Longitudinal pathways linking family factors and sibling relationship qualities to adolescent substance use and sexual risk behaviors

The Impact of Sibling Relationships on Behavioral and Sexual Health among Latino Sexual Minority Men

Pre-exposure prophylaxis (PrEP) is a highly effective method for preventing HIV acquisition and plays a crucial role in the Ending the HIV Epidemic in the US initiative. However, there are various barriers that hinder the access and uptake of PrEP among Latino sexual minority men (SMM) at individual, interpersonal, and cultural levels. While the significance of cultural factors in designing and implementing HIV prevention programs for Latino populations has been consistently emphasized in the literature and prioritized by the Centers for Disease Control and Prevention, few studies have directly integrated these cultural factors into their programs. Our study aimed to investigate the potential influence of siblings in promoting the utilization of PrEP for HIV prevention, an area that has received limited attention. We conducted interviews with 31 pairs of siblings between December 2020 and January 2021, which were held in either English or Spanish and lasted approximately 45-60 min. The data were analyzed using a deductive thematic content analysis approach. The interviews revealed several key themes and categories, including: (1) Sibling support for coming out; (2) Types of support that siblings provide to each other for behavior change; (3) Sibling support for PrEP; and (4) The impact of the study interview on the quality of the sibling relationships. Our findings indicated that siblings were willing to provide support for PrEP in various ways, ranging from emotional support for brothers who may be concerned about potential rejection to practical support such as transportation or financial assistance. These results have significant implications for the design of HIV prevention interventions for Latinos. Incorporating siblings or other extended family members into these interventions can facilitate communication between siblings and their brothers, ultimately encouraging the use of PrEP or similar prevention methods. By considering the unique dynamics and support systems within Latino communities, researchers can develop more effective strategies to promote HIV prevention and support the well-being of Latino SMM.

Associations between older siblings' substance use and younger siblings' substance use intentions: Indirect effects via substance use expectations

OBJECTIVE

We examined the direct and indirect effects of older siblings' substance use behaviors (i.e., cannabis and e-cigarettes) on younger siblings' later substance use intentions via their substance use expectations.

MATERIAL AND METHODS

Data were collected from 682 families (N = 2,046) with two adolescent siblings (older siblings: M age = 15.67 years, 51% female; younger siblings: M age = 13.14 years, 48% female) and one parent (M age = 45.15 years; 85% female). Participants completed annual online surveys at two occasions. Older siblings reported on their cannabis and e-cigarette use frequencies (Time 1) and younger siblings reported on their substance use expectations (Time 1) and intentions (Time 1 and 2); parents reported on adolescents' sociodemographic characteristics and their own substance use (Time 2).

RESULTS

Structural equation modeling results suggested that older siblings' cannabis and e-cigarette use was indirectly related to younger siblings' later intentions to use these substances through their positive expectations about substances, after accounting for younger siblings' earlier intentions to use substances and control variables including parents' and friends' use. There were no significant direct relations between older siblings' cannabis or e-cigarette use and younger siblings' intentions to use them.

CONCLUSIONS

Findings indicate that older siblings are critical and unique socialization agents of younger siblings' expectations and intentions to use substances. Intervention and prevention programs that target adolescents' substance use should consider the ways in which siblings shape each other's substance use.

Adolescent Sibling Associations among Alcohol, Cannabis, and Sexual Risk Behavior: A Test of Interdependence

BACKGROUND

Although siblings are conceptualized as a salient social influence during adolescence, few studies have examined how adolescent siblings influence each other's substance use and risky sexual behavior. Objectives: In this study, we investigated the influence of alcohol use days, cannabis use days, and cannabis and alcohol co-use days on the sexual risk behavior of siblings while accounting for dyadic influence.

METHODS

At the baseline visit for a randomized controlled trial for adolescents referred due to parents' concerns about their substance use ("referred adolescents"; n = 99; M_age=15.95; 38.38% female), we assessed alcohol and cannabis use days as well as sexual risk behavior of the referred adolescents and their sibling (M_age=15.03; 51.52% female). We computed the number of days in the 30 days prior to the baseline that alcohol and cannabis use occurred on the same day. Using a cross-sectional actor partner interdependence model, we tested two models of how adolescents' substance use is associated with their own ("actor effect") and their siblings' ("partner effect") sexual risk behavior-one model for alcohol and cannabis use, and one model for daily co-use.

RESULTS

For referred adolescents and their siblings, within an individual, greater alcohol, cannabis, and daily co-use was significantly associated with sexual risk behavior (actor effects). Furthermore, more sibling co-use days was positively associated with referred adolescent sexual risk behavior (partner effect), representing interdependence.

CONCLUSION

These findings confirm the influence siblings have on one another's risky behavior in adolescence and have implications for prevention and intervention efforts for adolescent substance use.

Family as a health promotion setting: A scoping review of conceptual models of the health-promoting family

Background

The family is a key setting for health promotion. Contemporary health promoting family models can establish scaffolds for shaping health behaviors and can be useful tools for education and health promotion.

Objectives

The objective of this scoping review is to provide details as to how conceptual and theoretical models of the health promoting potential of the family are being used in health promotion contexts.

Design

Guided by PRISMA ScR guidelines, we used a three-step search strategy to find relevant papers. This included key-word searching electronic databases (Medline, PSycINFO, Embase, and CINAHL), searching the reference lists of included studies, and intentionally searching for grey literature (in textbooks, dissertations, thesis manuscripts and reports.)

