Research Article| Volume 21, ISSUE 1-2, P97-107, January 2020

Download started.


Daily Peer Victimization Experiences of Adolescents With and Without Chronic Pain: Associations With Mood, Sleep, Pain, and Activity Limitations


      • Peer victimization is commonly experienced by youth with and without chronic pain.
      • Thirty-six percent of youth experienced distressing peer victimization during the monitoring week.
      • Chronic victimization predicted worse mood, sleep, pain, and activity limitations.
      • Peer victimization may influence pain outcomes through its negative impact on mood.


      This study aims to 1) examine the temporal influence of peer victimization on mood, sleep quality, pain, and activity limitations in clinical and community samples of youth, and 2) test mood and sleep as mediators of peer victimization-pain pathways. One hundred fifty-six adolescents (n = 74 chronic pain group) completed a week of online diary monitoring assessing their daily peer victimization experiences, negative mood, sleep quality, pain intensity, and pain-related activity limitations. In multilevel models controlling for group status, person-mean peer victimization (averaged across days) significantly predicted worse mood, pain, and activity limitations (all Ps < .01) while daily victimization predicted worse mood (P < .05). Results from within-person mediation indicated a significant indirect effect of daily peer victimization on next-day activity limitations, through daily negative mood. Results from between-person mediation indicated that negative mood significantly mediated the relation between peer victimization and pain and the relation between peer victimization and activity limitations. Peer victimization is associated with negative health indicators in clinical and community samples of youth and may exert its influence on pain and pain-related activity limitations through negative mood.


