Social Functioning in Adolescent Chronic Illness

描述（由申请人提供）：在青春期慢性疾病的发作是一个重要的生理、心理和社会变化时期的重大挑战。尽管青少年的社会世界很重要也很复杂，但人们对慢性疾病对青少年社会功能的影响知之甚少，对诊断后的社会适应过程更是知之甚少。炎症性肠病（IBD）是描述慢性疾病及其对青少年社会功能影响之间的生物-社会心理途径的理想疾病。IBD通常在青春期被诊断出来，并与抑郁症状、社交活动受限和青春期延迟有关，所有这些都可能对这一发育时期的社会功能特别有害。先前的研究表明，患有IBD的青少年在诊断后一年或更长时间内仍会经历社交困难，即使只有轻微的疾病症状，但这些关联的机制尚不清楚。我们的目标是通过确定社会功能的哪些方面是最成问题的，以及确定生物和心理因素是如何造成这些困难的，来改善患有慢性疾病的青少年的适应能力。我们将招募在诊断时患有IBD的青少年，并将每个人与同一所学校的健康对照青少年相匹配。将在基线、6个月、12个月和24个月进行评估，以检查青少年适应社会功能挑战的过程。社会功能将在几个方面进行评估（例如，社会行为和适应），并从几个来源（同伴，老师，父母，自己）。生物学因素包括青春期的时间和疾病的严重程度。心理因素包括抑郁症状和应对策略，性别也将被检查。这项研究将为慢性疾病及其对青少年社会功能的影响之间的生物-社会心理途径提供新的重要信息。公共卫生相关性：这项研究具有相关性，因为患有慢性疾病可能会影响青少年的社会功能。确定他们具体的社会困难和造成这些困难的原因是改善青少年生活的第一步，这不仅对他们很重要，而且对成功的成年也有重要的影响。

DESCRIPTION (provided by applicant): The onset of a chronic illness during adolescence presents a significant challenge during a period of important biological, psychological, and social changes. Despite the importance and complexity of the adolescent's social world, little is known about the effect of a chronic illness on adolescent social functioning, and even less is known about the process of social adjustment after diagnosis. Inflammatory bowel disease (IBD) is an ideal disease in which to describe the bio-psychosocial pathways between chronic illness and its impact on social functioning during adolescence. IBD is often diagnosed in adolescence and is associated with symptoms of depression, restrictions in social activities, and delayed puberty, all of which may be particularly detrimental to social functioning during this developmental period. Previous research has shown that adolescents with IBD continue to experience social difficulty a year or more after diagnosis, even with only mild disease symptoms, but the mechanisms underlying these associations are unknown. Our goal is to improve the adjustment of adolescents with chronic illnesses by determining which aspects of social functioning are most problematic and by determining how biological and psychological factors contribute to these difficulties. We will recruit adolescents with IBD at the time of diagnosis and match each to a healthy comparison adolescent who attends the same school. Assessments will occur at baseline, 6, 12 and 24 months to examine the processes by which adolescents adjust to the challenges in social functioning. Social functioning will be assessed in several areas (e.g., social behaviors and adjustment) and from several sources (peers, teacher, parent, self). Biological factors will include pubertal timing and disease severity. Psychological factors include depression symptoms and coping strategies, and gender will also be examined. This research will provide new, important information about the bio-psychosocial pathways between chronic illness and its impact on social functioning in adolescence. Public Health Relevance: This research is relevant because having a chronic illness likely affects adolescent social functioning. Identifying their specific social difficulties and what contributes to them is the first step in improving adolescents' lives in an area that is not only important to them, but also has important implications for successful adulthood.