Results

After applying inclusion and exclusion criteria, the overall search generated 113 included manuscripts/chapters with 118 unique models. Through our analysis of these models, three main themes were apparent: 1) ecological factors are central components to most models or conceptual frameworks; 2) models were attentive to cultural and other diversities, allowing room for a wide range of differences across family types, and for different and ever-expanding social norms and roles; and 3) the role of the child as a passive recipient of their health journey rather than as an active agent in promoting their own family health was highlighted as an important gap in many of the identified models.

Conclusions

This review contributes a synthesis of contemporary literature in this area and supports the priority of ecological frameworks and diversity of family contexts. It encourages researchers, practitioners and family stakeholders to recognize the value of the child as an active agent in shaping the health promoting potential of their family context.

Daily Family Connection and Objective Sleep in Latinx Adolescents: The Moderating Role of Familism Values and Family Communication

Spending time with family ("family connection") is a salient aspect of adolescents' daily lives linked with healthy sleep. Less is known regarding the unique effects of parent and sibling connection on sleep. This study examined daily and average associations between parent/sibling connection and objective sleep (duration, efficiency) in a sample of Latinx adolescents (N = 195; Mage = 18.11, SD = 0.41; 65.6% female) and explored familism values and family communication as moderators. Adolescents slept longer on days that they spent more time with siblings, and youth who typically spent more time with parents had longer sleep durations. Family communication and familism-obligation moderated associations between family connection and sleep. These results provide support for the role of family interactions in promoting healthy sleep among Latinx adolescents.

Let's Drink to Being Socially Active: Family Characteristics, Social Participation, and Alcohol Abuse across Mid- and Later-life

Researchers and practitioners often extol the health benefits of social relationships and social participation for older adults. Yet they often ignore how these same bonds and activities may contribute to negative health behaviors. Using data from the Wisconsin Longitudinal Study (16,065 observations from 7,007 respondents), we examined how family characteristics, family history, and social participation predicted three measures of alcohol abuse between ages 53 and 71. Results indicate that, generally, greater social participation is associated with increased drinking days per month. We also found that religious participation and having ever lived with an alcoholic are each associated with reporting possible alcohol dependence but not with alcohol consumption itself. Lastly, we identified gendered associations between marital dissolution and drinking behavior. These findings contextualize the increasing rates of alcohol abuse among older adults by emphasizing the possible negative consequences of "linked lives" on health via relationship stress and group norms.

Sibling mortality burden in low-income countries: A descriptive analysis of sibling death in Africa, Asia, and Latin America and the Caribbean

In high-income countries, emerging research suggests sibling bereavement can have significant health and life course consequences for young people. Yet, we know far less about its burden in lower-income countries. Due to higher fertility and mortality in lower-income countries, the level, timing, intensity, and circumstances surrounding sibling mortality are likely to follow patterns distinct from those in higher-income settings. Thus, in this study, we offer a descriptive overview of sibling death in 43 countries across sub-Saharan Africa, South and Southeast Asia, and Latin America and the Caribbean. Specifically, we analyze Demographic and Health Survey data from nationally representative samples of 352,930 15- to 34-year-old women, born between 1985 and 2003, to document experiences of sibling death before age 25. On average, roughly one-third of individuals report a deceased sibling in these countries; estimates reach 40-50% of respondents in multiple African countries, particularly those that have experienced conflict and war. Although some sibling deaths occurred before the focal respondent was born, most bereaved individuals recalled a death during their lifetime-often in late childhood/early adolescence. High proportions of bereaved respondents report multiple sibling deaths, highlighting the clustering of deaths within families. Even so, bereaved individuals tend to come from large families and thus frequently have a comparable number of surviving siblings as people who never experienced a sibling die. Together, the results offer a window into global inequality in childhood experiences, and they attest to the need for research that explores the implications of sibling mortality for young people in world regions where the experience is concentrated.

Sex behaviours and family sexuality communication among Hispanic adolescents

This study compared the extent to which Hispanic teenagers talk with mothers, fathers and extended family members about risks of sex, protection and relational sex, as well as the moderating role of teenagers' gender on the association between sexuality communication and risky sexual behaviours. Analysis is based upon 474 Hispanic young people's responses to a school-based survey recruited from six New England high schools. We (1) calculated descriptive statistics and tests of difference by teenagers' gender, and (2) ran logistic regression models for three sexual behaviours (vaginal sex, oral sex and number of sex partners) separately by gender. There were significant gender differences in teenagers' talk with mothers and fathers, but not extended family members. There was consistent "gender matching" between teenagers and the extended family member they talked to. The content of sexuality communication, the family member the teenager talked to and the gender of the teenager all contributed to whether communication was protective for teenagers' sexual behaviour. There are substantial differences in the types of sexuality communication Hispanic teenagers have with different family members, which are closely tied to teenager's and the family member's gender. Results suggests that one size does not fit all when it comes to family communication about sex and sexuality.

Predictors of sibling victimization and associations with self-perception and relationship attachment in adolescence

Research has shown that sibling victimization may be as detrimental to adolescent outcomes as peer victimization. However, many questions remain unanswered with regard to potential protective parenting factors and consequences sibling victimization among adolescents. This study tested a mediation model of sibling victimization with parental monitoring, a positive parenting factor, as a predictor and parent and peer-adolescent attachment as mediated by adolescent self-perceptions as potential outcomes. A three path mediation from parental monitoring → sibling victimization → adolescent self-perceptions → peer/parent-adolescent attachment was also tested. Structural Equation Modeling revealed that parental monitoring was negatively associated with sibling victimization only for girls. Sibling victimization had negative direct and indirect effects on parent- and peer-adolescent attachment via adolescent self-perceptions of social competence and self-worth. Findings suggest that parental monitoring may be important in the prevention of sibling victimization and self-perceptions may be an important point of intervention adolescents experiencing sibling victimization.