      This article examines the temporal influence of peer victimization on pain in adolescents with and without chronic pain, and examines mood and sleep quality as mechanisms linking victimization to pain. This information may be useful for pain prevention researchers as well as providers who assess and treat pain in childhood.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The Journal of Pain
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bauer DJ
        • Preacher KJ
        • Gil KM
        Conceptualizing and testing random indirect effects and moderated mediation in multilevel models: New procedures and recommendations.
        Psychol Methods. 2006; 11: 142-163
        • Biebl SJ
        • DiLalla LF
        • Davis EK
        • Lynch KA
        • Shinn SO
        Longitudinal associations among peer victimization and physical and mental health problems.
        J Pediatr Psychol. 2011; 36: 868-877
        • Bolger N
        • Davis A
        • Rafaeli E
        Diary methods: Capturing life as it is lived.
        Annu Rev Psychol. 2003; 54: 579-616
        • Bolger N
        • Laurenceau JP
        Methodology in the Social Sciences: Intensive Longitudinal Methods: An Introduction to Diary and Experience Sampling Research.
        Guilford, New York2013
        • Bromberg MH
        • Connelly M
        • Anthony KK
        • Gil KM
        • Schanberg LE
        Prospective mediation models of sleep, pain and daily function in children with arthritis using ecological momentary assessment.
        Clin J Pain. 2016; 32: 471-477
        • Copeland WE
        • Wolke D
        • Lereya ST
        • Shanahan L
        • Worthman C
        • Costello EJ
        Childhood bullying involvement predicts low-grade systemic inflammation into adulthood.
        Proc Natl Acad Sci USA. 2014; 111: 7570-7575
        • De Los Reyes A
        • Prinstein MJ
        Applying depression-distortion hypotheses to the assessment of peer victimization in adolescents.
        J Clin Child Adolesc Psychol. 2004; 33: 325-335
        • Eisenberger NI
        • Lieberman MD
        • Williams KD
        Does rejection hurt? An fMRI study of social exclusion.
        Science. 2003; 302: 290-292
        • Espinoza G
        • Gonzales NA
        • Fuligni AJ
        Daily school peer victimization experiences among Mexican-American adolescents: Associations with psychosocial, physical and school adjustment.
        J Youth Adolesc. 2013; 42: 1775-1788
        • Fales JL
        • Forgeron P
        The importance of friendships among adolescents with chronic pain: The next critical wave of research.
        Pediatr Pain Lett. 2014; 16: 35-39
        • Fales JL
        • Rice S
        • Aaron RV
        • Palermo TM
        Traditional and cyber-victimization among adolescents with and without chronic pain.
        Health Psychol. 2018; 37: 291-300
        • Fekkes M
        • Pijpers FI
        • Fredriks AM
        • Vogels T
        • Verloove-Vanhorick SP
        Do bullied children get ill, or do ill children get bullied? A prospective cohort study on the relationship between bullying and health-related symptoms.
        Pediatrics. 2006; 117: 1568-1574
        • Forgeron PA
        • McGrath P
        • Stevens B
        • Evans J
        • Dick B
        • Finley GA
        • Carlson T
        Social information processing in adolescents with chronic pain: My friends don't really understand me.
        Pain. 2011; 152: 2773-2780
        • Gini G
        • Pozzoli T
        • Lenzi M
        • Vieno A
        Bullying victimization at school and headache: A meta‐analysis of observational studies.
        Headache. 2014; 54: 976-986
        • Hamburger ME
        • Basile KC
        • Vivolo AM
        Measuring Bullying Victimization, Perpetration, and Bystander Experiences: A Compendium of Assessment Tools.
        Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, GA2011
        • Harris PA
        • Taylor R
        • Thielke R
        • Payne J
        • Gonzalez N
        • Conde JG
        Research electronic data capture (REDCap) – A metadata-driven methodology and workflow process for providing translational research informatics support.
        J Biomed Inform. 2009; 42: 377-381
        • Hayes AF
        Beyond Baron and Kenny: Statistical mediation analysis in the new millennium.
        Commun Monogr. 2009; 74: 408-420
        • Hayes AF
        Methodology in the Social Sciences: Introduction to Mediation, Moderation, and Conditional ProcessAnalysis: A Regression-Based Approach.
        Guilford, New York2013
        • Holley AL
        • Rabbitts J
        • Zhou C
        • Durkin L
        • Palermo TM
        Temporal daily associations among sleep and pain in treatment-seeking youth with acute musculoskeletal pain.
        J Behav Med. 2017; 40: 675-681
        • Holley AL
        • Zhou C
        • Wilson AC
        • Hainsworth K
        • Palermo TM
        The CALI-9: A brief measure for assessing activity limitations in children and adolescents with chronic pain.
        Pain. 2018; 159: 48-56
        • Huang YY
        • Chou C
        An analysis of multiple factors of cyberbullying among junior high school students in Taiwan.
        Comput Hum Behav. 2010; 26: 1581-1590
        • Hymel S
        • Swearer SM
        Four decades of research on school bullying: An introduction.
        Am Psychol. 2015; 70: 293-299
        • Landoll RR
        • La Greca AM
        • Lai BS
        Aversive peer experiences on social networking sites: Development of the Social Networking‐Peer Experiences Questionnaire (SN‐PEQ).
        J Res Adolesc. 2013; 23: 695-705
        • Lehman BJ
        • Repetti RL
        Bad days don't end when the school bell rings: The lingering effects of negative school events on children's mood, self-esteem, and perceptions of parent–child interaction.
        Soc Dev. 2007; 16: 596-618
        • Lewandowski AS
        • Palermo TM
        • De la Motte S
        • Fu R
        Temporal daily associations between pain and sleep in adolescents with chronic pain versus healthy adolescents.
