This study investigated the association between the structure of adolescent friendship networks, and distress responses in a private school. The 254 students in grades nine through twelve completed sociometric questionnaires, and measures of physiological, psychological, and behavioral distress. Results showed, first, that indices of network structure were more strongly associated with distress responses than were sociometric counts of relationships. Second, some dimensions of network structure were associated with reduced distress, but others were associated with increased distress. Third, physiological, psychological, and behavioral distress responses exhibited different patterns of association with network structure. Overall, psychological responses were positively associated with sociometric counts of relationships, but higher reachability was consistently associated with higher blood pressure, suggesting that some network roles may enhance psychological well-being while simultaneously involving physiological costs.