Extended-Family Talk about Sex and Teen Sexual Behavior

Research shows that family communication about sexuality can protect against teens' risky sexual behavior. However, few studies assess talk with extended family about sex or how this communication relates to teens' sexual behavior. The current study includes cross-sectional survey data from 952 adolescents. Structural equation modeling (SEM) was used to assess associations between teens' sexual risk behaviors and communication with extended family about protection methods, risks of sex and relational approaches to sex, defined as talk about sex within a close relationship. For sexually active teens, talk about protection methods was associated with fewer sexual partners and talk about risks of sex was associated with more sexual partners regardless of teen gender and the generation of extended family with whom teens talk. Results suggest that extended-family talk about sex may influence teens' sexual behavior independent of effects of teen⁻parent communication. However, the direction of the effect depends on the content of the conversations. These findings suggest the need to explore whether and how extended family could be included in health prevention and intervention programs, because programs which include family largely focus on parents.

Sibling bullying at 12 years and high-risk behavior in early adulthood: A prospective cohort study

Emerging evidence suggests that sibling aggression is associated with the development of high-risk behavior. This study investigated the relationship between sibling bullying perpetration and victimization in early adolescence and high-risk behavior in early adulthood. Sibling bullying was assessed at 12 years in 6,988 individuals from the Avon Longitudinal Study of Parents and Children, a birth cohort based in the UK and high-risk behavioral outcomes were assessed at 18-20 years. Frequent sibling bullying perpetration predicted antisocial behavior (OR = 1.74; 95%CI, 1.38-2.20), while frequent sibling bullying victimization increased the odds of nicotine dependence (OR = 2.87; 95%CI, 1.55-5.29), even after accounting for peer bullying and parent maltreatment. Categorical analysis revealed that particularly bullies and bully-victims were at risk of developing high-risk behavior. Finally, this study found that adolescents who were involved in bullying perpetration across multiple contexts (home and school) had the highest odds of reporting antisocial behavior (OR = 3.05; 95%CI, 2.09-4.44), criminal involvement (OR = 2.12; 95%CI, 1.23-3.66), and illicit drug use (OR = 2.11; 95%CI, 1.44-3.08). Findings from this study suggest that sibling bullying perpetration may be a marker of or a contributory factor along the developmental trajectory to antisocial behavior problems. Intervention studies are needed in order to test whether reducing sibling bullying can alleviate long-term adverse social and behavioral outcomes.

Mexican-Origin Youth's Cultural Orientations and Values: Do Older Sisters and Brothers Matter?

Family is an important context for cultural development, but little is known about the contributions of siblings. This study investigated whether older siblings' cultural orientations and familism values predicted changes in younger siblings' cultural orientations and familism values across 2 years and tested sibling characteristics and younger siblings' modeling as moderators. Participants were 246 Mexican-origin younger (M_age  = 17.72; SD = 0.57) and older siblings (M_age  = 20.65; SD = 1.57) and their parents. Findings revealed that older siblings' Anglo orientations and familism values interacted with younger siblings' modeling: When younger siblings reported high modeling, older siblings' Anglo orientations and values predicted increases in younger siblings' Anglo orientations and values. Discussion highlights the importance of siblings in cultural socialization.

Sibling Influences on Risky Behaviors from Adolescence to Young Adulthood: Vertical Socialization or Bidirectional Effects?

This study built on research on sibling influences to assess potential bidirectional effects of older and younger siblings' risky behaviors on one another's risky behaviors; our longitudinal design allowed us to test these effects when siblings were at about the same chronological age, at different points in time. We also tested whether the strength and/or direction of effects of siblings' risky behaviors changed from middle adolescence to young adulthood. Reports of risky behaviors (i.e., deviant behaviors and excessive alcohol use) were provided by firstborn and secondborn siblings from up to 201 families on five occasions spanning 10 years. In general, accounting for known covariates, multilevel models revealed bidirectional sibling effects and some evidence that secondborns' risky behaviors were stronger and more consistent predictors of firstborns' behaviors than the reverse. Sibling influence generally declined with age and sibling effects were not moderated by gender constellation. Findings indicate that both older and younger siblings are important socializers of risk behaviors across adolescence and continue to shape each other's alcohol use into early adulthood.

Cross-Cultural Differences in Sibling Power Balance and Its Concomitants Across Three Age Periods

We examined cross-cultural differences in (1) sibling power balance and (2) the associations between sibling power balance and internalizing and externalizing problems in three separate cross-cultural studies (early childhood, late childhood, and adolescence). The early childhood samples consisted of 123 Turkish and 128 Dutch mothers (mean age for children was 4.9 years). In the late childhood samples, self-report data were collected from 124 Indian and 129 Dutch children (mean age 10.9 years). In the adolescent samples self-report data were collected from 165 ethnic Moroccan and 165 ethnic Dutch adolescents (mean age 15.2 years). In all studies, questionnaire data on sibling power imbalance and internalizing and externalizing problems were collected. Results showed only one significant cross-cultural difference in sibling power imbalance: The Indian sample reported more sibling power imbalance than the Dutch. Links between sibling power imbalance and problem behavior were highly similar between the different cultural samples. The only significant difference was a stronger impact of sibling power imbalance on externalizing problems for the Dutch compared to the Turkish sample. Concluding, few cross-cultural differences were found in sibling power imbalance. Across cultures and age groups, more sibling power imbalance was linked to more internalizing and externalizing problems.

