Factors Associated With the Psychological and Behavioral Adjustment of Siblings of Youths With Spina Bifida

The intensive health management activities associated with spina bifida (SB) often com-mand a pervasive presence in the lives of families and may place some members at risk for psychosocial difficulties. However, research on the risk and protective factors associated with sibling adjustment is lim-ited. Anchored upon a social-ecological the-oretical framework, the purpose of this cross-sectional study was to explore the relationships between select individual, family, and peer factors and sibling adjust-ment. A convenience sample of 224 adoles-cent siblings and parents of youths with SB responded to anonymous mailed surveys. Siblings completed measures of attitude to-ward spina bifida, family satisfaction, warmth and conflict in the sibling relation-ship, peer support, and three dimensions of adjustment—self-concept, prosocial behav-ior, and behavior problems. Parents pro-vided SB clinical data and family demo-graphics. The individual, family, and peer factors explained a significant amount of variance in sibling self-concept, prosocial behavior, and behavior difficulties, with R2 ranging from.27 to.57. Differing patterns of the relationships between the ecological factors and sibling adjustment emerged. Findings highlight multi-level opportuni-ties to intervene and support siblings. Min-imizing threats and bolstering protective influences on sibling adjustment is an es-sential component of family-centered ser-vices in SB