See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/312591351

Sibling relationship quality and psychosocial outcomes among adult siblings of

individuals with autism spectrum disorder and individuals with intellectual
disability without autism

Article  in  Research in Developmental Disabilities · January 2017

DOI: 10.1016/j.ridd.2017.01.008

CITATIONS READS

44 508

4 authors, including:

Theodore Tomeny Brandi Michelle Ellis

University of Alabama University of Southern Mississippi
39 PUBLICATIONS   581 CITATIONS    4 PUBLICATIONS   68 CITATIONS   

SEE PROFILE SEE PROFILE

James Rankin
University of Pennsylvania
12 PUBLICATIONS   255 CITATIONS   

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Understanding Sibling Risk in ASD View project

All content following this page was uploaded by Theodore Tomeny on 07 October 2017.

The user has requested enhancement of the downloaded file.

Running head: SIBLING RELATIONSHIP QUALITY 1

Sibling Relationship Quality and Psychosocial Outcomes among Adult Siblings of Individuals

with Autism Spectrum Disorder and Individuals with Intellectual Disability without Autism

Theodore S. Tomeny1, Brandi M. Ellis2, James A. Rankin1, Tammy D. Barry3

1
The University of Alabama, 2 The University of Southern Mississippi, 3 Washington State

University

Author Note: This work was not supported by any funding agencies, and the authors have no
conflicts of interest to report.

CITATION:

Tomeny, T. S., Ellis, B. M., Rankin, J. A., & Barry, T. D. (2017). Sibling relationship quality

and psychosocial outcomes among adult siblings of individuals with autism spectrum

disorder and individuals with intellectual disability without autism. Research in

Developmental Disabilities, 62, 104-114. doi: 10.1016/j.ridd.2017.01.008

Link to article: http://dx.doi.org/10.1016/j.ridd.2017.01.008

SIBLING RELATIONSHIP QUALITY 2

Abstract

Research on adult typically-developing (TD) siblings of individuals with developmental

disabilities remains limited, and outcomes for TD siblings appear to vary widely. For the current

study, 82 adult TD siblings of individuals with autism spectrum disorder (ASD) or intellectual

disability (ID) completed questionnaires about themselves and their affected sibling. Results of

this study suggest that the attitudes possessed by adult TD siblings are important to consider

when understanding adult TD sibling outcomes. Specifically, data indicate that higher levels of

positive sibling relationship attitudes are related to TD siblings providing more aid/support to

their sibling with a disability, along with having higher levels of general life satisfaction, and

negatively related to levels of stress and depressive symptoms among TD siblings. Consistent

with previous child research, siblings of individuals with ASD reported fewer positive sibling

relationship attitudes compared to siblings of individuals with ID. Finally, group membership

related to aid provided, depressive symptoms, and stress of TD siblings indirectly through sibling

relationship attitudes. Overall, results indicate that sibling relationship attitudes may be

particularly important to consider when conceptualizing sibling relationships when one sibling

has an intellectual or developmental disability.

Keywords: Autism Spectrum Disorder, Intellectual Disability, Siblings, Adults, Relationship

Attitudes
SIBLING RELATIONSHIP QUALITY 3

What this paper adds:

This study helps to fill gaps in the literature on adult typically-developing (TD) siblings of

individuals with developmental disabilities by identifying a potential predictor of sibling

outcomes: sibling relationship attitudes. The results of this paper indicate that TD siblings of

individuals with ASD may possess less positive attitudes about their sibling relationships

compared to TD siblings of individuals with ID without ASD. Moreover, sibling relationship

attitudes were associated with TD sibling outcomes (e.g., stress, depressive symptoms, life

satisfaction) and amount of support that TD siblings provide their affected sibling. Due to rising

rates of diagnoses and a healthcare system already in crisis with regard to care for adults with

developmental disabilities, siblings likely will be increasingly charged with assuming care after

parents are no longer able. Thus, clinicians must be ready to assist TD siblings in this role, and

improving attitudes and views about the sibling relationship may be one approach to consider.
SIBLING RELATIONSHIP QUALITY 4

Sibling Relationship Quality and Psychosocial Outcomes among Adult Siblings of

Individuals with Autism Spectrum Disorder and Individuals with Intellectual Disability

without Autism

1. Introduction

According to the United States Census Bureau, data collected in 2010 indicated that 0.4%

of the population (i.e., about 1.2 million adults) had intellectual disability (ID), whereas the

estimated U.S. prevalence of autism spectrum disorder (ASD) is 1 in 68 children or roughly

1.5% of the population (Baio, 2014). Moreover, a significant portion of individuals with ASD

also have co-occurring ID (e.g., Levy et al., 2010). These numbers alone are noteworthy, but it

also is important to consider that each individual’s disability is likely to impact their family

members. Having a family member with a developmental disability (DD) places unique demands

on those within the family unit and may have implications for the outcomes and functioning of

all those involved (McHale & Gamble, 1989; Roper, Allred, Mandleco, Freeborn, & Dyches,

2014; Tozer & Atkin, 2015). It would seem that those closely connected to individuals with a

DD may require support services themselves, substantially raising the number of individuals

needing services related to any given disability.

2. Sibling Relationships

Generally, siblings seem to have strong and persistent influence over one another’s

development, life choices, outcomes, and functioning compared to individuals fulfilling other

roles in a person’s life. As Cicirelli (1995) observed, sibling relationships span a greater expanse

of time than most relationships—including parents-child and spousal—rendering sibling

relationships generally the longest lasting relationships in a person’s life. The longevity of this

particular familial relationship and the far-reaching nature of disability underscore the
SIBLING RELATIONSHIP QUALITY 5

importance of understanding the outcomes and functioning of typically-developing (TD) siblings

of individuals with a DD. Further, healthy functioning and positive outcomes in TD siblings is

particularly relevant to the disabled sibling because, as adults, many TD siblings may assume the

primary caregiver role once parents can no longer do so (Coyle, Kramer, & Mutchler, 2014).

3. Adult Siblings Provision of Aid/Support

Adult siblings of individuals with a DD often play important, supportive roles to their

siblings with DD (Atkin & Tozer, 2014). Most adult siblings in this population indicate that they

desire to be involved in the care of their sibling (Tozer & Atkin, 2015), with many expecting to

provide assistance in the future if they are not already doing so (Burke, Fish, & Lawton, 2015).