Getting Under the Skin: Children's Health Disparities as Embodiment of Social Class

Social class gradients in children's health and development are ubiquitous across time and geography. The authors develop a conceptual framework relating three actions of class-material allocation, salient group identity, and inter-group conflict-to the reproduction of class-based disparities in child health. A core proposition is that the actions of class stratification create variation in children's mesosystems and microsystems in distinct locations in the ecology of everyday life. Variation in mesosystems (e.g., health care, neighborhoods) and microsystems (e.g., family structure, housing) become manifest in a wide variety of specific experiences and environments that produce the behavioral and biological antecedents to health and disease among children. The framework is explored via a review of theoretical and empirical contributions from multiple disciplines and high-priority areas for future research are highlighted.

The role of older siblings in the sexual and reproductive health of Mexican-origin young women in immigrant families

In the USA, young people of Mexican-origin are more economically disadvantaged and experience higher birth rates than many other Latino groups. In this paper, we examine the influence of older siblings on the sexual and reproductive health of Mexican-origin immigrant women. Qualitative data were drawn from life history interviews with 21 first- and second-generation Mexican-origin women, aged 27-41 years old, resident in the Metro Denver area. Data suggest that older siblings may protect younger sisters from risky sexual behaviours through older siblings' responsibility and care for younger siblings, close and supportive sibling relationships, older siblings' advice about both sexual health and academic success, and sibling modelling. These mechanisms appear particularly protective due to the social and economic hardships immigrant families often face. Implications include fostering healthy sibling relationships and involving older siblings more fully in the sexuality education of younger siblings.

Sibling teenage pregnancy and clinic-referred girls' condom use: The protective role of maternal monitoring

Younger sisters of teenage parents have elevated rates of engaging in unprotected sex. This may result from changes in parenting behavior after a sibling becomes pregnant or impregnates a partner, and be particularly pronounced for girls seeking mental health treatment. The current study examines condom use over time in 211 African-American girls recruited from outpatient psychiatric clinics. Findings indicate that having a sibling with a teenage pregnancy history predicts less consistent condom use two years later. After accounting for earlier condom use and mental health problems, maternal monitoring moderates condom use such that for girls with a sibling with a pregnancy history, more vigilant maternal monitoring is associated with increased condom use, while for girls with no sibling pregnancy history, maternal monitoring is unrelated to adolescents' condom use two years later. Findings suggest that targeted interventions to increase maternal monitoring of high-risk teens may be beneficial for girls with a sibling history of teenage pregnancy.

Sibling Facilitation Mediates the Association Between Older and Younger Sibling Alcohol Use in Late Adolescence

Previous research has shown adolescent siblings are similar in their alcohol use and that this similarity is largely due to their shared environment. Using a genetically-informed sibling sample (196 full-biological pairs, 384 genetically unrelated pairs), we confirmed that the extent to which older siblings facilitate younger siblings' alcohol use (i.e., help them get alcohol) was one factor contributing to this shared environmental association. All analyses controlled for parent and peer influences. Findings were not moderated by sibling differences in genetic relatedness, gender, or ethnicity. Proximity in sibling age strengthened these associations, somewhat. Results were especially strong for sibling pairs where the older sibling was of legal drinking age. Implications for prevention and intervention are discussed.

The role of extended family in diverse teens' sexual health

Despite increasing extended family involvement in childrearing, particularly in minority families, few studies investigate their role in talking with teens about sex or how this relates to teens' sexual behavior. This mixed methods study assesses extended family sexuality communication through a survey of 1492 diverse middle school students and interviews with 32 students. Logistic regression shows that participants who report having had sex are more likely to report talking with extended family than those who report not having had sex. Interview themes explored reasons for and content of teen sexuality conversations with extended family. More sexually active teens' reporting communication with extended family is interpreted as extended family members gaining importance in sexuality communication as teens become sexually active.

Development and feasibility of a sibling intervention for youth in foster care

Due to their ubiquity and possible influence on youth mental health, academic, and other outcomes, sibling-focused intervention strategies may be important for the development and implementation of evidence-based practices (EBPs) in child welfare. However, there is no rigorous evidence as to either the best methods for, or feasibility of, incorporating the sibling link within existing clinical treatments for foster youth. This paper applies the literature on evidence-based practices (EBP) and implementation research in child welfare to sibling-focused intervention; and presents data concerning the development, delivery, cost, and feasibility of a novel sibling-focused intervention program, Supporting Siblings in Foster Care (SIBS-FC). Results suggest that despite the challenges and costs involved with delivering SIBS-FC, the program catered to the diverse needs of pre-adolescent and adolescent siblings living together and apart, was viewed positively by youth, and was implemented with a high degree of fidelity. These findings underscore the importance of attending to the early-stage development of psychosocial interventions in child welfare and highlight the role of interagency collaboration, program planning, staff training and supervision, and fidelity tracking for EBP development in child welfare. Implications for prevention research and sibling-focused intervention programming in child welfare are discussed.

