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Convergence and divergence of mental health symptoms among adolescents and their friends
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Convergence and divergence of mental health symptoms among adolescents and their friends

European Child & Adolescent Psychiatry·August 24Open Access
PediatricsConfirms priorAdolescent Mental HealthExternalising SymptomsInternalising SymptomsLongitudinal Cohort Study (Secondary Data Analysis)Adolescent

Summary

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What was studied

This longitudinal secondary analysis examined whether internalising and externalising symptoms converged or diverged between adolescents (mean age 14.89) and their best friend(s) over one year, and whether gender or victimisation moderated these patterns, using two waves of CILS4EU data from Sweden and Germany (n=5,705).

Key findings

On average, adolescents **diverged** from friends in internalising symptoms over time. For externalising symptoms, only girls (not boys) showed significant **convergence** with their friendship group. Victimisation predicted higher symptoms and greater peer dissimilarity but did not amplify longitudinal convergence. Friendship stability was the key driver of convergence in exploratory LASSO analyses.

Study limitations

- Two-wave design limits ability to separate social selection from social influence and to capture dynamic change. - Non-clinical composite symptom measures (3–11 items) may lack sensitivity to detect subtle symptom changes. - Complete-case analysis required for network outcomes may introduce selection bias and reduce generalisability.

Clinical implications

Peer friendship networks cluster adolescent mental health symptoms, so school-based screening and interventions should consider the peer group, not just the individual. Girls may be a specific target for externalising symptom peer-influence programs, and stable friendships appear to amplify this transmission.

Caveats

  • Gender was measured as a binary variable, limiting applicability to non-binary adolescents.
  • Sample overrepresents children of immigrants (by design), which may limit generalisability to the broader European adolescent population.
  • The externalising symptom measure was modified from the pre-registered version due to poor internal consistency of the original two-item scale.
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  • The study cannot disentangle social selection (choosing similar friends) from social influence (becoming more like friends) due to the two-wave design without stochastic actor-based modelling.

Related Questions

Explore related topics

How do peer friendships influence depression and anxiety symptoms in teenagers over time?Does being bullied or victimized make adolescents more susceptible to peer influence on mental health?What school-based interventions target peer network effects on adolescent internalising and externalising problems?

Publication Details

Year
2026
Journal
European Child & Adolescent Psychiatry
Sample Size
n=5,705
Source
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