Relatedly, TD siblings have expressed difficulty in balancing the demands of caring for their

own family, caring for their aging parents, and being consistently involved with their siblings

with ASD (Tozer & Atkin, 2015). Duignan and Connell’s (2015) study suggests that caring for

an individual with ASD can alter the home environment in ways that result in negative effects on

siblings’ social relationships. Many TD siblings expect to assume greater caregiving roles when

their parents get older (Coyle et al., 2014), especially if they have a closer relationship with their

sibling (Burke, Taylor, Urbano, & Hodapp, 2012; Heller & Kramer, 2009). Thus, consideration

of adult sibling relationships is of particular interest when assessing the outcomes and

functioning of adult siblings of individuals with a DD.

4. Adult Sibling Relationships and Developmental Disabilities

Little research considers the importance of sibling relationships in this population

(Hastings & Petalas, 2014), particularly in adults (Ferraioli & Harris, 2009). Adult siblings of

individuals with a DD have unique sibling relationships as compared to similar but younger

sibling dyads (Orsmond, Kuo, & Seltzer, 2009), adult siblings of individuals with other types of
SIBLING RELATIONSHIP QUALITY 6

diagnoses (e.g., psychiatric, chronic health conditions), and TD sibling dyads (e.g., Hodapp &

Urbano, 2007). Whereas the closeness of sibling relationships appears to fluctuate in typical

sibling dyads (Orsmond et al.), closeness of siblings when one has a DD appears more stable

over time (Orsmond & Seltzer, 2007). Thus any social and emotional difficulties related to a lack

of closeness in the early sibling relationship may continue into adulthood (Orsmond & Seltzer,

2007). Furthermore, TD siblings of individuals with a DD who report positive, rewarding, close

sibling relationships also tend to have good health and perceive benefits of being a sibling to a

brother/sister with disabilities (Hodapp & Urbano, 2007; Hodapp, Urbano, & Burke, 2010).

Although mostly unexplored in adults, childhood sibling relationship quality predicts

psychosocial adjustment outcomes in adulthood (Dunn, Slomkowski, Beardsall, & Rende, 1994;

Waldinger, Vaillant, & Orav, 2007). Considering the longevity and impact of this relationship, it

is critical to assess adult sibling relationships in families of individuals with a DD.

5. Consideration of Group differences

Research concerning the functioning and outcomes of TD siblings of individuals with

DDs when compared to siblings within typical dyads appears inconsistent, with some siblings

exhibiting positive outcomes (Macks & Reeve, 2007), some negative outcomes (Gold, 1993;

Verté, Roeyers, & Buysse, 2003), and some no differences (Di Biasi et al., 2015; Tomeny, Barry,

& Bader, 2012). As suggested by Seltzer, Greenberg, Orsmond, and Lounds (2005), these

inconsistencies in TD siblings’ outcomes may be dependent upon their siblings’ type of DD.

Rossiter and Sharpe’s (2001) meta-analysis suggests that the type of disability and its severity

are what influence the effects of the disability on the TD siblings. Caroli and Sagone (2013)

found that youth TD siblings (ages 13 to 18 years) of individuals with ASD had more negative

social attitudes toward their disabled siblings and more negative emotions than did TD siblings
SIBLING RELATIONSHIP QUALITY 7

of individuals with Down syndrome (DS) or ID. Alternatively, TD siblings of children with DS

have reported higher levels of relationship quality and social support within the sibling

relationship (Pollard, Barry, Freedman, & Kotchick, 2013) and viewed their sibling more

positively (Mandleco & Webb, 2015) than TD siblings of children with ASD.

The limited research on adults suggests that TD siblings of individuals with ASD

experience more depressive symptoms and poorer health compared to TD siblings of adults with

DS (Hodapp & Urbano, 2007). Further, TD siblings of adults with ID report more positive affect,

closeness, and compassion in the sibling relationship compared to siblings of adults with ASD

(Orsmond & Seltzer, 2000). Though few, these studies support the need for further investigation

of differences in sibling outcomes according to disability type, particularly among adults.

6. Current Study

Given the substantial number of individuals in the U.S. with a DD, the longevity of

sibling relationships (Cicirelli, 1995), and the unique demands placed upon the families of

individuals with a DD (McHale & Gamble, 1989; Roper et al., 2014; Tozer & Atkin, 2015), it is

important to examine the functioning and outcomes of TD siblings of individuals with a DD.

Research displaying the differential effects of ID and ASD on TD siblings’ functioning warrants

further examination of group differences. Because most studies to date have focused on

differences in youth siblings of individuals with various mental disabilities, the current study

aims to build upon current literature by examining similar factors among adult siblings of

individuals with DD.

First, it was expected that sibling relationship quality would predict amount of

aid/support provided by TD siblings, TD sibling life satisfaction, and depressive, anxiety and

stress symptoms in TD siblings over and above demographic correlates (Hypothesis 1). Second,
SIBLING RELATIONSHIP QUALITY 8

we hypothesized that TD siblings of those with ASD would report significantly lower levels of

positive sibling relationship attitudes compared to siblings of individuals with ID without ASD

(Hypothesis 2). We then conducted exploratory post hoc analyses based on results from

Hypotheses 1 and 2 that examined indirect effects between group inclusion (ASD vs. ID) and TD

sibling outcomes through sibling relationship attitudes.

Insert Figure 1 about here

7. Method

7.1. Participants

As part of a larger study, 82 TD siblings of individuals with either ASD or ID without

ASD provided data about themselves and their sibling with a disability. The ASD group was

composed of 45 TD siblings ages 18 to 62 (M = 29.42, SD = 11.08; 82% were female) and

siblings with ASD ages 18 to 52 (M = 26.49, SD = 8.55; 20% were female). The ID without ASD

group (referred to as the ID group) was composed of 37 TD siblings ages 19 to 61 (M = 36.30,

SD = 13.07; 86% were female) and siblings with ID ages 19 to 55 (M = 35.24, SD = 12.71; 49%

were female). Those within the ID group were of mixed etiology and had disorders such as

Down Syndrome, Cerebral Palsy, Fragile X, and intellectual disability not otherwise specified.

Across both groups, 4.67 years was the average absolute value of sibling age differences and

63% of respondents were older than their sibling with a disability. The racial distribution of the

overall sample was 88% Caucasian, 4% Hispanic, 4% Asian, 1% African-American, and 4%

other. Thirty-two percent of TD siblings reported making over $100,000 annually, 42% reported

being married, and 38% described themselves as never married or living alone.