Alcohol and Substance Use in Adolescence and Young Adulthood: The Role of Siblings

Interpersonal relationships both within and outside the family have been a central part of alcohol and substance use research. Many studies have focused on the role of parents and peers; fewer studies have focused on siblings. This paper examined siblings' roles in ATOD use patterns and trajectories in the context of familial and non-familial factors across time. First, intraclass correlations (ICCs) were used to examine the degree to which older siblings' ATOD use was associated with younger siblings' ATOD use. Second, hierarchical regression analyses were conducted to examine the degree to which individual, parent, sibling and peer factors over time were associated with adolescents' and young adults' ATOD use. It should be noted that developmentally proximal predictors were utilized in these models and within-family replication was also examined. Results demonstrate strong associations between older and younger siblings' ATOD use. Moreover, the developmentally proximal sibling variables were predictive of younger sibling ATOD use in the context of other variables across all substances. Study findings are discussed in terms of identifying promising and potentially malleable points of intervention for future investigators.

Sibling influence on mexican-origin adolescents' deviant and sexual risk behaviors: the role of sibling modeling

PURPOSE

A growing body of research indicates that siblings uniquely influence each other's health risk behaviors during adolescence and young adulthood. Mechanisms underlying these associations, however, are largely unknown because they are rarely tested directly. The present study addressed this gap by examining the role of sibling modeling in explaining changes in Mexican-origin youths' deviant and sexual risk behaviors over time.

METHODS

The sample included 380 Mexican-origin siblings (older sibling age: M = 21.18, SD = 1.59; younger sibling age: M = 18.19, SD = .46) from (N = 190) families. Participants provided self-reports of their sibling relationship qualities, including modeling, as well as their engagement in deviant and sexual risk-taking behaviors in two home interviews across a 2-year span.

RESULTS

A series of residualized regression models revealed that younger siblings' perceptions of modeling moderated the links between older siblings' deviant and sexual risk behaviors and younger siblings' subsequent behaviors in those same domains. Specifically, high levels of modeling predicted stronger associations between older siblings' earlier and younger siblings' later risk behaviors controlling for younger siblings' earlier behaviors as well as variables that have been used as proxies for social learning in previous research.

CONCLUSIONS

Social learning mechanisms, especially modeling, are salient processes through which older siblings transmit norms and expectations regarding participation in health risk behaviors. Future research should continue to explore the ways in which siblings influence each other because such processes are emerging targets for intervention and prevention.

Intervening to Improve Outcomes for Siblings in Foster Care: Conceptual, Substantive, and Methodological Dimensions of a Prevention Science Framework

In recent years, the child welfare field has devoted significant attention to siblings in foster care. Policymakers and practitioners have supported efforts to connect siblings via shared foster placements and visitation while researchers have focused on illuminating the empirical foundations of sibling placement and sibling intervention in child welfare. The current paper synthesizes literature on sibling relationship development and sibling issues in child welfare in the service of presenting a typology of sibling-focused interventions for use with foster youth. The paper provides two examples of current intervention research studies focused on enhancing sibling developmental processes and understanding their connection to child welfare outcomes. The paper concludes by presenting an emerging agenda informing policy, practice, and research on siblings in foster care.

Positive and Negative Interactions Observed Between Siblings: Moderating Effects for Children Exposed to Parents' Conflict

This study investigated links between interparental conflict appraisals (specifically threat and self-blame), sibling relationship quality (positive and negative dimensions), and anxiety in sibling pairs comprised of an adolescent and a younger sibling close in age. Sibling relationship quality was measured through behavioral observation. Links between self-blame and anxiety were moderated by sibling relationship quality. In older siblings, positive behavior with a sibling was associated with an attenuated relation between self-blame and anxiety. A paradoxical moderating effect was found for negative interactions; for both younger and older siblings, a relation between self-blame and anxiety was weakened in the presence of sibling negativity. Results offered support for theorized benefits of sibling relationship quality in helping early adolescents adjust to conflict between parents.

Siblings are special: initial test of a new approach for preventing youth behavior problems

PURPOSE

A growing body of research documents the significance of siblings and sibling relationships for development, mental health, and behavioral risk across childhood and adolescence. Nonetheless, few well-designed efforts have been undertaken to promote positive and reduce negative youth outcomes by enhancing sibling relationships.

METHODS

Based on a theoretical model of sibling influences, we conducted a randomized trial of Siblings Are Special (SIBS), a group-format afterschool program for fifth graders with a younger sibling in second through fourth grades, which entailed 12 weekly afterschool sessions and three Family Nights. We tested program efficacy with a pre- and post-test design with 174 families randomly assigned to condition. In home visits at both time points, we collected data via parent questionnaires, child interviews, and observer-rated videotaped interactions and teachers rated children's behavior at school.

RESULTS

The program enhanced positive sibling relationships, appropriate strategies for parenting siblings, and child self-control, social competence, and academic performance; program exposure was also associated with reduced maternal depression and child internalizing problems. Results were robust across the sample, not qualified by sibling gender, age, family demographics, or baseline risk. No effects were found for sibling conflict, collusion, or child externalizing problems; we will examine follow-up data to determine if short-term impacts lead to reduced negative behaviors over time.

CONCLUSIONS

The breadth of the SIBS program's impact is consistent with research suggesting that siblings are an important influence on development and adjustment and supports our argument that a sibling focus should be incorporated into youth and family-oriented prevention programs.

