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Authenticity, Vulnerability, and Shame in Peer Relationships among Marginalized Youth Living with Mood and Anxiety Disorders

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Abstract

Meaningful peer relationships are developmentally important for adolescents and young adults. Yet trauma histories and stigma around mental illness can impede connection for marginalized youth living with mental health challenges. This study was grounded in relational-cultural theory, which posits that relationships characterized by authenticity and supported vulnerability foster growth; however, in the absence of support for vulnerability, people are likely to relate inauthentically. This qualitative study explored how young people living with mental health challenges navigated issues of authenticity, shame, and vulnerability in peer relationships. As part of a broader feasibility study of an intervention providing services to youth living with mental illness, in-depth interviews were conducted with 11 young women, ages 17–20. Participants were ethnically diverse, primarily low-income, and most had histories of child maltreatment. Interviews focused on participants’ peer relationships, and were audio recorded and transcribed verbatim. Coders analyzed transcripts using thematic analysis and interpreted results using relational-cultural theory. While nearly all participants identified a friend or romantic partner as a significant peer, their experiences within these relationships varied considerably. These are described as a continuum of authenticity, along which participants varied in their experiences of supported vulnerability, feelings of shame, and willingness to represent themselves authentically in these relationships. Some participants who lived with mental health challenges and histories of trauma experienced close, supportive relationships with friends and intimate partners. The ability of marginalized youth to navigate issues of authenticity, vulnerability, shame and stigma in their peer relationships is a worthwhile focus for both practitioners and researchers.

Highlights

  • Close peer relationships are protective for youth with mental health challenges, but stigma and trauma can impede connection with others.

  • Despite barriers to connection, some marginalized youth with mental health challenges and trauma histories experience strong, supportive connections with peers.

  • Participants’ peer relationship experiences varied in terms of support for vulnerability, authenticity, and feelings of shame.

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References

  • Ahrens, K. R., DuBois, D. L., Garrison, M., Spencer, R., Richardson, L. P., & Lozano, P. (2011). Qualitative exploration of relationships with important non-parental adults in the lives of youth in foster care. Children & Youth Services Review, 33(6), 1012–1023. https://doi.org/10.1016/j.childyouth.2011.01.006.

    Article  Google Scholar 

  • Bagwell, C. L., Molina, B. S. G., Pelham, W. E., & Hoza, B. (2001). Attention-deficit hyperactivity disorder and problems in peer relations: Predictions from childhood to adolescence. Journal of the American Academy of Child & Adolescent Psychiatry, 40(11), 1285–1292. https://doi.org/10.1097/00004583-200111000-00008.

    Article  Google Scholar 

  • Bernstein, D. P., Ahluvalia, T., Pogge, D., & Handelsman, L. (1997). Validity of the Child Trauma Questionnaire in an adolescent psychiatric population. Journal of the American Academy of Child & Adolescent Psychiatry, 36(3), 340–348.

    Article  Google Scholar 

  • Black, R. S. A., Curran, D., & Dyer, K. F. W. (2013). The impact of shame on the therapeutic alliance and intimate relationships. Journal of Clinical Psychology (Print), 69(6), 646–654. https://doi.org/10.1002/jclp.21959.

    Article  Google Scholar 

  • Boyatzis, R. E. (1998). Transforming qualitative information: Thematic analysis andcode development. Sage.

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa.

    Article  Google Scholar 

  • Brown, B. (2006). Shame resilience theory: A grounded theory study on women and shame. Families in Society: The Journal of Contemporary Social Services, 87(1), 43–52.

    Article  Google Scholar 

  • Burke, T., & Brown, B. (Eds.). (2021). You are your best thing: Vulnerability, shame resilience, and the Black experience (First edition). Random House.

  • Buskirk-Cohen, A. (2012). Intimate disclosure among best friends of youth: an opportunity for prevention of internalizing disorders. Forum on Public Policy Online, 2012(1). https://eric.ed.gov/?id=EJ979434.

  • Center for Behavioral Health Statistics and Quality. (2020). Results from the 2019 National Survey on Drug Use and Health: Detailed tables. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/.

  • Collins, W. A. (2003). More than myth: the developmental significance of romantic relationships during adolescence. Journal of Research on Adolescence, 13(1), 1–24. https://doi.org/10.1111/1532-7795.1301001.

