared to those in interdependent friendships, highlighting the importance of supportive friendships for mental health and problem-solving development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developmental trajectories of perceived friendship intimacy, constructive problem solving, and depression from early to late adolescence. Selfhout, MH., Branje, SJ., Meeus, WH.[2018]

A study of 628 adolescents found that those who engage in co-rumination, or excessive discussion of problems with friends, tend to focus more on interpersonal issues like family and peer relationships, which can increase their risk for internalizing problems.

Middle adolescents and girls were observed to co-ruminate more about interpersonal problems, suggesting that improving problem-solving skills in these areas could help reduce co-rumination and its associated risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Friends' discussions of interpersonal and noninterpersonal problems during early and middle adolescence: Associations with co-rumination. Rose, AJ., Smith, RL., Schwartz-Mette, RA., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Friendship in adolescence. [2005]

2. France pubmed.ncbi.nlm.nih.gov

[Characteristics and functions of friendship in adolescence]. [2019]

3. England pubmed.ncbi.nlm.nih.gov

Friendship and personal adjustment during adolescence. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

The Effect of Positive Adolescent Life Skills Training on Long Term Outcomes for High-Risk Teens. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

The role of school friendship stability, instability, and network size in early adolescents' social adjustment. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

US adolescents' friendship networks and health risk behaviors: a systematic review of studies using social network analysis and Add Health data. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Actual versus perceived peer sexual risk behavior in online youth social networks. [2021]

8. England pubmed.ncbi.nlm.nih.gov

Future Directions in Peer Relations Research. [2020]

9. United States pubmed.ncbi.nlm.nih.gov

Sources of Social Influence on Adolescents' Alcohol Use. [2020]

10. Norway pubmed.ncbi.nlm.nih.gov

Behavioral risks for HIV in adolescents. [2019]

11. United States pubmed.ncbi.nlm.nih.gov

On processes of peer influences in adolescent drug use: a developmental perspective. [2007]

12. United States pubmed.ncbi.nlm.nih.gov

Developmental trajectories of perceived friendship intimacy, constructive problem solving, and depression from early to late adolescence. [2018]

13. United States pubmed.ncbi.nlm.nih.gov

Friends' discussions of interpersonal and noninterpersonal problems during early and middle adolescence: Associations with co-rumination. [2023]