Longitudinal associations between sibling relationship qualities and risky behavior across adolescence

This study examined the associations between sibling intimacy and conflict and youths' reports of risky behavior in a sample of adolescents ages 11-20. Participants were mothers, fathers, and sibling dyads in 393 families who were interviewed annually for 3, 4, or 5 years. Multivariate multilevel models tested longitudinal links between sibling intimacy and conflict and youths' risky behavior and whether these associations were moderated by birth order, sex, or dyad sex constellation. Controlling for parent-youth conflict, the results showed positive within-person covariation between sibling conflict and risky behavior for all youths except firstborns with younger brothers. Controlling for parent-youth intimacy, sibling intimacy was positively linked with risky behavior at the between-person level, but only in brother-brother pairs. The discussion focuses on sibling relationships as a context for adolescents' individual development and the roles of birth order, sex, and dyad sex constellation.

A sibling death in the family: common and consequential

Although a large literature analyzes the determinants of child mortality and suggests policy and medical interventions aimed at its reduction, there is little existing analysis illuminating the consequences of child mortality for other family members. In particular, there is little evidence exploring the consequences of experiencing the death of a sibling on one's own development and transition to adulthood. This article examines the prevalence and consequences of experiencing a sibling death during one's childhood using two U.S. data sets. We show that even in a rich developed country, these experiences are quite common, affecting between 5 % and 8 % of the children with one or more siblings in our two data sets. We then show that these experiences are associated with important reductions in years of schooling as well as a broad range of adult socioeconomic outcomes. Our findings also suggest that sisters are far more affected than brothers and that the cause of death is an important factor in sibling effects. Overall, our findings point to important previously unexamined consequences of child mortality, adding to the societal costs associated with childhood mortality as well as suggesting additional benefits from policy and medical innovations aimed at curbing both such deaths and subsequent effects on family members.

Similarities in adolescent siblings' substance use: testing competing pathways of influence

OBJECTIVE

An accumulating body of work indicates that siblings uniquely influence each other's alcohol and substance use behaviors during adolescence. The mechanisms underlying these associations, however, are unknown because most studies have not measured sibling influence processes. The present study addressed this gap by exploring the links between multiple influence processes and sibling similarities in alcohol and substance use.

METHOD

The sample included one parent and two adolescent siblings (earlier born age: M = 17.17 years, SD = 0.94; later born age: M = 14.52 years, SD = 1.27) from 326 families. Data were collected via telephone interviews with parents and the two siblings.

RESULTS

A series of logistic regressions revealed that, after parents' and peers' use as well as other variables including parenting was statistically controlled for, older siblings' alcohol and other substance use was positively associated with younger siblings' patterns of use. Furthermore, sibling modeling and shared friends were significant moderators of these associations. For adolescents' alcohol use, the links between sibling modeling and shared peer networks were interactive, such that the associations between modeling and similarity in alcohol use were stronger when siblings shared friends.

CONCLUSIONS

Future research should continue to investigate the ways in which siblings influence each other because such processes are emerging targets for intervention and prevention efforts.

The role of economic strain on adolescent delinquency: a microsocial process model

The current study examines the role of economic strain as a moderator of the microsocial processes influencing younger siblings' delinquency (externalizing behavior and substance use) in a longitudinal design. The younger siblings (122 younger brothers and 122 younger sisters) were from 244 families with same-sex biological siblings. Structural equation modeling was utilized to examine a process model whereby mothers' harsh/inconsistent parenting and older sibling delinquency influence younger siblings' delinquent behavior via sibling aggression and delinquent peer affiliation. Findings suggest that indirect mechanisms vary as a function of economic strain, with sibling aggression having a stronger, more detrimental effect on adolescent delinquency in economically strained families. Data suggest that familial economic conditions contextualize the relative roles of parenting, sibling, and peer processes in the transmission of risk to adolescent delinquency.

Family relationships and parental monitoring during middle school as predictors of early adolescent problem behavior

The middle school years are a period of increased risk for youths' engagement in antisocial behaviors, substance use, and affiliation with deviant peers (Dishion & Patterson, 2006 ). This study examined the specific role of parental monitoring and of family relationships (mother, father, and sibling) that are all critical to the deterrence of problem behavior in early adolescence. The study sample comprised 179 ethnically diverse 6th-grade (46% female) students who were followed through 8th grade. Results indicated that parental monitoring and father-youth connectedness were associated with reductions in problem behavior over time, and conflict with siblings was linked with increases in problem behaviors. No associations were found for mother-youth connectedness. These findings did not differ for boys and for girls, or for families with resident or nonresident fathers.

The third rail of family systems: sibling relationships, mental and behavioral health, and preventive intervention in childhood and adolescence

Sibling relationships are an important context for development, but are often ignored in research and preventive interventions with youth and families. In childhood and adolescence, siblings spend considerable time together, and siblings' characteristics and sibling dynamics substantially influence developmental trajectories and outcomes. This paper reviews research on sibling relationships in childhood and adolescence, focusing on sibling dynamics as part of the family system and sibling influences on adjustment problems, including internalizing and externalizing behaviors and substance use. We present a theoretical model that describes three key pathways of sibling influence: one that extends through siblings' experiences with peers and school, and two that operate largely through family relationships. We then describe the few existing preventive interventions that target sibling relationships and discuss the potential utility of integrating siblings into child and family programs.