    Article  Google Scholar 

  • Corrigan, P. W., Kosyluk, K. A., Markowitz, F., Brown, R. L., Conlon, B., Rees, J., Rosenberg, J., Ellefson, S., & Al-Khouja, M. (2016). Mental illness stigma and disclosure in college students. Journal of Mental Health, 25(3), 224–230. https://doi.org/10.3109/09638237.2015.1101056.

    Article  PubMed  Google Scholar 

  • Czyz, E. K., Liu, Z., & King, C. A. (2012). Social connectedness and one-year trajectories among suicidal adolescents following psychiatric hospitalization. Journal of Clinical Child & Adolescent Psychology, 41(2), 214–226. https://doi.org/10.1080/15374416.2012.651998.

    Article  Google Scholar 

  • Delgado, M. Y., Nair, R. L., Updegraff, K. A., & Umaña‐Taylor, A. J. (2019). Discrimination, parent–adolescent conflict, and peer intimacy: examining risk and resilience in Mexican‐origin youths’ adjustment trajectories. Child Development, 90(3), 894–910. https://doi.org/10.1111/cdev.12969.

    Article  PubMed  Google Scholar 

  • DiFulvio, G. T. (2011). Sexual minority youth, social connection and resilience: from personal struggle to collective identity. Social Science & Medicine, 72(10), 1611–1617. https://doi.org/10.1016/j.socscimed.2011.02.045.

    Article  Google Scholar 

  • Downs, M. F. (2012). Changing the meaning of help: clinical approaches to reducing stigma among suicidal young adults. Families in Society, 93(1), 22–28. https://doi.org/10.1606/1044-3894.4182.

    Article  Google Scholar 

  • Eldridge, J., John, M., & Gleeson, K. (2020). Confiding in others: exploring the experiences of young people who have been in care. Adoption & Fostering, 44(2), 156–172. https://doi.org/10.1177/0308575920920389.

    Article  Google Scholar 

  • Emslie, C., Ridge, D., Ziebland, S., & Hunt, K. (2006). Men’s accounts of depression: reconstructing or resisting hegemonic masculinity? Social Science & Medicine, 62(9), 2246–2257. https://doi.org/10.1016/j.socscimed.2005.10.017.

    Article  Google Scholar 

  • Erath, S. A., Flanagan, K. S., Bierman, K. L., & Tu, K. M. (2010). Friendships moderate psychosocial maladjustment in socially anxious early adolescents. Journal of Applied Developmental Psychology, 31(1), 15–26. https://doi.org/10.1016/j.appdev.2009.05.005.

    Article  Google Scholar 

  • Gardner, A., Cotton, S., O’Donoghue, B., Killackey, E., Norton, P., & Filia, K. (2019). Group differences in social inclusion between young adults aged 18 to 25 with serious mental illness and same-aged peers from the general community. International Journal of Social Psychiatry, 65(7–8), 631–642. https://doi.org/10.1177/0020764019868749.

    Article  PubMed  Google Scholar 

  • Greeson, J. K., & Bowen, N. K. (2008). “She holds my hand”: the experiences of foster youth with their natural mentors. Children and Youth Services Review, 30(10), 1178–1188. https://doi.org/10.1016/j.childyouth.2008.03.003.

    Article  Google Scholar 

  • Hall-Lande, J. A., Eisenberg, M. E., Christenson, S. L., & Neumark-Sztainer, D. (2007). Social isolation, psychological health, and protective factors in adolescence. Adolescence, 42(166), 265–286.

    PubMed  Google Scholar 

  • Han, S. C., & Theran, S. A. (2021). Relational health with peers as a buffer between childhood maltreatment and trauma symptoms among college women: brief report. Journal of Aggression, Maltreatment & Trauma, 0(0), 1–10. https://doi.org/10.1080/10926771.2021.2008081.

    Article  Google Scholar 

  • Hartling, L. M., Rosen, W. B., Walker, M., & Jordan, J. V. (2004). Shame and humiliation: from isolation to relational transformation. In J. V. Jordan, M. Walker, & L. M. Hartling (Eds.), The complexity of connection: Writings from the Stone Center’s Jean Baker Miller Training Institute. (pp. 103–128. Guilford).

  • Hartup, W. W. (1996). The company they keep: friendships and their developmental significance. Child Development, 67(1), 1 https://doi.org/10.2307/1131681.

    Article  PubMed  Google Scholar 

  • Hauser, S. T., & Allen, J. P. (2006). Overcoming adversity in adolescence: narratives of resilience. Psychoanalytic Inquiry, 26(4), 549–576. https://doi.org/10.1080/07351690701310623.

