Parents' Differential Treatment of Adolescent Siblings in African American Families.

Research on European and European American families suggests that parents' differential treatment of siblings has negative implications for youths' adjustment, but few studies have explored these dynamics in minority samples. This study examined parents' differential acceptance and conflict in a sample of mothers, fathers, and two adolescent siblings in 179 African American families who were interviewed on three annual occasions. In an effort to replicate findings from European and European American samples, we assessed the longitudinal associations between differential treatment and adolescent adjustment and tested three sibling characteristics (birth order, gender, and dyad gender composition) as potential moderators of these linkages. To illuminate the sociocultural context of differential treatment and its implications, we also explored parents' cultural socialization practices and experiences of financial stress as potential moderators of these links. Multilevel models revealed that, controlling for average parent-child relationship qualities, decreases in parental acceptance and increases in parent-youth conflict over time-relative to the sibling-were associated with increases in youths' risky behavior and depressive symptoms. Links between differential treatment and adjustment were not evident, however, when mothers engaged in high levels of cultural socialization and in families under high financial stress. The discussion highlights the significance of sociocultural factors in family dynamics.

Sibling Relationships and Adolescent Adjustment: Longitudinal Associations in Two-Parent African American Families.

Sibling relationships have been described as love-hate relationships by virtue of their emotional intensity, but we know little about how sibling positivity and negativity operate together to affect youth adjustment. Accordingly, this study charted the course of sibling positivity and negativity from age 10 to 18 in African American sibling dyads and tested whether changes in relationship qualities were linked to changes in adolescents' internalizing and externalizing behaviors. Participants were consecutively-born siblings [at Time 1, older siblings averaged 14.03 (SD = 1.80) years of age, 48 % female; younger siblings averaged 10.39 (SD = 1.07) years of age, 52 % female] and two parents from 189 African American families. Data were collected via annual home interviews for 3 years. A series of multi-level models revealed that sibling positivity and sibling negativity declined across adolescence, with no significant differences by sibling dyad gender constellation. Controlling for age-related changes as well as time-varying parent-adolescent relationship qualities, changes in sibling negativity, but not positivity, were positively related to changes in adolescents' depressive symptoms and risky behaviors. Like parent-adolescent relationships, sibling relationships displayed some distancing across adolescence. Nevertheless, sibling negativity remained a uniquely important relational experience for African American adolescents' adjustment.

The effects of the family foundations prevention program on coparenting and child adjustment: a mediation analysis.

Behavioral and emotional problems are common in early childhood and put children at risk for developing more serious problems. This study tested the mediating mechanisms through which a universal coparenting intervention implemented during the transition to parenthood led to reduced child adjustment problems at age 3 and explored child gender as a potential moderator. One hundred sixty-nine heterosexual couples expecting their first child were randomly assigned to a control condition or Family Foundations, a series of eight classes that targeted the coparenting relationship. Data were collected through videotaped triadic mother-father-child interaction tasks when the child was 1 and 3 years of age. Separate longitudinal path analyses for mothers and fathers tested coparenting competition and positivity as mediators of program effects on child adjustment problems. Significant mediated effects for coparenting competition were found for fathers with both sons and daughters and for mothers with sons but not for mothers with daughters. These effects accounted for between 39 and 55% of the intervention's impact on child adjustment problems. Coparenting positivity did not mediate program effects. These results support the use of a prevention approach to reduce coparenting competition and enhance child adjustment and provide information that can be used to refine theory.

Sibling relationships and empathy across the transition to adolescence.

Although socioemotional competencies have been identified as key components of youths' positive development, most studies on empathy are cross-sectional, and research on the role of the family has focused almost exclusively on parental socialization. This study examined the developmental course of empathy from age 7 to 14 and the within-person associations between sibling warmth and conflict and youths' empathy. On three occasions across 2 years, mothers, fathers, and the two eldest siblings from 201 White, working- and middle-class families provided questionnaire data. Multilevel models revealed that, controlling for youths' pubertal status and parental education, girls' empathy increased during the transition to adolescence and then leveled off, but boys' lower levels of empathy remained relatively unchanged. Moreover, controlling for parental responsiveness and marital love, at times when firstborns and second-borns reported more sibling warmth and less sibling conflict than usual, they also reported more empathy than usual. The within-person association between sibling warmth and empathy also became stronger over time. Findings highlight gender differences in empathy development and the unique role of siblings in shaping each other's socioemotional characteristics during adolescence.

Association of Project ECHO Training With Buprenorphine Prescribing by Primary Care Clinicians in Minnesota for Treating Opioid Use Disorder.