Few respondents (i.e., four) described themselves as the primary caregiver of their

sibling. However, across both groups, 43% reported providing direct care [defined as “assistance
SIBLING RELATIONSHIP QUALITY 9

with activities of daily living (e.g., grooming, feeding, household chores)”] at least once per

month (15% reported daily direct care), 51% reported providing transportation at least once per

month (15% reported daily transportation assistance), 28% reported providing financial

assistance at least once per month (13% reported providing daily financial assistance), and 40%

reported running errands for their sibling at least once per month (16% reported performing daily

errands).

7.2. Measures

7.2.1. Demographic and Diagnostic Questionnaire. TD siblings provided demographic

data (e.g., age, gender, ethnicity, marital status, income, level of education) about themselves and

their sibling with a DD, along with information about their siblings’ diagnosis (e.g., specific

diagnosis, age of diagnosis, who made the diagnosis) via a demographic and diagnostic

questionnaire. Amount of aid/support provided by TD siblings to their sibling with a DD was

measured via this questionnaire: a Total score was calculated by summing responses to five

questions on a 5-point Likert scale (0 = none to 4 = daily or almost daily) about amount of direct

care, transportation, financial assistance, errands completed, and “other” care provided.

7.2.2. Depression Anxiety and Stress Scale. The Depression, Anxiety, and Stress Scale

(DASS; Lovibond & Lovibond, 1995) is a 21-item self-report measure of distress. Using a 0

(Did not apply to me) to 3 (Applied to me very much, or most of the time) scale, respondents rate

how much each item applied to them during the previous week. The DASS provides a Total

scale and Depression, Anxiety, and Stress subscales. Scale scores are calculated by multiplying

the sum of scores by two to allow for comparisons to the 42-item version of the DASS per

Lovibond and Lovibond (1995). Example items from the DASS include “I found it difficult to

relax” and “I was unable to become enthusiastic about anything.” The DASS has shown
SIBLING RELATIONSHIP QUALITY 10

appropriate convergent validity and internal consistency in previous research (Lovibond &

Lovibond, 1995), and coefficient alphas for the current sample ranged from .80 to .91 for the

subscales.

7.2.3. Lifespan Sibling Relationship Scale. The Lifespan Sibling Relationship Scale

(LSRS; Riggio, 2000) is a self-report adult measure of sibling relationship quality and attitudes.

The LSRS aims to provide an overall assessment of relationship quality by measuring affective,

cognitive, and behavioral components of a sibling relationship (Riggio, 2000). Respondents

report on current and retrospective attitudes, and they were asked to think about their sibling with

a disability when completing this measure. The LSRS is composed of 48 items on a 5-point

Likert scale from 1 (Strongly disagree) to 5 (Strongly agree) and higher scores indicate more

positive attitudes about the sibling relationship. The LSRS produces six subscale scores that

measure affective, behavioral, and cognitive characteristics of sibling relationships during

childhood and adulthood. Example items include: “My sibling is a good friend” and “My sibling

and I often helped each other as children.” The LSRS also produces a Total score, which was of

interest for the current study. Previous psychometric research suggests that the LSRS shows

appropriate validity and reliability, and this validity appears to remain stable across the lifespan

(Riggio, 2000). The LSRS Total scale produced a coefficient alpha of .96 for the current sample,

indicating good internal consistency.

7.2.4. Satisfaction with Life Scale. The Satisfaction with Life Scale (SWLS) is a brief 5-

item measure of overall life satisfaction (Diener, Emmons, Larsen, & Griffin, 1985).

Respondents are asked to rate the extent to which they agree with each statement using a 7-point

Likert scale from 1 (Strongly Disagree) to 7 (Strongly agree). Example items include: “I am

satisfied with my life” and “The conditions of my life are excellent.” The total scale produced a
SIBLING RELATIONSHIP QUALITY 11

coefficient alpha of .89, suggesting good internal reliability for the current sample, consistent

with previous research (Diener et al., 1985).

7.3. Procedure

Data were collected following approval from the University Institutional Review Board

and provision of electronic consent by each participant. TD siblings were recruited via

organizations associated with developmental disabilities. TD siblings who agreed to participate

were sent a link to a secure survey website on which study questionnaires were stored and

completed. Seventy-three percent of those TD siblings who accessed the survey completed the

study. After consent, TD siblings completed a Demographic and Diagnostic form, the DASS, the

LSRS, and the SLS. TD siblings were instructed to consider their sibling with a DD when

answering questions about their sibling relationship and interactions.

8. Results

Less than 0.01% of data was missing at the item-level; the mean of the items on

respective scales was imputed to replace missing data according to Harrell (2001). Group

differences among variables of interest are listed in Table 1. Intercorrelations of the variables of

interest are listed in Table 2.

Insert Tables 1 and 2 about here

8.1. Control Variables

Possible control variables for Hypothesis 1 and the post hoc analyses were determined

using zero-order correlations between the possible control variables and the criterion variables

for the total sample (Table 3). TD sibling depression was negatively correlated with TD sibling

income and marital status (dichotomized: 0 = living alone, 1 = living with a significant other).

TD sibling anxiety and stress were also negatively associated with TD sibling income, and TD
SIBLING RELATIONSHIP QUALITY 12

sibling stress was positively associated with birth order of siblings with DD. Aid/support was

positively correlated with age discrepancy (absolute value), distance between siblings, and birth

order of siblings with DD and was negatively correlated with TD sibling race (dichotomized: 0 =

nonwhite, 1 = white). As such, TD sibling income, TD sibling marital status, birth order of

siblings with DD, age discrepancy, distance between siblings, and TD sibling race were included

as covariates when their respective criterion variables were examined for Hypothesis 1 and post

hoc analyses.

Because the ASD and ID groups were not matched on demographic variables,

independent samples t-tests were conducted to examine group differences in possible confounds

for Hypothesis 2 (Table 4). Results revealed that the two groups differed in gender of sibling

with a disability (coded 1 = male, 2 = female), t(80) = 2.79, p = .007, TD sibling age, t(80) =

2.54, p = .01, TD sibling birth order, t(80) = 3.28, p = .002, and number of people in their

household during childhood, t(79) = 2.74, p = .009. In order to maximize statistical power via

conservative use of degrees of freedom (Cepeda, Boston, Farrar, & Strom, 2003) when

examining group differences, propensity scores were calculated according to procedures outlined

by Rosenbaum and Rubin (1983). The aforementioned variables were entered into a binary

logistic regression as predictors of group membership (ASD vs. ID), and the probability scores

from these logistic regressions were saved and served as a single covariate when examining

group differences. Although the groups also differed on age of siblings with a DD, this variable

was not included as a covariate due to its strong association with TD sibling age (r = .88, p <

.001).