    Article  Google Scholar 

  • Herman, J. (1992). Trauma and recovery. Basic Books.

  • Impett, E. A., Sorsoli, L., Schooler, D., Henson, J. M., & Tolman, D. L. (2008). Girls’ relationship authenticity and self-esteem across adolescence. Developmental Psychology, 44(3), 722–733. https://doi.org/10.1037/0012-1649.44.3.722.

    Article  PubMed  Google Scholar 

  • Institute of Medicine (IOM) and National Research Council (NRC). (2014). Investing in the health and well-being of young adults. The National Academies Press. https://doi.org/10.17226/18869

  • Jivanjee, P., Kruzich, J., & Gordon, L. J. (2008). Community integration of transition-age individuals: views of young with mental health disorders. Journal of Behavioral Health Services & Research, 35(4), 402–418. https://doi.org/10.1007/s11414-007-9062-6.

    Article  Google Scholar 

  • Jordan, J. V. (2004). Relational resilience. In J. V. Jordan, M. Walker, & L. M. Hartling (Eds.), The complexity of connection (pp. 28–46. Guilford).

  • Jordan, J. V. (2009). Relational-cultural therapy. American Psychological Association.

  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602.

    Article  PubMed  Google Scholar 

  • Khesht-Masjedi, M. F., Shokrgozar, S., Abdollahi, E., Golshahi, M., & Zamiri, A. (2017). Exploring social factors of mental illness stigmatization in adolescents with mental disorders. Journal of Clinical & Diagnostic Research, 11(11), 1–4.

    Google Scholar 

  • Kranke, D. A., Floersch, J., Kranke, B. O., & Munson, M. R. (2011). A qualitative investigation of self-stigma among adolescents taking psychiatric medication. Psychiatric Services, 62(8), 893–899.

    Article  PubMed  Google Scholar 

  • Kranke, D. A., Floersch, J., Townsend, L., & Munson, M. R. (2010). Stigma experience among adolescents taking psychiatric medication. Children and Youth Services Review, 32(4), 496–505. https://doi.org/10.1016/j.childyouth.2009.11.002.

    Article  Google Scholar 

  • Kulkarni, S. J. (2009). Adolescent mothers negotiating development in the context of interpersonal violence (IPV) and gendered narratives: a qualitative study. Youth & Society, 41(1), 100–123. https://doi.org/10.1177/0044118X08318120ß.

    Article  Google Scholar 

  • La Greca, A. M., & Harrison, H. M. (2005). Adolescent peer relations, friendships, and romantic relationships: do they predict social anxiety and depression? Journal of Clinical Child & Adolescent Psychology, 34(1), 49–61. https://doi.org/10.1207/s15374424jccp3401_5.

    Article  Google Scholar 

  • Liang, B., Tracy, A., Taylor, C. A., Williams, L. M., Jordan, J. V., & Miller, J. B. (2002). The relational health indices: a study of women’s relationships. Psychology of Women Quarterly, 26(1), 25–35. https://doi.org/10.1111/1471-6402.00040.

    Article  Google Scholar 

  • Malterud, K., Siersma, V. D., & Guassora, A. D. (2016). Sample size in qualitative interview studies: guided by information power. Qualitative Health Research, 26(13), 1753–1760. https://doi.org/10.1177/1049732315617444.

    Article  PubMed  Google Scholar 

  • Mead, S., & Copeland, M. E. (2000). What recovery means to us: consumers’ perspectives. Community Mental Health Journal, 36(3), 315–328. https://doi.org/10.1023/a:1001917516869.

    Article  PubMed  Google Scholar 

  • Mead, S., Hilton, D., & Curtis, L. (2001). Peer support: a theoretical perspective. Psychiatric Rehabilitation Journal, 25(2), 134–141. https://doi.org/10.1037/h0095032.

    Article  PubMed  Google Scholar 

  • Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989. https://doi.org/10.1016/j.jaac.2010.05.017.

    Article  Google Scholar 

  • Miles, M. B., Huberman, A. M., & Saldaña, J. (2013). Qualitative data analysis: a methods sourcebook. SAGE Publications, Incorporated.

  • Miller, J. B., & Stiver, I. P. (1997). The healing connection: how women form relationships in therapy and in life. Beacon Press.

  • Morton, B. M. (2017). Growing up fast: Implications for foster youth when independence and early adulthood collide. Children and Youth Services Review, 82, 156–161. https://doi.org/10.1016/j.childyouth.2017.09.028.

