The literature on the experience of siblings of children with autism spectrum disorder (ASD) has been growing in recent years. However, most studies have been conducted in Western countries. This study aimed to address this gap by conducting a thematic analysis on childhood experiences of typically developed (TD) siblings of children with ASD in Iran, exploring their challenging and positive experiences along with the support they received and would have needed. In this regard, five adult TD siblings who grew up with an ASD sibling in Iran were interviewed about their childhood experiences. The analysis of the interviews resulted in six main themes: Experience of distress and personal growth, Complex sibling dynamics: challenges and joys, Challenges within the family, Informal support as the main resource, Inadequate formal support, and Social and cultural barriers This study indicated that the Iranian TD siblings experienced emotional difficulties, challenges in interactions with their ASD siblings, and challenges in their families. Despite these issues, positive outcomes such as personal growth and enhanced empathy were also reported. This study also underscored the critical role of both informal and formal support systems, highlighting a significant gap in professional support and a lack of societal understanding of ASD within the Iranian context. Recommendations include developing formal supports adjusted to the unique needs of TD siblings considering their social and cultural context.

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Stressrelaterade besvär ökar bland ungdomar och majoriteten av studenter upplever stress flera dagar i veckan. Tidigare forskning har visat att det finns samband mellan stress och egenförmåga, egenförmåga och socialt stöd och mellan stress och socialt stöd. Viss forskning visar även att plats i syskonskaran har ett samband med egenförmåga. Syftet med studien var att undersöka dessa samband ytterligare. De frågor som formulerades var (a) Finns det samband mellan stress, egenförmåga och socialt stöd? (b) Kan upplevt socialt stöd och upplevd egenförmåga predicera stress hos studenter? (c) Finns det skillnad mellan studenter som är yngstabarn, mellanbarn eller äldstabarn när det gäller stress, egenförmåga och socialt stöd? Deltagarna var 41 programstudenter, 37 kvinnor och 4 män (M = 25.88, SD = 5.6). Etablerade frågeformulär användes för att mäta stress, egenförmåga och socialt stöd med Cronbachs alfa på .80, .89 och .85. Data analyserades med hjälp av korrelationsanalys, regressionsanalys och oberoende envägsANOVA. Resultatet visade att (a) stress hade ett medelstarkt positivt samband med egenförmåga (r = .55, p <.01), att (b) egenförmåga hade ett medelstarkt positivt samband med socialt stöd (r = .37, p <.05) och att (c) det inte fanns något samband mellan stress och socialt stöd. Det var endast egenförmåga som predicerade stress (R = .52, p <.01). Inga skillander fanns mellan syskonplacering kopplat till stress, egenförmåga samt socialt stöd. Resultaten var delvis i linje med tidigare forskning, dock med ett oväntat resultat angående avsaknad på samband mellan stress och socialt stöd. Resultatet diskuteras utifrån möjliga kulturella skillnader. / Stress-related disorders are increasing among adolescents and the majority of students experience stress several days a week. Previous research has shown that there is a link between stress and self-efficacy, between self-efficacy and social support and between stress and social support. Research has also shown that birth order has a link to self-efficacy. The purpose of this study was to investigate these relationships further. The questions for the study was (a) Is there a connection between stress, self-efficacy and social support? (b) Can social support and self-efficacy predict stress among students? (c) Is there a difference between students depending on birth order when it comes to stress, self-efficacy and social support? The participants were 41 students, 37 women and 4 men (M = 25.88, SD = 5.6). Established questionnaires were used to measure stress, self-efficacy and social support, with Cronbachs alpha of .80, .89 and .85. The data was analyzed by using correlation analysis, multiple regression analysis and independent one-way ANOVA. The results showed that (a) stress had a positive, medium strong correlation with self-efficacy (r = .55, p <.01), and (b) self-efficacy had a positive, medium strong correlation with social support (r = .37, p <.05) and that (c) there was no correlation between stress and social support. Self-efficacy predicted stress (R = .52, p <.01). No differences were found regarding sibling position was correlated with stress, self-efficacy and social support. The results were partially in line with previous research, however, an unexpected result were regarding the absence of correlation between stress and social support. The results are discussed on the basis of possible cultural differences.

Professionals in early intervention have little information about the levels of sibling involvement in intervention, factors that contribute to sibling involvement, or how sibling involvement is related to families’ perceptions of self-efficacy. Few studies have investigated siblings in early intervention, and none have focused on relationships between sibling involvement in early intervention and parent self-efficacy. Using quantitative survey research this study investigated factors related to sibling involvement in early intervention strategies. Respondents completing the survey consisted of 129 parents who had a child enrolled in Michigan’s early intervention program, and at least one sibling in the home. Results indicated a significant relationship between sibling use of early intervention strategies and 1) the region in which the family lives, and 2) the age difference between the siblings in each sibling dyad. Practical implications of the findings are discussed.