Insert Tables 3 and 4 about here

8.2. Hypothesis 1
SIBLING RELATIONSHIP QUALITY 13

Hypothesis 1 (that sibling relationship attitudes would predict amount of aid provided by

TD siblings, TD sibling life satisfaction, TD sibling depression, TD sibling anxiety, and TD

sibling stress across the whole sample) was tested via a series of multiple regression analyses

(Table 5). Statistically determined covariates (Table 3) were entered in Step 1 of their respective

analyses. Sibling relationship attitudes were entered in Step 2. Positive sibling relationship

attitudes were positively associated with aid provided by TD siblings, ΔF(5, 76) = 7.65, p = .01,

ΔR2 = .07, and TD sibling life satisfaction, ΔF(1, 79) = 6.31, p = .01, ΔR2 = .07. Alternatively,

positive sibling relationship attitudes were negatively associated with TD sibling depression,

ΔF(3, 77) = 9.33, p = .003, ΔR2 = .09, and stress, ΔF(3, 78) = 4.78, p = .03, ΔR2 = .05. Sibling

relationship attitudes did not predict TD sibling anxiety, ΔF(2, 78) = 1.69, p = .20, ΔR2 = .02.

Insert Table 5 about here

8.3. Hypothesis 2

Hypothesis 2 (that TD siblings of individuals with ASD would have significantly lower

levels of positive sibling relationship attitudes compared to TD siblings of individuals with ID)

was examined via an analysis of covariance. On average, TD siblings of individuals with ASD

(M = 153.45, SD = 31.82) reported significantly fewer positive sibling relationship attitudes

compared to TD siblings of individuals with ID (M = 171.55, SD = 31.63) while holding gender

of siblings with a disability, TD sibling age, TD sibling birth order, and childhood family size

constant. Analyses were conducted twice (with separate covariates and with the propensity

scores as a single covariate); each analysis yielded significant group differences: F(1,75) = 7.07,

p = .01, when using separate covariates, F(1,78) = 7.55, p = .01, when using the propensity

score.

8.4. Exploratory Post Hoc Analyses

SIBLING RELATIONSHIP QUALITY 14

Given the group differences in sibling relationship attitudes and the relations between

sibling relationship attitudes and outcomes in TD siblings, we explored whether an indirect

pathway exists between group membership (ASD vs. ID) and (1) aid provided by, (2) life

satisfaction, (3) depression, and (4) stress in TD siblings through sibling relationship attitudes.

Although a total effect between group membership and outcomes in TD siblings was not found, a

total effect between the predictor and the criterion variable is not a precursor for determining

meaningful indirect effects (Hayes, 2013). Despite the lack of evidence of a direct relation, it

could be that TD sibling group membership relates to outcomes in TD siblings in an indirect way

through group differences in sibling relationship attitudes.

Indirect effects (i.e., the product of the effect for the path between group membership and

sibling relationship attitudes and the effect for the path between sibling relationship attitudes and

each criterion variable; i.e., path a X path b; Hayes, 2013) were examined using bootstrapping

methods to estimate bias-corrected asymmetric confidence intervals (CIs) of the indirect effects

with 5000 resamples with replacement. A CI not inclusive of zero indicates a significant indirect

effect (Preacher & Hayes, 2008). These bootstrap analyses were conducted using Hayes’s (2013)

PROCESS macro tool for SPSS. Aforementioned propensity scores were entered as a control

variable to account for group differences in demographic variables during each analysis.

Additional control variables were entered based on their bivariate relations with each respective

criterion variable (Table 4). Specifically, siblings with a DD birth order, geographic distance

between siblings, TD sibling race (dichotomized: 1 = Caucasian, 0 = non-Caucasian), and the

age difference between siblings (absolute value) were entered as control variables when

predicting amount of aid provided. Age difference between siblings (absolute value) and age of

siblings with a DD served as control variables when predicting TD sibling life satisfaction.
SIBLING RELATIONSHIP QUALITY 15

When predicting TD sibling depression, TD sibling marital status (dichotomized: 1 = living with

a significant other, 0 = living alone) and TD sibling income were entered as control variables.

When predicting TD sibling stress, birth order of siblings with a DD and TD sibling income were

entered as control variables.

Figure 2 displays the indirect effect of group membership (coded 0 = ID, 1 = ASD)

through sibling relationship attitudes when predicting aid provided by TD siblings (Panel A), TD

sibling depression (Panel B), and TD sibling stress (Panel C). The point estimate of the indirect

effect was -.93 (95% CI [-2.26, -.22]) when predicting TD sibling aid, 2.00 (95% CI [.52, 4.53])

when predicting TD sibling depression, and 1.52 (95% CI [.25, 3.61]) when predicting TD

sibling stress. No indirect effect was found when predicting TD sibling life satisfaction -1.16

(95% CI [-3.0, .004]). The negative coefficients between group membership and sibling

relationship attitudes reflect the Hypothesis 2 findings (that TD siblings of those with ID report

higher levels of positive sibling relationship attitudes compared to TD siblings of those with

ASD).

For these three TD sibling outcomes (aid, depression, stress), three additional post-hoc

analyses were conducted to examine indirect effects of group membership on sibling relationship

attitudes indirectly through each of the TD sibling outcomes. Despite the total effect of group

membership on sibling relationship attitudes, none of the indirect effects through the TD sibling

outcomes were significant. These additional analyses further bolster our confidence in the

directionality of the indirect effect.

Insert Figure 2 about here

9. Discussion
SIBLING RELATIONSHIP QUALITY 16

In this study, we found that TD siblings of individuals with ASD reported fewer positive

attitudes about their sibling relationship compared to TD siblings of individuals with ID. Across

the whole sample, sibling relationship attitudes accounted for significant variance over and

above demographic covariates in amount of aid/support provided by TD siblings, in TD sibling

life satisfaction, and in TD sibling depressive symptoms and stress. Specifically, results

suggested that more positive sibling relationship attitudes were related to increased levels of aid

provided and life satisfaction and lower levels of depressive symptoms and stress. Despite the

challenges related to caring for a sibling with a disability described in previous research

(Dunigan & Connell, 2015; Tozer & Atkin, 2015), TD siblings in our sample who expressed

more positive attitudes about their sibling relationships also provided higher levels of aid to their

sibling, described being more satisfied with life, and reported fewer depressive and stress

symptoms.

