A Controlled, Longitudinal Study of the Social Functioning of Youth With Sickle Cell Disease

Abstract

OBJECTIVE: To assess the peer relationships of adolescents with sickle cell disease (SCD) and demographically similar comparison peers who did not have a chronic illness 2 years after an initial evaluation. As a result of ongoing medical challenges associated with SCD and the psychological demands of adolescence, we hypothesized that children with SCD would be viewed by peers as more sensitive and isolated, they would have fewer friends, and they would be less well liked than comparison peers. PATIENTS AND METHODS: At follow-up, peer (n = 2067) and teacher (n = 120) reports of social functioning were obtained for 60 children with SCD and 66 comparison peers. Social reputation (What is the child like?) and social acceptance (Is the child liked?) were evaluated cross-sectionally and longitudinally at the 2-year follow-up (ages 10–17). RESULTS: Relative to comparison peers, children with SCD were perceived as less aggressive by peers and teachers. No significant differences were found between groups on measures of friendship or social acceptance. Results of longitudinal analyses indicated that teacher-reported levels of sensitive and isolated behavior increased over time for comparison peers but remained stable for children with SCD. CONCLUSIONS: In general, the social functioning of children with SCD remained stable over time and was not suggestive of emergent social dysfunction. Findings are discussed within a developmental psychopathology framework, possible protective effect of SCD for youth from high-risk environments, and implications regarding pain management for these youth.