Empirical Support: Peer Rejection, PV, and Internalizing Problems
In this section, we integrate and discuss both peer rejection and PV experiences in relation to internalizing problems. Note, however, that PV differs from peer rejection in that victimization focuses on negative experiences that are specifically directed toward a child or adolescent, whereas peer rejection reflects the prevailing attitudes of peers toward an individual (Lopez & DuBois, 2005). Although rejected youth experience PV, accepted youth can also be the targets of PV (Prinstein & Cillessen, 2003). Nevertheless, PV and peer rejection both are aversive, are interpersonal stressors, and are associated with youths’ internalized distress.
Community Studies. Although there are multiple pathways to peer rejection (La Greca & Prinstein, 1999), peer-rejected youth are at high risk for current and future psychological difficulties (Coie et al., 1990; Parker & Asher, 1987). Community studies find that peer-rejected youth have substantial interpersonal and emotional difficulties (Coie et al., 1990; La Greca & Prinstein, 1999) and report greater social anxiety than their peers (La Greca & Lopez, 1998; La Greca & Stone, 1993), as well more depressive symptoms (Prinstein & Aikins, 2004).
Similarly, PV experiences also have an impact on youths’ anxious and depressive symptoms (see meta-analysis by Hawker & Boulton, 2000). In particular, overt and relational PV experiences are strongly associated with both anxiety (especially social anxiety) and depression (e.g., Crick & Grotpeter, 1996; La Greca & Harrison, 2005; Prinstein, Borelli, Cheah, Simon, & Aikins, 2005; Siegel et al., 2009; Vernberg, 1990; Wang, Iannotti, Luk, & Nansel, 2010). Among adolescents, relational PV is uniquely and strongly associated with social anxiety, even when controlling for other forms of PV (La Greca & Harrison, 2005; Siegel et al., 2009). Moreover, in a study of more than 3,000 adolescents ages 15-16, Ranta, Kaltiala-Heino, Pelkonen, and Marttunen (2009) demonstrated that PV is significantly associated with adolescents’ symptoms of social phobia/anxiety, regardless of their level of depressive symptoms.
Prospective Studies. Prospective studies find that peer rejection and other aversive PV experiences predict loneliness and depressive affect and, conversely, that symptoms of depression predict subsequent peer rejection and aversive peer experiences (Harrison, 2006; Little & Garber, 1995; Vernberg, 1990). For example, Little and Garber (1995) found that depressive symptoms among early adolescents predicted increases in peer rejection over a 3-month period. Vernberg (1990) evaluated early adolescents at two time points during the school year, finding that aversive peer experiences predicted increases in depressive affect over time and that initial levels of depressive symptoms also predicted increases in aversive peer experiences. Similarly, Harrison (2006) found that PV predicted increases in depressive symptoms over a 2-month period, and this relationship was stronger for adolescents who were high in rejection sensitivity (the tendency to expect, perceive, and overreact to rejection).
Prospective studies also elucidate potential pathways between PV and anxiety in youth (Siegel et al., 2009; Storch, Brassard, & Masia-Warner, 2003; Vernberg, Abwender, Ewell, & Beery, 1992). Vernberg and colleagues (1992) evaluated adolescents at three time points during a school year, assessing the quality of their peer relationships, PV experiences, and levels of social anxiety. They found that rejection and social exclusion (i.e., relational PV) predicted increases in adolescents’ social anxiety over a 2-month period and increases in social avoidance and distress over the school year. Other recent work shows that relational PV leads to increases in adolescents’ symptoms of social anxiety over time (Siegel et al., 2009) and in symptoms of social phobia (Storch et al., 2003).
In contrast, these same studies provide mixed evidence regarding the reverse pathway—whether social anxiety leads to subsequent PV. Two studies did not find that social anxiety led to increases in PV over the school year (Storch et al., 2003; Vernberg et al., 1992), although Siegel and colleagues (2009) did find that social anxiety predicted increases in adolescents’ relational victimization over a two month period. Others have found evidence that youth who are socially anxious are treated more negatively by their classmates than are those who are not socially anxious (Blote & Westenberg, 2007). One reason that it may be difficult to evaluate whether social anxiety leads to increases in PV is that youth with social anxiety who are victimized may learn to avoid social situations in order to limit their opportunities for further victimization. Studies are needed that examine the bidirectional influences of PV and social anxiety, as well as mediating and moderating variables (e.g., presence of a close friend in school).
Clinical Samples. Among youth with clinical diagnoses, studies also support associations between peer rejection, PV, and internalizing disorders. Strauss, Frame, and Forehand (1987) found that anxiety-disordered (AD) children were less well liked than non-anxiety-disordered (NAD) children. Ginsburg, La Greca, and Silverman (1998) evaluated children with simple phobia, finding that those with comorbid social phobia had significantly lower levels of peer acceptance and more negative peer interactions than those without comorbid social phobia. Relatedly, Verduin and Kendall (2008) found that AD children were significantly less liked than were NAD children, and AD children with social phobia were significantly less liked than those without social phobia; however, children with other anxiety disorders did not differ in peer liking compared with NAD youth. Clinical samples of adolescents also provide evidence that PV is associated with social anxiety. Ranta and colleagues (2009) found that adolescents who met criteria for social phobia had substantially higher rates of PV than those without social phobia.
Similarly, youth with clinical depression have interpersonal difficulties with peers, and the social behaviors of youth with depression appear to contribute to their problematic peer relations. Adolescents with depression are rejected more frequently by peers and are less popular than youth without depression (Little & Garber, 1995). Moreover, laboratory studies examining adolescents’ opinions of unfamiliar peers find that adolescents with clinical depression are rated more negatively than adolescents without depression (Connolly, Geller, Marton, & Kutcher, 1992). Some studies also find a stronger relationship between peer rejection and depression for girls than for boys (e.g., Lopez & DuBois, 2005). For example, Connolly and colleagues (1992) found that peers viewed adolescent girls with depression as less skilled at making friends and less interested in getting to know others than girls without depression but that the same was not true for boys.
Summary. Evidence clearly supports a relationship between youths’ aversive peer experiences, such as peer rejection and PV, and their social anxiety and depressive affect. Some associations may be stronger for girls than for boys, and for adolescents who display certain cognitive vulnerabilities (e.g., rejection sensitivity). Available findings are consistent with interpersonal theories of depression (e.g., Hammen, 1991) and with stress- diathesis perspectives on depression (e.g., Lewinsohn, Joiner, & Rohde, 2001) that emphasize the contributions of rejection experiences and interpersonal stress. Findings are also consistent with theories of social anxiety that emphasize interpersonal threat and fear of negative evaluation from others as important contributing factors (e.g., Juster & Heimberg, 1995). Further research would benefit from theory-driven studies examining underlying mechanisms and moderating variables that explain why some youth develop depressive or anxious symptoms in response to peer rejection/aversive peer experiences whereas others do not.