An introduction to the special issue on peer relations in youth with chronic illness.

Although estimates of the number of children afflicted with chronic illness vary widely, in part due to the difficulty in defining what constitutes a chronic illness, it is clear that most chronic illnesses are on the rise among children (Centers for Disease Control and Prevention, 2009; Van Cleave, Gortmaker, & Perrin, 2010). By definition, these illnesses persist; thus, it is important to examine factors that influence how children live with and manage chronic disease. One potential determinant is the social environment. According to Bronfenbrenner’s social ecological theory (1986), there are different contextual levels of the social environment, ranging from the immediate social environment to the macrosystem, which emphasizes the larger cultural context. Within the microsystem, the social context most often studied in relation to childhood chronic illness is the family. There is a substantial body of research showing that the family plays an important role in how a child adjusts to different chronic illnesses (Helgeson & Palladino, 2012; Kazak, Schneider, & Kassam-Adams, 2010). Another important facet of that microsystem that is widely acknowledged by researchers to play a role in children’s adjustment to chronic illness is peer relationships. Despite widespread agreement that peer relationships are important to children and become increasingly important as the child moves through adolescence into adulthood (Fuligni, Eccles, Barber, & Clements, 2001; Larson & Verma, 1999), there is much less research on the role of peer relationships in childhood chronic illness. This dearth of research was the impetus for this special section. There are two primary questions one can ask in regard to the role of peer relationships in chronic illness. First, what is the impact of chronic illness on peer relationships specifically and social functioning more broadly? Second, what is the impact of peer relationships on psychological and physical health for those with chronic illness? The articles in the present issue address these two questions.