The long-range objectives are to identify (1) mechanisms by which siblings of children with severe emotional disturbances (SED) adjust under conditions of adversity, and (2) strategies for intervention to foster successful adaptation in the face of stress.
The specific aims are to examine adjustment and the contextual (family and community) variables related to adjustment among young siblings (ages 5 - 10 years) of children with SED targeted in four sites of the NC System of Care (SOC) initiative. This work has important health implications, since there are over four million children with SED in the U.S., and their understudied siblings are at significant risk for developing health and mental health problems. Enhancing understanding of the adjustment, risk, and resilience of siblings of SED children served by SOCs, and the factors that influence their adjustment, can inform family-centered approaches to mental health care. Specifically, findings can guide policy and practice regarding how to best meet the needs of children and families. A short-term longitudinal approach, with two data collections separated by six months, will be used. Four hundred families with SED children in SOCs will be invited to participate, and young, school-aged siblings of SED children will be the focus. Primary caregivers and teachers will rate sibling adjustment, including both competencies and problem behaviors, and caregivers will complete measures regarding family and community contextual variables. Data about the SED child and family will also be obtained from the national SOC evaluation. The project will then use person- and variable-centered approaches to address the following aims: (1) describe the adjustment evidenced by the siblings at initial assessment (Time 1), by a) deriving composite adjustment factors, reflecting key domains of adjustment, from multiple indicators of adjustment, and b) using these adjustment factors to identify adjustment clusters, or profiles, that best describe groups of siblings; (2) determine which family and community variables are associated with membership in the adjustment cluster groupings at Time 1; (3) identify the family and community variables associated with the derived adjustment factors at Time 1; and (4) evaluate the degree to which changes in family and community variables from Time 1 to Time 2 (a 6-month period) are associated with changes in adjustment longitudinally.
| Palamaro Munsell, Eylin; Kilmer, Ryan P; Cook, James R et al. (2012) The effects of caregiver social connections on caregiver, child, and family well-being. Am J Orthopsychiatry 82:137-45 |
| Kilmer, Ryan P; Cook, James R; Palamaro Munsell, Eylin (2010) Moving from principles to practice: recommended policy changes to promote family-centered care. Am J Community Psychol 46:332-41 |
| Kilmer, Ryan P; Cook, James R; Munsell, Eylin Palamaro et al. (2010) Factors associated with positive adjustment in siblings of children with severe emotional disturbance: the role of family resources and community life. Am J Orthopsychiatry 80:473-81 |
| Kilmer, Ryan P; Cook, James R; Taylor, Christina et al. (2008) Siblings of children with severe emotional disturbances: risks, resources, and adaptation. Am J Orthopsychiatry 78:1-10 |