TD siblings of those with ASD reported significantly fewer positive sibling relationship

attitudes. Multiple studies have compared child siblings of those with ASD to those with Down

Syndrome and other intellectual disabilities, and several differences have been observed. For

example, siblings of children with ASD often describe their sibling’s disability as stressful and as

having a negative impact on the sibling relationship (e.g., Petalas, Hastings, Nash, Dowey, &

Reilly, 2009; Ross & Cuskelly, 2006; Sage & Jegatheesan, 2010) and on their relationships with

friends (Petalas et al., 2009). TD siblings of individuals with ASD also report lower levels of

nurturance, intimacy, and prosocial behavior toward their sibling with ASD and increased

internalizing problems when compared to those with DS (Fisman, Wolf, Ellison, & Freeman,

2000; Kaminsky & Dewey, 2001). Alternatively, siblings of those with DS do not report the

aforementioned psychoscial problems as frequently (Kaminsky & Dewey, 2002), report higher
SIBLING RELATIONSHIP QUALITY 17

levels of relationship quality and more social support within the sibling relationship (Pollard et

al., 2013), and more overall positive views about their sibling’s disability (Mandleco & Webb,

2015). Many have suggested that there is something different about living with an individual

with ASD compared to living with individuals with other, similar disorders (Fisman et al., 2000;

Kaminsky & Dewey, 2001; Mascha & Boucher, 2006). The core deficits in social functioning

inherent in ASD often create interpersonal challenges, and these difficulties likely extend to

sibling relationships (Kaminsky & Dewey, 2001; Orsmond & Seltzer, 2000). The results of the

current study suggest that these distinct characteristics of ASD sibling relationship dyads appear

to extend into adulthood.

Finally, multiple indirect pathways through sibling relationship attitudes were identified.

These results indicate that there is an indirect effect of group membership on amount of aid

provided and TD sibling depressive symptoms and stress through sibling relationship attitudes.

Specifically, results indicate that TD siblings of those with ASD may be at greater risk for

depression and stress and for providing less aid/support due to lower levels of positive sibling

relationship attitudes. Again, these results support the notion that siblings of individuals with

ASD are at greater risk for negative outcomes when compared to siblings of individuals with ID

(Hodapp & Urbano, 2007; Orsmond & Seltzer, 2000) and that these effects may be explained, at

least in part, by sibling relationship attitudes. In contrast, group membership did not demonstrate

an indirect effect on life satisfaction through sibling relationship attitudes, perhaps because life

satisfaction is a global, positive outcome.

Previous research indicates that time spent with siblings with developmental disabilities

may often be spent providing instrumental support rather than engaging in close emotional and

interpersonal sibling relationship behaviors (Burbidge & Minnes, 2014). The unique nature of
SIBLING RELATIONSHIP QUALITY 18

these relationships may leave TD siblings feeling unsatisfied, particularly TD siblings of

individuals with ASD given that those affected with ASD may be even less likely to reciprocate

prosocial behavior. Nevertheless, these indirect pathways indicate that sibling relationship

attitudes may be a particularly salient point of intervention. According to the current results,

improvements in sibling relationship attitudes may lead to reductions in depression and stress

and increases in amount of aid provided, particularly among TD siblings of individuals with

ASD.

9.1. Limitation and Future Research

Several limitations should be considered when interpreting these results. The sample is

relatively small and data were collected in a way that may have led to sampling bias, thus

reducing the generalizability of results. The relatively wide sibling age range could confound the

findings due to differences in experiences of young adults versus middle-age adults. However,

age of TD siblings was statistically accounted for given the significant differences between the

groups and its relation with criterion variables. In addition, data indicate that some of the TD

siblings may have lived with both their parents and their sibling with a disability; this may have

introduced error given differences related to varied living arrangements. Moreover, a large

segment of the sample was female and previous research indicates that sisters may interact with

siblings with disabilities differently compared to brothers (Burke et al., 2012; Cridland, Jones,

Stoyles, Caputi, & Magee, 2015; Orsmond & Seltzer, 2000, 2009). Finally, many of the

respondents were recruited via organizations that provide support for those with disabilities and

their families. Thus, the current sample’s representation of the broader population may be less

than optimal.
SIBLING RELATIONSHIP QUALITY 19

The study’s cross-sectional design also limits conclusions that can be drawn. Larger,

more diverse longitudinal studies that yield contemporaneous data early in childhood and later in

life are necessary for achieving a more accurate assessment of sibling functioning. Also,

directionality and temporal relations among these variables cannot be determined. Although

sibling relationship attitudes was theorized as a predictor in the current analyses, the relations

between the variables of interest may be in the opposite direction. For example, it may be that

those siblings who provide high levels of aid to their sibling with a disability or who are

generally satisfied in life may then experience more positive attitudes about the sibling

relationship. However, we have higher confidence in the directionality of the indirect effects

given that diagnoses (i.e., group membership) were likely determined, in most cases, when

siblings were children and given that the tests for an indirect effect when reversing sibling

relationship attitudes with TD sibling outcomes in the model were all not significant.

Additionally, diagnoses of the siblings with disabilities were not independently confirmed, and

standardized measures of disability, behavior problems, and adaptive functioning were not

performed—all of which are additional domains that may influence sibling relationship attitudes

and outcomes in TD siblings. Future research would be strengthened by direct assessment of the

affected individuals so that diagnoses are confirmed and more thorough information about the

characteristics of the siblings can be gathered. Finally, data from multiple informants (e.g.,

multiple siblings, parents) would allow for a more comprehensive view of the constructs of

interest.

9.2. Conclusions

Although developmental disability diagnostic classifications rarely change, the results of

this study suggest that the attitudes possessed by TD siblings are important to consider when
SIBLING RELATIONSHIP QUALITY 20

understanding adult sibling outcomes. Specifically, data suggest that higher levels of positive

sibling relationship attitudes are related to TD siblings providing more aid/support to their

sibling with a disability, along with higher levels of general life satisfaction. More positive

sibling relationship attitudes also appear associated with lower levels of stress and depressive

symptoms among TD siblings. Consistent with previous child research (e.g., Mandleco & Webb,

2015), siblings of individuals with ASD report fewer positive sibling relationship attitudes

compared to siblings of individuals with ID without ASD. Finally, given the indirect effects of

group membership on aid/support provided, depressive symptoms, and stress through sibling

relationship attitudes, sibling relationship attitudes may be a salient point of intervention,

particularly for siblings of individuals with ASD. Although prior changes in public policy would

be needed, clinicians working with adult siblings of those with ASD may be able to work with

clients to improve their attitudes about the sibling relationship when targeting other psychosocial

outcomes. Despite this study’s limitations, the results provide promising clues for improving our

understanding of adult sibling relationships when disabilities are involved.