Sibling influences on adolescent substance use: the role of modeling, collusion, and conflict

The longitudinal associations of older sibling substance use as well as dyadic sibling conflict and collusion to younger sibling substance use were examined in a community-based sample of 244 same-sex sibling pairs. Indirect effects of older siblings on younger sibling substance use were hypothesized via younger sibling deviant peer affiliation and conflict with friends. Adolescents, parents, friends, and teachers completed measures of substance use, conflict, and deviant peer involvement. Observational data were used for both measures of collusion and conflict. Findings suggest that older sibling substance use has a direct effect on younger sibling use, but relationship dynamics and reinforcement played a significant role as well. Specifically, collusion and conflict in the sibling relationship both had indirect effects through younger siblings' deviant peer affiliation. Findings validate the powerful socializing role of both siblings and peers, and elucidate the complex mechanisms through which socialization occurs. Furthermore, data underscore the importance of considering how multiple dimensions of socialization operate in the elaboration of antisocial behavior.

The Drift toward Problem Behavior during the Transition to Adolescence: The Contributions of Youth Disclosure, Parenting, and Older Siblings

Prospective associations of mothers' parenting processes, youth disclosure and youth problem behavior were examined in a longitudinal design following 244 adolescent sibling dyads over a three year period. For both siblings, authoritative parenting was positively associated with youth disclosure and negatively related to problem behavior, and coercive parenting was negatively associated with youth disclosure and positively related to problem behavior. When the influence of older sibling problem behavior on younger sibling problem behavior was modeled, younger sibling disclosure accounted for the relationship of maternal parenting processes to problem behavior. Findings indicate the important role of sibling influence in the development of problem behavior, contextualizing the relative roles of maternal parenting and youth disclosure in the transmission of risk.

Psychiatric symptom typology in a sample of youth receiving substance abuse treatment services: associations with self-reported child maltreatment and sexual risk behaviors

Latent profile analysis (LPA) was used to classify 394 adolescents undergoing substance use treatment, based on past year psychiatric symptoms. Relations between profile membership and (a) self-reported childhood maltreatment experiences and (b) current sexual risk behavior were examined. LPA generated three psychiatric symptom profiles: Low-, High- Alcohol-, and High- Internalizing Symptoms profiles. Analyses identified significant associations between profile membership and childhood sexual abuse and emotional neglect ratings, as well as co-occurring sex with substance use and unprotected intercourse. Profiles with elevated psychiatric symptom scores (e.g., internalizing problems, alcohol abuse and dependence symptoms) and more severe maltreatment histories reported higher scores for behavioral risk factors for HIV/STI exposure. Heterogeneity in psychiatric symptom patterns among youth receiving substance use treatment services, and prior histories of childhood maltreatment, have significant implications for the design and delivery of HIV/STI prevention programs to this population.

Associations between Family Communication Patterns, Sibling Closeness, and Adoptive Status

Previous research has demonstrated the protective effect of family and sibling closeness on child adjustment, but fewer studies have investigated how closeness is promoted within families. Guided by Family Communication Patterns Theory, we tested the association between family communication and sibling emotional and behavioral closeness, and whether adoptive status moderated this relationship. Participating families included 616 adoptive and non-adoptive families with two adolescent children. Hypotheses were tested using structural equation modeling. Sibling closeness was highest in families that emphasized both conversation and conformity and lowest in families that emphasized only conversation or neither conversation nor conformity. Emotional and behavioral closeness were differentially associated with adoption status, sibling age, and sibling gender. Few moderating effects of adoption status were found. Post hoc analyses showed moderating effects of sibling gender composition.

Family relationships and children's stress responses

In this chapter, the theoretical and empirical associations between family relationships and children's responses to stressors are reviewed. Family relationships explored are primarily dyadic, representing the emphasis of past empirical research; these include parent-parent, parent-child, and sibling relationships. However, in recognition of the more complicated and interconnected nature of family relationships, also reviewed are associations between the broader family context and children's stress responses. Multiple measures of stress responses are considered, including both physiological and emotional responses to and recovery from stressful experiences. Overall, the studies reviewed suggest that poor-quality family environments, including those characterized by low emotional support or high conflict, are associated with dysregulated stress responses throughout childhood and adolescence. In contrast, children and adolescents in families with high emotional support or low conflict seem to be protected from developing stress regulatory problems. Limitations in this body of research as well as directions for future research are discussed.

Family influences on adolescent gambling behavior: a review of the literature

Gambling, and gambling related problems, are recognized as an emerging health issue among adolescents. Adolescent gambling is associated with numerous individual, social, and family characteristics. This paper provides a review of 21 empirical studies published between 1997 and 2008 that examine family influences on adolescent gambling behavior. Family influences on gambling behavior are conceptualized in the following five domains: (1) family sociodemographic factors, (2) general family climate, (3) family members' attitudes and behaviors, (4) parenting practices, and (5) family relationship characteristics. Based on the review of extant literature, there is empirical evidence that family characteristics are associated with adolescent gambling and further examination of family system influences on gambling behavior is needed. Gaps in the current literature and recommendations for future research are discussed to help inform the study of family influences on adolescent gambling behavior.

Family relationships and the psychosocial adjustment of school-aged children in intact families

The authors investigated whether the quality of three family relationships (i.e., marital, parent-child, sibling) in intact families are associated with each other and with children's psychosocial adjustment. Data were collected by means of maternal and child reports (N = 88) using standardized instruments (i.e., Marital Satisfaction Scale, Strengths and Difficulties Questionnaire). The findings confirm associations between the marital and the parent-child relationship, and between the parent-child and the sibling relationship, Further, both father-child relationships and sibling relationships predict children's adjustment. Father-child conflicts contribute to children's problem behavior, while father-child acceptance and sibling affection contribute significantly to children's general self-esteem. However, contrary to previous studies no support was found for the association between marital relationship and sibling relationship, or for that between marital relationship quality and children's adjustment.