Importance: Buprenorphine is an approved medication for opioid use disorder (MOUD); however, prescribing buprenorphine is limited by a requirement to obtain a waiver to prescribe it (hereinafter, "DATA [Drug Abuse Treatment Act]-waiver") and a lack of knowledge of the best practices among clinicians. Objective: To examine how Project ECHO (Extension for Community Healthcare Outcomes) telementoring is associated with changes in DATA-waiver attainment and buprenorphine prescribing among primary care clinicians in Minnesota. Design, Setting, and Participants: In this retrospective matched-cohort study of 918 clinicians, ECHO-trained clinicians were enrolled on the date they first attended ECHO (January 3, 2018, to June 11, 2020); comparison clinicians were assigned an enrollment date from the distribution of the first ECHO sessions. The baseline period was 12 months preceding enrollment, with follow-up for 18 months or until June 30, 2020. The ECHO-trained clinicians were a population-based sample of primary care clinicians who treated Medicaid patients in Minnesota 12 months prior to the initiation of ECHO training. This analysis used propensity score matching to select comparison clinicians who were similar across demographic and clinical practice characteristics at baseline in a 2:1 ratio. Follow-up was available for 167 ECHO-trained clinicians (54.6%) and 330 comparison clinicians (53.9%) at 18 months. Exposures: ECHO-trained clinicians attended at least 1 weekly, hour-long ECHO session. Comparison clinicians never participated in any ECHO sessions. Main Outcomes and Measures: DATA-waiver attainment, any buprenorphine prescribing, and the percentage of patients with opioid use disorder (OUD) who were prescribed buprenorphine. Results: The final sample included 918 clinicians (ECHO-trained [306]; comparison [612]), of whom 620 (67.5%) practiced outside the metropolitan Twin Cities (Minneapolis-St Paul) region. The mean (SD) age of the ECHO-trained clinicians was 46.0 (12.1) years and that of the comparison clinicians was 45.7 (12.3) years. Relative to the changes among the matched comparison clinicians, the ECHO-trained clinicians were more likely to obtain a DATA-waiver (difference-in-differences, 22.7 percentage points; 95% CI, 15.5-29.9 percentage points; P < .001) and prescribe any buprenorphine (16.5 percentage points; 95% CI, 10.4-22.5 percentage points; P < .001) after 6 quarters of follow-up. ECHO-trained clinicians prescribed buprenorphine to a greater share of patients with OUD (a difference of 7.6 percentage points per month; 95% CI, 4.6-10.6 percentage points per month; P < .001), relative to that prescribed by the comparison clinicians. Conclusions and Relevance: According to the findings of this matched-cohort study, ECHO telementoring may be associated with greater prescribing of buprenorphine by primary care clinicians. These findings suggest that Project ECHO training could be a useful tool for expanding access to MOUD.

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.

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.

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 differences in parent-child conflict and risky behavior: a three-wave longitudinal study.

To better understand why siblings growing up in the same family are often as different as unrelated individuals, this study explored the role of differential experiences with parents in the development of sibling differences. Cross-lagged models tested directions of effect by examining whether differential parent-child conflict predicted sibling differences in risky behavior over time, or vice versa. Participants were mothers, fathers, and the 2 eldest adolescent siblings (mean ages at Time 1 = 15.12 and 12.58 years) from 355 European American, working- and middle-class families. On 3 occasions over a 2-year period, mothers and fathers reported on their conflict with each of the 2 siblings, and siblings reported on their own risky behavior. Results revealed that, controlling for sibling age differences and average levels of conflict and risky behavior at Time 1, youths who had more conflict with their mothers and fathers in relation to their siblings subsequently engaged in relatively more risky behavior. Also, youths who engaged in more risky behavior in relation to their siblings experienced relatively more conflict with their fathers, but not mothers, at later time points. Findings highlight the importance of examining both family dynamics and child characteristics in understanding sibling differentiation, and illuminate potential differences in parenting processes involving mothers versus fathers.

Mother and father adjustment during early parenthood: the roles of infant temperament and coparenting relationship quality.

We explored how parent gender, infant temperament, and coparenting dynamics worked together to shape mothers' and fathers' depressive symptoms, stress, and parental efficacy during early parenthood. We were interested in the coparenting relationship as a context that shapes how parents respond to their infant's temperamental qualities. Participants were 139 couples who had recently given birth to their first child. Parent reports of temperament were collected when the infant was 4-8 months old and reports of coparenting and parent adjustment were collected at 13 months. Two-level random intercept models revealed interactions between temperament and coparenting, highlighting the family system as a context for how men and women adapt to their parenting role. There was little evidence for mother-father differences in these associations.

Coparenting around siblings' differential treatment in Mexican-origin families.

In this study we examined patterns of mothers' and fathers' differential affection and discipline toward 2 adolescent offspring in 243 Mexican-origin families. Grounding our work in a family systems perspective, we used interparental patterns of differential treatment as an index of the coparental alliance and tested their associations with parents' reports of familism values, traditional gender role attitudes, and cultural orientations. We also sought to replicate prior research on European American samples linking interparental patterns of differential treatment to marital qualities (coparenting satisfaction, love, and conflict) and adolescent depressive symptoms and risky behaviors. Three interparental patterns emerged: families in which both mothers and fathers treated their 2 offspring equally, incongruent families in which 1 parent treated both offspring equally while the other parent favored 1 offspring, and congruent families in which both parents favored the same offspring. Most parents reported equal treatment, but others fell into the incongruent affection (30%), incongruent discipline (45%), and congruent discipline (16%) groups. Mixed model analyses of variances revealed that in families in which mothers and fathers both treated their offspring equally, parents reported higher familism values, more traditional gender role attitudes, and relatively stronger orientations to Mexican than Anglo culture. Consistent with previous research, interparental incongruence was associated with less positive marital qualities and more adolescent adjustment problems. Discussion focuses on the role of culture in shaping coparenting and the processes through which these coparenting dynamics are linked to marital and youth adjustment.