    Article  Google Scholar 

  • Moses, T. (2009). Stigma and self-concept among adolescents receiving mental health treatment. American Journal of Orthopsychiatry, 79(2), 261–274. https://doi.org/10.1037/a0015696.

    Article  PubMed  Google Scholar 

  • Moses, T. (2010). Being treated differently: stigma experiences with family, peers, and school staff among adolescents with mental health disorders. Social Science & Medicine, 70(7), 985–993. https://doi.org/10.1016/j.socscimed.20.

    Article  Google Scholar 

  • Munson, M. R., Cole, A., Stanhope, V., Marcus, S. C., McKay, M., Jaccard, J., & Ben-David, S. (2016). Cornerstone program for transition-age youth with serious mental illness: study protocol for a randomized controlled trial. Trials, 17(1), 537 https://doi.org/10.1186/s13063-016-1654-0.

    Article  PubMed  PubMed Central  Google Scholar 

  • Munson, M. R., Jaccard, J., Smalling, S. E., Kim, H., Werner, J. J., & Scott, Jr, L. D. (2012). Static, dynamic, integrated, and contextualized: a framework for understanding mental health service utilization among young adults. Social Science & Medicine, 75(8), 1441–1449. https://doi.org/10.1016/j.socscimed.2012.05.039.

    Article  Google Scholar 

  • Munson, M. R., Lee, B. R., Miller, D., Cole, A., & Nedelcu, C. (2013). Emerging adulthood among former system youth: the ideal versus the real. Children and Youth Services Review, 35, 923–929. https://doi.org/10.1016/j.childyouth.2013.03.003.

    Article  Google Scholar 

  • Munson, M. R., Smalling, S. E., Spencer, R., Scott, L. D., & Tracy, E. M. (2010). A steady presence in the midst of change: non-kin natural mentors in the lives of older youth exiting foster care. Children and Youth Services Review, 32, 527–535. https://doi.org/10.1016/j.childyouth.2009.11.005.

    Article  PubMed  PubMed Central  Google Scholar 

  • Narendorf, S. C. (2017). Intersection of homelessness and mental health: a mixed methods study of young adults who accessed psychiatric emergency services. Children and Youth Services Review, 81, 54–62. https://doi.org/10.1016/j.childyouth.2017.07.024.

    Article  Google Scholar 

  • Newcomb, A. F., & Bagwell, C. L. (1995). Children’s friendship relations: a meta-analytic review. Psychological Bulletin, 117(2), 306–347. https://doi.org/10.1037/0033-2909.117.2.306.

    Article  Google Scholar 

  • Padgett, D. K. (2008). Qualitative methods in social work research (2nd ed.). Sage.

  • Patton, M. Q. (2002). Qualitative research & evaluation methods. Sage.

  • Pottick, K. J., Bilder, S., Vander Stoep, A., Warner, L. A., & Alvarez, M. F. (2008). US patterns of mental health service utilization for transition-age youth and young adults. The Journal of Behavioral Health Services & Research, 35(4), 373–389.

    Article  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.

    Article  Google Scholar 

  • Sapiro, B., & Ward, A. Marginalized youth, mental health and connection with others: A review of the literature. Child and Adolescent Social Work Journal, 37(4), 343–357. https://doi.org/10.1007/s10560-019-00628-5.

  • Siegel, R. S., Freeman, A. J., La Greca, A. M., & Youngstrom, E. A. (2015). Peer relationship difficulties in adolescents with bipolar disorder. Child & Youth Care Forum, 44(3), 355–375. https://doi.org/10.1007/s10566-014-9291-9.

    Article  Google Scholar 

  • Sparks, E. (2004). Relational experiences of delinquent girls. In M. Walker & W. B. Rosen (Eds.), How connections heal: stories from relational-cultural therapy (pp. 233–252. Guilford Press).

  • Spencer, R. (2006). Understanding the mentoring process between adolescents and adults. Youth & Society, 37(3), 287–315. https://doi.org/10.1177/0743558405278263.

    Article  Google Scholar 

  • Steenbakkers, A., van der Steen, S., & Grietens, H. (2016). ‘To talk or not to talk?’ Foster youth’s experiences of sharing stories about their past and being in foster care. Children and Youth Services Review, 71, 2–9. https://doi.org/10.1016/j.childyouth.2016.10.008.