Connectedness as a predictor of sexual and reproductive health outcomes for youth

To review research examining the influence of "connectedness" on adolescent sexual and reproductive health (ASRH). Connectedness, or bonding, refers to the emotional attachment and commitment a child makes to social relationships in the family, peer group, school, community, or culture. A systematic review of behavioral research (1985-2007) was conducted. Inclusion criteria included examination of the association between a connectedness sub-construct and an ASRH outcome, use of multivariate analyses, sample size of >or=100, and publication in a peer-reviewed journal. Results were coded as protective, risk, or no association, and as longitudinal, or cross sectional. Findings from at least two longitudinal studies for a given outcome with consistent associations were considered sufficient evidence for a protective or risk association. Eight connectedness sub-constructs were reviewed: family connectedness (90 studies), parent-adolescent general communication (16 studies), parent-adolescent sexuality communication (58 studies), parental monitoring (61 studies), peer connectedness (nine studies), partner connectedness (12 studies), school connectedness (18 studies), and community connectedness (four studies). There was sufficient evidence to support a protective association with ASRH outcomes for family connectedness, general and sexuality-specific parent-adolescent communication, parental monitoring, partner connectedness, and school connectedness. Sufficient evidence of a risk association was identified for the parent overcontrol sub-construct of parental monitoring. Connectedness can be a protective factor for ASRH outcomes, and efforts to strengthen young people's pro-social relationships are a promising target for approaches to promote ASRH. Further study regarding specific sub-constructs as well as their combined influence is needed.

Risk and Protective Effects of Sibling Relationships among African American Adolescents

This study investigated associations between sibling relationships and adjustment among 179 African American adolescent siblings (controlling for family factors), and tested moderating effects of familism values and birth order. Two-level random intercept models revealed that familism values moderated sibling relationship-adjustment linkages, suggesting that youth who reported both strong familism values and harmonious sibling relationships showed the most positive outcomes. These effects were more consistent for older than for younger siblings. Findings highlight the role of cultural values and birth order in shaping sibling influence processes.

Expressed emotion in children: associations with sibling relationships

OBJECTIVE

To investigate the reliability and validity of the expressed emotion (EE) measure, the Pre-school Five Minute Speech Sample (PFMSS), in child-to-child sibling relationships.

METHOD

A total of 106 boys aged 7-11 were recruited from 12 mainstream primary schools in North Wales. The children completed the PFMSS regarding their sibling and two self-report measures of sibling relationship: the Sibling Relationship Questionnaire (SRQ) and a Child Visual Analogue Scale (CVAS). The parents of 60 participants completed the Strengths and Difficulties Questionnaire regarding the behavioural problems of the participating child and his younger sibling.

RESULTS

The PFMSS demonstrated good inter-rater and code-recode reliability. The significant associations between EE dimensions such as relationship, positive comments and critical comments with various components of the SRQ and CVAS provided support for the concurrent validity of the PFMSS. Significantly higher levels of Conflict and Rivalry and significantly lower levels of Warmth/Closeness on the SRQ were reported by children with high EE, demonstrating good discriminant validity for the PFMSS. There was no significant association between the child's EE profile and the behavioural difficulties of both siblings as reported by parents.

CONCLUSIONS

The study found that the PFMSS is a valid and reliable measure of child EE. Future research is needed to clarify the concurrent validity of the warmth and initial statement components of the measure as well as the association between EE dimensions and behaviour.

The relationship of character strengths to sexual behaviors and related risks among African American adolescents

BACKGROUND

Relatively few studies have examined positive character traits that are associated with lower HIV/STD risks.

PURPOSE

In the present study, the relationships of character strengths with sexual behaviors and attitudes were assessed among 383 African-American adolescents.

METHOD

Character strengths were measured using the Values in Action Inventory of Strengths. Because the strengths were highly inter-correlated, stepwise discriminant function analyses were utilized to assess their independent associations with sexual behaviors and attitudes.

RESULTS

Greater Love of Learning was related to self-reported abstinence from sexual intercourse for boys and self-reported abstinence from drug use for boys and girls. Greater Love of Learning and Curiosity were related to the belief in no premarital sex for boys, whereas only Curiosity was significant for girls. Prudence was related to reported abstinence from sexual intimacy (e.g., touching or kissing). Judgment was related to sexual initiation efficacy for girls and boys, whereas Leadership was only significant for girls.

CONCLUSIONS

The findings suggest that character strengths may be associated with lower levels of sexual behaviors and sex-related beliefs among a sample of African-American adolescents.

Brief report: a qualitative analysis of discussions about HIV in families of parents with HIV

OBJECTIVE

To explore communication about HIV prevention, risk behaviors, and transmission in families affected by HIV.

METHODS

Semi-structured interviews were conducted with 33 parents with HIV, 27 children (9- to 17-years old), and 19 adult children (>or=18-years old) across the U.S. Coders reviewed transcripts, identified themes, and coded transcripts.

RESULTS

Youth felt uncomfortable discussing HIV with their parent who has HIV because they worried about upsetting and reminding the parent of his/her illness. Adult children reported learning about HIV prevention by watching how the illness affected their parents. Few siblings reported talking with one another about HIV because they worried about upsetting their brother/sister and about their sibling unintentionally disclosing the parent's illness to others.

CONCLUSIONS

Discussions between youth and their parent with HIV and their siblings vary, highlighting the need for further research in this area.