SIBLING RELATIONSHIP QUALITY 21

References

Atkin, K., & Tozer, R. (2014). Personalization, family relationships and autism: Conceptualizing

the role of adult siblings. Journal of Social Work, 14, 225–242.

Baio, J. (2014). Prevalence of autism spectrum disorder among children aged 8 Years—Autism

and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2010.

MMWR 2014; 63 (No. 2): 1-13.

Brault, M. W. (2010). Americans with Disabilities: 2010. Household Economic Studies, 2012.

U.S. Census Bureau: 1-23.

Burbidge, J. & Minnes, P. (2014). Relationship quality in adult siblings with and without

developmental disabilities. Family Relations, 63, 148-162.

Burke, M. M., Fish, T., & Lawton, K. (2015). A Comparative analysis of adult siblings'

perceptions toward caregiving. Intellectual and Developmental Disabilities, 53, 143-157.

Burke, M. M., Taylor, J. L., Urbano, R., & Hodapp, R. M. (2012). Predictors of future caregiving

by adult siblings of individuals with intellectual and developmental disabilities. American

Journal on Intellectual and Developmental Disabilities, 117, 33-47.

Caroli, M. & Sagone, E. (2013). Siblings and disability: a study on social attitudes toward

disabled brothers and sisters. Procedia-Social and Behavioral Sciences. 93, 1217-1223.

Cepeda, M. S., Boston, R., Farrar, J. T. & Strom, B. L. (2003). Comparison of logistic

regression versus propensity score when the number of events is low and there are

multiple confounders. American Journal of Epidemiology, 158, 280-287.

Cicirelli, V. G. (1995). Sibling Relationships across the Lifespan. New York, NY: Plenum

Press.
SIBLING RELATIONSHIP QUALITY 22

Coyle, C. E., Kramer, J., & Mutchler J. E., (2014). Aging together: sibling carers of adults with

intellectual and developmental disabilities. Journal of Policy & Practice in Intellectual

Disabilities, 11, 302-312.

Cridland, E. K., Jones, S. C., Stoyles, G., Caputi, A. P., & Magee, C. A. (2015). Families living

with autism spectrum disorder: Roles and responsibilities of adolescent sisters. Focus on

Autism and Other Developmental Disabilities, 1-12.

Duignan, M., Connell, J. (2015). Living with autistic spectrum disorders: Families, homes and

the disruption of space. Geographical Research, 53, 199-210.

Dunn, J., Slomkowski, C., Bcardsall, L., & Rende, R. (1994). Adjustment in middle childhood

and early adolescence: Links with earlier and contemporary sibling relationships. Journal

of Child Psychology and Psychiatry, 35, 491-504.

Di Biasi, S., Trimarco, B., D’Ardia, C., Melogno, S., Meledandri, G., & Levi, G. (2015).

Psychological adjustment, social responsiveness and parental distress in an Italian sample

of siblings of children with high-functioning autism spectrum disorder. Journal of Child

and Family Studies, 1-8.

Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale.

Journal of Personality Assessment, 49, 71-75.

Ferraioli, S. J., & Harris, S. L. (2009). The impact of autism on siblings. Social Work in Mental

Health, 8, 41-53.

Fisman, S., Wolf, L., Ellison, D., & Freeman, T. (2000). A longitudinal study of siblings of

children with chronic disabilities. The Canadian Journal of Psychiatry, 45, 369-375.

Gold, N. (1993). Depression and social adjustment in siblings of boys with autism. Journal of

Autism and Developmental Disorders, 23, 147-163.

SIBLING RELATIONSHIP QUALITY 23

Harrell, F. E. (2001). Regression Modeling Strategies. New York: Springer.

Hastings, R. P. & Petalas, M. A. (2014). Self-reported behaviour problems and relationship

quality by siblings of children with autism spectrum disorder. Child: Care, Health and

Development, 40, 833-839.

Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A

regression-based approach. New York: Guilford.

Heller, T., & Kramer, J. (2009). Involvement of adult siblings of persons with developmental

disabilities in future planning. Intellectual and Developmental Disabilities, 47, 208-219.

Hodapp, R. M., & Urbano, R. C. (2007). Adult siblings of individuals with Down syndrome

versus with autism: findings from a large‐scale US survey. Journal of Intellectual

Disability Research, 51, 1018-1029.

Hodapp, R. M., Urbano, R. C., & Burke, M. M. (2010). Adult female and male siblings of

persons with disabilities: Findings from a national survey. Journal Information, 48, 52-

62.

Kaminsky, L., & Dewey, D. (2001). Siblings relationships of children with autism. Journal of

Autism and Developmental Disorders, 31, 399-410.

Kaminsky, L. & Dewey, D. (2002). Psychosocial adjustment of siblings of children with autism.

Journal of Child Psychology and Psychiatry, 43, 225-232.

Levy, S. E., Giarelli, E., Lee, L., Schieve, L. A., Kirby, R. S., Cunniff, C., . . . Rice, C.E. (2010).

Autism spectrum disorder and co-occurring developmental, psychiatric, and medical

conditions among children in multiple populations of the United States. Journal of

Developmental & Behavioral Pediatrics, 31, 267-275.

SIBLING RELATIONSHIP QUALITY 24

Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states:

Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression

and Anxiety Inventories. Behaviour Research and Therapy, 33, 335-343.

Macks, R. J., & Reeve, R. E. (2007). The adjustment of non-disabled siblings of children with

autism. Journal of Autism and Developmental Disorders, 37, 1060-1067.

Mandleco, B. & Webb, A. (2015). Sibling perceptions of living with a young person with Down

syndrome or autism spectrum disorder: an integrated review. Journal for Specialists in

Pediatric Nursing. 20, 138-156.

Mascha, K. & Boucher, J. (2006). Preliminary investigation of a qualitative method of examining

siblings’ experiences of living with a child with ASD. The British Journal of

Developmental Disabilities, 52, 19-28.

