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 command 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 limited. Anchored upon a social-ecological theoretical framework, the purpose of this cross-sectional study was to explore the relationships between select individual, family, and peer factors and sibling adjustment. A convenience sample of 224 adolescent siblings and parents of youths with SB responded to anonymous mailed surveys. Siblings completed measures of attitude toward spina bifida, family satisfaction, warmth and conflict in the sibling relationship, peer support, and three dimensions of adjustment-self-concept, prosocial behavior, and behavior problems. Parents provided SB clinical data and family demographics. The individual, family, and peer factors explained a significant amount of variance in sibling self-concept, prosocial behavior, and behavior difficulties, with R(2) ranging from .27 to .57. Differing patterns of the relationships between the ecological factors and sibling adjustment emerged. Findings highlight multi-level opportunities to intervene and support siblings. Minimizing threats and bolstering protective influences on sibling adjustment is an essential component of family-centered services in SB.