The impact of family, peer, and school contexts on depressive symptoms in adolescents with spina bifida.

OBJECTIVE Based on social ecological theory, this study examined the joint relations among adolescents' family, peer, and school contexts and depressive symptoms in youth with spina bifida using cumulative, protective, and specific effects models. METHOD Sixty families of adolescents with spina bifida and 65 comparison families reported on adolescents' positive experiences within these contexts and on depressive symptoms when youth were 14-15 and 16-17 years old. RESULTS Adolescents with spina bifida had fewer total positive contexts and less positive experience within peer and school contexts, as compared to typically developing adolescents. Greater total number of positive contexts and higher levels of positive experiences within family and school contexts were associated with fewer depressive symptoms for both groups; peer positive experiences were related to lower depressive symptoms for typically developing adolescents only. CONCLUSION Adolescents with spina bifida have fewer positive contexts, which may place them at risk for higher levels of depressive symptoms.