    Article  Google Scholar 

  • Tew, J., Ramon, S., Slade, M., Bird, V., Melton, J., & Le Boutillier, C. (2012). Social factors and recovery from mental health difficulties: a review of the evidence. British Journal of Social Work, 42(3), 443–460. https://doi.org/10.1093/bjsw/bcr076.

    Article  Google Scholar 

  • Theran, S. A. (2010). Authenticity with authority figures and peers: girls’ friendships, self-esteem, and depressive symptomatology. Journal of Social and Personal Relationships, 27(4), 519–534. https://doi.org/10.1177/0265407510363429.

    Article  Google Scholar 

  • Theran, S. A. (2011). Authenticity in relationships and depressive symptoms: a gender analysis. Personality and Individual Differences, 51(4), 423–428. https://doi.org/10.1016/j.paid.2011.04.001.

    Article  Google Scholar 

  • Theran, S. A. (2018). Authenticity in relationships. In Encyclopedia of Adolescence (2nd ed.). Springer Science+Business Media. https://doi.org/10.1007/978-1-4419-1695-2.

  • Venetis, M. K., Chernichky-Karcher, S., & Gettings, P. E. (2018). Disclosing mental illness information to a friend: exploring how the disclosure decision-making model informs strategy selection. Health Communication, 33(6), 653–663. https://doi.org/10.1080/10410236.2017.1294231.

    Article  PubMed  Google Scholar 

  • Ware, N. C., Hopper, K., Tugenberg, T., Dickey, B., & Fisher, D. (2007). Connectedness and citizenship: redefining social integration. Psychiatric Services, 58(4), 469–474. https://doi.org/10.1176/appi.ps.58.4.469.

    Article  PubMed  Google Scholar 

  • Way, N., Gingold, R., Rotenberg, M., & Kuriakose, G. (2005). Close friendships among urban, ethnic-minority adolescents. New Directions for Child and Adolescent Development, 2005(107), 41–59. https://doi.org/10.1002/cd.120.

    Article  Google Scholar 

  • Weisz, B. M., Quinn, D. M., & Williams, M. K. (2016). Out and healthy: being more “out” about a concealable stigmatized identity may boost the health benefits of social support. Journal of Health Psychology, 21(12), 2934–2943. https://doi.org/10.1177/1359105315589392.

    Article  PubMed  Google Scholar 

  • Wenzel, A. J., & Lucas-Thompson, R. G. (2012). Authenticity in college-aged males and females, how close others are perceived, and mental health outcomes. Sex Roles, 67(5–6), 334–350. https://doi.org/10.1007/s11199-012-0182-y.

    Article  Google Scholar 

  • Wolfe, D. A., & Mash, E. J. (2006). Behavioral and emotional problems in adolescents: Overview and issues. In D. A. Wolfe & E. J. Mash (Eds.), Behavioral and emotional disorders in adolescents: Nature, assessment, and treatment (pp. 3–20. Guilford Press).

  • Wolfe, D. A., Rawana, J. S., & Chiodo, D. (2006). Abuse and trauma. In D. A. Wolfe & E. J. Mash (Eds.), Behavioral and emotional disorders in adolescents: nature, assessment, and treatment (pp. 642–671. Guilford Press).

    Google Scholar 

  • Yatchmenoff, D. K. (2005). Measuring client engagement from the client’s perspective in nonvoluntary child protective services. Research on Social Work Practice, 15(2), 84–96. https://doi.org/10.1177/1049731504271605.

    Article  Google Scholar 

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Acknowledgements

This research was supported by a Dissertation Grant from the Fahs-Beck Fund for Research and Experimentation. This research was partially supported by a National Institute of Mental Health grant (R34-MH102525-01A1; PI: Michelle R. Munson, PhD). The views, opinions, and content of this manuscript are those of the author and do not necessarily reflect the views, opinions, or policies of the National Institute of Mental Health (NIMH). Thanks to Michelle Munson for her feedback on this article and to Steven Grossman and Sarah Haworth for assistance with this manuscript.

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  1. Department of Social Work and Child Advocacy, Montclair State University, Dickson Hall 367, 1 Normal Avenue, Montclair, NJ, 07043, USA

    Beth Sapiro & Silvia Ramirez Quiroz

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Correspondence to Beth Sapiro.

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Sapiro, B., Quiroz, S.R. Authenticity, Vulnerability, and Shame in Peer Relationships among Marginalized Youth Living with Mood and Anxiety Disorders. J Child Fam Stud 31, 3192–3208 (2022). https://doi.org/10.1007/s10826-022-02358-2

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