McHale, S. & Gamble, W. (1989). Sibling relationships and adjustment of children with disabled

brothers and sisters. Journal of Children in Contemporary Society, 19, 131-158.

Orsmond, G. I., Kuo, H. Y., & Seltzer, M. M. (2009). Siblings of individuals with an autism

spectrum disorder Sibling relationships and wellbeing in adolescence and

adulthood. Autism, 13, 59-80.

Orsmond, G.I. & Seltzer, M.M. (2000). Brothers and Sisters of Adults with Mental Retardation:

Gendered Nature of the Sibling Relationship. American Journal on Mental Retardation,

105, 486–508.

Orsmond, G. I., & Seltzer, M. M. (2007). Siblings of individuals with autism spectrum disorders

across the life course. Mental Retardation and Developmental Disabilities Research

Reviews, 13, 313.

Orsmond, G. I., & Seltzer, M. M. (2009). Adolescent siblings of individuals with autism
SIBLING RELATIONSHIP QUALITY 25

spectrum disorder: Testing a diathesis-stress model of sibling well-being. Journal of

Autism and Developmental Disorders, 39, 1053-1065.

Petalas, M. A., Hastings, R. P., Nash, S., Dowey, A., & Reilly, D. (2009). “I like that he always

shows who he is”: The perceptions and experiences of siblings with a brother with autism

spectrum disorder. International Journal of Disability, Development and Education, 56,

381-399.

Pollard, C., Barry, C., Freedman, B., & Kotchick, B. (2013) Relationship quality as a moderator

of anxiety in siblings of children diagnosed with autism spectrum disorders or Down

syndrome. Journal of Child & Family Studies, 22, 647-657.

Preacher, K. J. & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and

comparing indirect effects in multiple mediator models. Behavior Research Methods, 40,

879-891.

Riggio, H. (2000). Measuring attitudes toward adult sibling relationships: The lifespan sibling

relationship scale. Journal of Social and Personal Relationship, 17, 707-728.

Roper, S. O., Allred, D. W., Mandleco, B., Freeborn, D., & Dyches, T. (2014). Caregiver burden

and sibling relationships in families raising children with disabilities and typically

developing children. Families, Systems, & Health: The Journal of Collaborative Family

Healthcare, 32, 241-246.

Rosenbaum, P. R. & Rubin, D. B. (1983). The central role of the propensity score in

observational studies for causal effects. Biometrika, 70, 41-55.

Ross, P., & Cuskelly, M. (2006). Adjustment, sibling problems and coping strategies of brothers

and sisters of children with autistic spectrum disorder. Journal of Intellectual and

Developmental Disability, 31, 77-86.

SIBLING RELATIONSHIP QUALITY 26

Rossiter, L., & Sharpe, D. (2001). The siblings of individuals with mental retardation: a

quantitative integration of the literature. Journal of Child and Family Studies, 10, 65-84.

Sage, K. D. & Jegatheesan, B. (2010). Perceptions of siblings with autism and relationships with

them: European American and Asian American siblings draw and tell. Journal of

Intellectual and Developmental Disability, 35, 92-103.

Seltzer, M. M., Greenberg, J. S., Orsmond, G. I., & Lounds, J. (2005). Life course studies of

siblings of individuals with developmental disabilities. Mental Retardation, 43, 354-359.

Tomeny, T. S., Barry, T. D., & Bader, S. H. (2012). Are typically-developing siblings of children

with an autism spectrum disorder at risk for behavioral, emotional, and social

maladjustment? Research in Autism Spectrum Disorders, 6, 508-518.

Tozer, R. & Atkin, K. (2015). ‘Recognized, valued and supported’? The experiences of adult

siblings of people with autism plus learning disability. Journal of Applied Research in

Intellectual Disabilities, 28, 341-351.

Verté, S., Roeyers, H., & Buysse, A. (2003). Behavioural problems, social competence and self‐

concept in siblings of children with autism. Child: Care, Health and Development, 29,

193-205.

Waldinger, R. J., Vaillant, G. E., & Orav, E. J. (2007). Childhood sibling relationships as a

predictor of major depression in adulthood: A 30-year prospective study. American

Journal of Psychiatry, 164, 949-954.

SIBLING RELATIONSHIP QUALITY 27

Figure Captions:

Figure 1. Conceptual model of indirect effect between group membership and TD sibling
outcomes through sibling relationship attitudes.

Figure 2. Mediated outcomes on TD sibling aid/support provided (panel A), depression (panel
B), and stress (panel C) showing indirect effects of group membership through sibling
relationship attitudes. Note: Propensity scores were entered as a control variable for all three
panels to account for group differences in demographic characteristics. For panel A, birth order,
race (dichotomized: 1 = white, 0 = nonwhite), geographic distance, and sibling age difference
(absolute value) were additional covariates. For panel B, TD sibling marital status
(dichotomized: 1 = living with significant other, 0 = living alone) and TD sibling income were
additional covariates. For panel C, birth order and TD sibling income were additional covariates.
Unstandardized regression coefficients are reported. Statistics in brackets show the total effect of
the predictor on the outcome; statistics in parentheses show the direct effect of the predictor on
the outcome, after controlling for the indirect effect of the mediator. Each indirect effect
(depicted above each curved, dashed arrow) was significant based on an asymmetric 95%
confidence interval with 5000 resamples with replacement (Hayes, 2013).
SIBLING RELATIONSHIP QUALITY 28

Table 1

Group Means and Group Differences among Variables of Interest

Groups
Total Sample ASD ID
(N = 82) (n = 45) (n = 37)
Variables M SD M SD M SD F d
DASS Depression 8.57 8.54 8.80 8.16 8.28 9.08 .08 .06
DASS Anxiety 5.56 6.64 5.42 7.02 5.73 6.24 .13 .05
DASS Stress 11.67 8.02 11.89 7.87 11.41 8.29 .00 .06
Total Aid 5.49 4.80 5.00 4.85 6.08 4.73 .93 .23
SLS Total 25.40 6.84 24.73 6.55 26.22 7.19 3.06 .22
LSRS Total 161.62 32.81 153.45 31.82 171.55 31.63 7.55** .57
Note. ASD = autism spectrum disorder; ID = intellectual disability (without autism); DASS =
Depression, Anxiety, and Stress Scale; Aid = Amount of aid/support provided by TD sibling;
SLS = Satisfaction with Life Scale; LSRS = Lifespan Sibling Relationship Scale. Group
differences between ASD and ID were examined using ANCOVA with propensity score as a
single covariate (analyses were repeated with individual covariates; results remained
unchanged).
** p < .01.
SIBLING RELATIONSHIP QUALITY 29