        Pain. 2010; 151: 220-225
        • MacDonald G
        • Leary MR
        Why does social exclusion hurt? The relationship between social and physical pain.
        Psych Bull. 2005; 131: 202-223
        • McDougall P
        • Vaillancourt T
        Long-term adult outcomes of peer victimization in childhood and adolescence: Pathways to adjustment and maladjustment.
        Am Psychol. 2015; 70: 300-310
        • Modecki KL
        • Minchin J
        • Harbaugh AG
        • Guerra NG
        • Runions KC
        Bullying prevalence across contexts: A meta-analysis measuring cyber and traditional bullying.
        J Adolesc Health. 2014; 55: 602-611
        • Morrow MT
        • Hubbard JA
        • Barhight LJ
        • Thomson AK
        Fifth-grade children's daily experiences of peer victimization and negative emotions: Moderating effects of sex and peer rejection.
        J Abnorm Child Psychol. 2014; 42: 1089-1102
        • Nishina A
        Microcontextual characteristics of peer victimization experiences and adolescents’ daily well-being.
        J Youth Adolesc. 2012; 41: 191-201
        • Nishina A
        • Juvonen J
        • Witkow MR
        Sticks and stones may break my bones, but names will make me feel sick: The psychosocial, somatic, and scholastic consequences of peer harassment.
        J Clin Child Psychol. 2005; 34: 37-48
        • Palermo TM
        • Fonareva I
        • Janosy NR
        Sleep quality and efficiency in adolescents with chronic pain: Relationship with activity limitations and health-related quality of life.
        Behav Sleep Med. 2008; 6: 234-250
        • Palermo TM
        • Lewandowski AS
        • Long AC
        • Burant CJ
        Validation of a self report questionnaire version of the Child Activity Limitations Interview (CALI): The CALI-21.
        Pain. 2008; 139: 644-652
        • Pouwels JL
        • Lansu TA
        • Cillessen AH
        Participant roles of bullying in adolescence: Status characteristics, social behavior, and assignment criteria.
        Aggress Behav. 2016; 42: 239-253
        • Prinstein MJ
        • Boergers J
        • Vernberg EM
        Overt and relational aggression in adolescents: Social-psychological adjustment of aggressors and victims.
        J Clin Child Psychol. 2001; 30: 479-491
        • Rabbitts JA
        • Zhou C
        • Narayanan A
        • Palermo TM
        Longitudinal and temporal associations between daily pain and sleep patterns after major pediatric surgery.
        J Pain. 2017; 18: 656-663
        • Rights JD
        • Sterba SK
        Quantifying explained variance in multilevel models: An integrative framework for defining R-squared measures.
        Psychol Methods. 2018; ([Epub ahead of print])
        • Roth-Isigkeit A
        • Thyen U
        • Stöven H
        • Schwarzenberger J
        • Schmucker P
        Pain among children and adolescents: Restrictions in daily living and triggering factors.
        Pediatrics. 2005; 115: e152-e162
        • Schwartz D
        • Lansford JE
        • Dodge KA
        • Pettit GS
        • Bates JE
        Peer victimization during middle childhood as a lead indicator of internalizing problems and diagnostic outcomes in late adolescence.
        J Clin Child Psychol. 2015; 44: 393-404
        • Sigurdson JF
        • Wallander J
        • Sund AM
        Is involvement in school bullying associated with general health and psychosocial adjustment outcomes in adulthood?.
        Child Abuse Negl. 2014; 38: 1607-1617
        • Simons LE
        • Logan DE
        • Chastain L
        • Stein M
        The relation of social functioning to school impairment among adolescents with chronic pain.
        Clin J Pain. 2010; 26: 16-22
        • Sinclair CM
        • Meredith P
        • Strong J
        • Feeney R
        Personal and contextual factors affecting the functional ability of children and adolescents with chronic pain: A systematic review.
        J Dev Behav Pediatr. 2016; 37: 327-342
        • Troop-Gordon W
        Peer victimization in adolescence: The nature, progression, and consequences of being bullied within a developmental context.
        J Adolesc. 2017; 55: 116-128
        • Turner HA
        • Finkelhor D
        • Hamby SL
        • Shattuck A
        • Ormrod RK
        Specifying type and location of peer victimization in a national sample of children and youth.
        J Youth Adolesc. 2011; 40: 1052-1067
        • Vaillancourt T
        • Hymel S
        • McDougall P
        The biological underpinnings of peer victimization: Understanding why and how the effects of bullying can last a lifetime.
        Theory Pract. 2013; 52: 241-248
        • Valrie CR
        • Bromberg MH
        • Palermo T
        • Schanberg LE
        A systematic review of sleep in pediatric pain populations.
        J Dev Behav Pediatr. 2013; 34: 120-128
        • van Geel M
        • Goemans A
        • Vedder PH
        The relation between peer victimization and sleeping problems: A meta-analysis.
        Sleep Med Rev. 2016; 27: 89-95
        • van Rijsbergen GD
        • Burger H
        • Hollon SD
        • Elgersma HJ
        • Kok GD
        • Dekker J
        • de Jong PJ
        • Bockting CL
        How do you feel? Detection of recurrent major depressive disorder using a single-item screening tool.
        Psychiatry Res. 2014; 220: 287-293
        • Vivolo-Kantor AM
        • Martell BN
        • Holland KM
        • Westby R
        A systematic review and content analysis of bullying and cyber-bullying measurement strategies.
        Aggress Violent Behav. 2014; 19: 423-434
        • von Baeyer CL
        Children's self-reports of pain intensity: Scale selection, limitations, and interpretation.
        Pain Res Manag. 2006; 11: 157-162
        • Wolke D
        • Copeland WE
        • Angold A
        • Costello EJ
        Impact of bullying in childhood on adult health, wealth, crime, and social outcomes.
        Psychol Sci. 2013; 24: 1958-1970