Table 2

Correlations among Variables of Interest for Total Sample

1. 2. 3. 4. 5. 6.
1. DASS Depression -- .60** .66** .09 -.36** -.28*
2. DASS Anxiety -- .65** .21 -.15 -.07
3. DASS Stress -- .18 -.16 -.13
4. Total Aid -- .03 .41**
5. SLS Total -- .31**
6. LSRS Total --
Note. DASS = Depression, Anxiety, and Stress Scale; Aid = Amount of aid provided by TD
sibling; SLS = Satisfaction with Life Scale; LSRS = Lifespan Sibling Relationship Scale; SD =
Standard deviation.
** p < .01. * p < .05.
SIBLING RELATIONSHIP QUALITY 30

Table 3

Correlations between Possible Control Variables and Criterion Variables (Total Sample)

Criterion Variables
Possible Control Variables DASS DASS DASS Total SLS LSRS
Dep. Anxiety Stress Aid Total Total
Sib w/ Dis Age -.09 -.13 -.01 .07 -.16 -.003
Sib w/ Dis Gender -.16 -.15 -.15 -.13 -.04 -.10
Sib w/ Dis Birth Order .03 -.03 .26* .22* .13 .18
Distance from Sib w/ Dis -.05 -.03 -.11 .42** -.08 .19
TD Sibling Gender -.003 -.06 -.06 -.16 -.004 -.003
TD Sibling Age -.12 -.15 .00 .19 -.01 .11
TD Sibling Birth Order .08 .06 -.06 .12 -.11 .07
TD Sibling Race (Dich.) -.05 -.05 .06 -.31** .14 -.21
TD Sibling Education -.08 -.06 .05 -.09 -.08 .05
TD Sibling Income -.25* -.37** -.26* -.13 -.05 -.18
Childhood Family Size .16 .07 .17 .19 -.06 .07
TD Sib Marital Stat (Dich) -.31** -.19 -.12 -.01 .11 .007
Age Disc. (Abs. Value) -.03 -.01 -.08 .23* .26* .19
Note. Sib w/ Dis = Sibling with a disability; TD = Typically-developing; Dich = Dichotomized;
Abs. Value = Absolute Value; DASS = Depression, Anxiety and Stress Scale; SLS = Satisfaction
with Life Scale; Aid = Amount of aid provided by TD sibling; LSRS = Lifespan Sibling
Relationship Scale. Race coded as 0 = nonwhite, 1 = white; Marital status coded as 0 = living
alone, 1 = living with a significant other.
** p < .01. * p < .05.
SIBLING RELATIONSHIP QUALITY 31

Table 4

Group Means and Group Differences of Possible Covariates

Groups
Total Sample ASD ID
(N = 82) (n = 45) (n = 37)
Possible Control Variables M SD M SD M SD t d
Sib w/ Dis Age 30.44 11.43 26.49 8.55 35.24 12.71 3.58** .81
Sib w/ Dis Gender 1.33 .47 1.20 .41 1.49 .51 2.79** .62
Sib w/ Dis Birth Order 2.37 1.18 2.29 .90 2.46 1.46 .62 .14
Distance From Sib w/ Dis 2.24 1.22 2.29 1.27 2.19 1.16 -.37 .08
TD Sib Gender 1.84 .37 1.82 .39 1.86 .35 .53 .11
TD Sib Age 32.52 12.43 29.42 11.08 36.30 13.07 2.54* .57
TD Sib Birth Order 1.93 1.03 1.60 .84 2.32 1.11 3.28** .73
TD Sib Race (Dich) .88 .33 .84 .37 .92 .28 1.05 .24
TD Sib Education 5.93 .84 5.91 .82 5.95 .88 .19 .05
TD Sib Income 7.14 2.01 7.00 2.21 7.31 1.74 .70 .16
Childhood Family Size 5.12 1.47 4.71 .82 5.64 1.90 2.74** .64
TD Sib marital status (Dich) .56 .50 .56 .50 .57 .50 .11 .02
Age Discrepancy (Abs. Value) 4.67 4.29 4.71 4.97 4.62 3.34 -.10 .02
Note. ASD = autism spectrum disorder; ID = intellectual disability (without autism); Sib w/ Dis
= sibling with disability; TD Sib = typically-developing sibling; Dich = dichotomized; Abs.
Value = absolute value; Gender coded as 1 = male, 2 = female; Race coded as 0 = nonwhite, 1 =
white; Marital status coded as 0 = living alone, 1 = living with a significant other.
** p < .01. * p < .05.
SIBLING RELATIONSHIP QUALITY 32

Table 5
Results of Multiple Regression Analyses of Sibling Relationship Attitudes Predicting Aid/Support Provided by TD Siblings, TD
Siblings’ Life Satisfaction, and Depression, Anxiety, and Stress in TD Siblings (Total Sample)

Criterion Variables
Predictor Variables Total Aid SLS Total Depression Anxiety Stress
Model 1
Age Discrepancy (Abs. Value) .17 .26* -- -- --
Distance from Sib w/ Dis .34** -- -- -- --
Sib w/ Dis Birth Order .18 -- -- -- .25*
TD Sibling Race (Dich) -.18 -- -- -- --
TD Sibling Income -- -- -.18 -.37** -.27*
TD Sibling Marital Stat (Dich) -- -- -.28* -- --
R2 (df) .28 (4,77)*** .07 (1,80)* .14 (2,78)** .14 (1,79)** .13 (2,78)**
Model 2
Sibling Relationship Attitudes .27** .27* -.31** -.14 -.23*
ΔR2 (df) .07 (1,76)** .07 (1,79)* .09 (1,77)** .02 (1,78) .05 (1,77)*
Note. Abs. Value = absolute value; Sib w/ Dis = sibling with disability; TD = Typically-developing; Race coded as 1 = white, 0 =
nonwhite; Marital Status coded as 0 = living alone, 1 = living with a significant other. Standardized beta-weights reported for each
predictor. Degrees of freedom reported in parentheses following each R2 value. Dashes indicate that control variables are not
applicable for respective analyses.
*** p < .001. ** p < .01. * p < .05.

Figure 1
 A

Figure 2

View publication stats