This thesis offers a broad approach in elucidating biological risk factors, as well as psychological and social functioning in schizophrenia. The aims are as follows: (I) investigate the association between birth characteristics and schizophrenia, (II) study the association between levels of neurotransmitter neuropeptide Y (NPY) in cerebrospinal fluid (CSF), social function and longitudinal outcome in schizophrenia, (III) compare social functioning of patients with schizophrenia with their biological siblings and (IV) explore how siblings to patients with schizophrenia perceive the sibling relationship and their role. Paper I was a cohort analysis of 11,360 same-sexed twins in which obstetric records were used. Low birth weight and small head circumference were associated with later development of schizophrenia. To some extent the results persisted in the within-pair analyses conducted on 82 pairs discordant for schizophrenia. Fifty-six patients with schizophrenia were included in paper II. Levels of NPY in CSF correlated to social competence at index admission. For each standard deviation increase in baseline NPY, there was a concomitant increased risk of being unemployed, having moderate or severe symptoms or recent hospitalization at the 3-year follow-up. In paper III, social functioning was investigated using the Swedish version of the videotaped test Assessment of Interpersonal Problem Solving Skills (AIPSS) in 70 participants (25 patients with schizophrenia, 20 siblings and 25 randomly selected controls). The patients presented severe deficits in social functioning. The siblings expressed subtle impairments in nonverbal language but did not generally differ from the controls. To explore the siblings’ perspective on schizophrenia a qualitative study was conducted with interviews of 16 siblings in paper IV. A unifying major theme was an emotional sibling bond. Siblings developed several coping patterns, including avoidance, isolation, normalization, care giving and grieving. A third major theme consisted of the fear of inheriting schizophrenia. In conclusion, fetal growth, altered levels of NPY in CSF and subtle impairments in nonverbal social behavior might be important risk factors in schizophrenia. Patients with schizophrenia revealed extensive impaired social functioning, and from the siblings’ perspective, a brother or sister’s diagnosis of schizophrenia seems to have a profound psychological impact on the siblings.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

This thesis is focused on the current concept of coping with stressful situations and the concept of posttraumatic growth of healthy siblings of disabled children. The first part of this thesis deals with stressful situations throughout the life of healthy sibling. The work describes the ways of coping with difficult life situations as well as coping strategies oriented to the future (proactive coping). It also focuses on the positive effects of this experience within the concept of posttraumatic growth. The empirical part presents the data obtained from nine respondents. There were used these methods: interview, narrative inspired by life-story, questionnaire PTGI-CZ and PCI questionnaire. The data were elaborated by means of qualitative and quantitative methods. The aim of the thesis was to identify the coping strategies used by siblings and identify potential posttraumatic growth. The most considerable development was reflected in the areas of "appreciation of life" and "personal growth". The most helpful coping strategies were considered to be positive thinking and positive reappraisal of a situation. We believe that these research findings might be helpful in counselling for siblings or in the area of psychotherapy.

Trauma and grief often co-occur, however the degree to which these two constructs overlap or are distinguishable is still poorly understood. Homicidally bereaved individuals are exposed to both trauma and loss-related stressors. Previously collected data were used to explore the relationship between trauma and grief components in homicide bereavement distress, and whether homicide bereavement distress was distinguishable from that of other adverse life events. The overarching research question for this study was: Are event and loss related distress distinguishable among siblings bereaved by homicide,1 as measured on the Impact of Event Scale-Revised (IES-R)? Data from 67 individuals who lost a sibling to murder while growing up (Murder Group) were compared to data from 80 comparison individuals who grew up with a sibling (Comparison Group), but who had no experience of homicide bereavement. A cross-sectional, iterative survey design using group comparisons was used. Participants in the Murder Group reported significantly higher levels of current subjective distress compared with the Comparison Group. Among the siblings bereaved by the homicide loss of a sibling, event- and loss-related subjective distresses were highly and significantly correlated. In addition, both decreased significantly over time (years), and at similar rates. Preliminary findings from exploratory analyses of the IES-R provide insight into the avoidance, intrusion, and hyperarousal components of subjective distress following homicide loss. Findings will inform understanding of the overlap, and distinguishing features, of concurrent trauma and grief. Implications for theory and empirical research are noted, and recommendations for future research and counselling practice are discussed. / Graduate / 2017-09-13 / simpson9@uvic.ca

Submitted by JOSIANE SANTOS DE OLIVEIRA (josianeso) on 2017-10-13T13:02:58Z No. of bitstreams: 1 Daiana Fernandez Garcia_.pdf: 543125 bytes, checksum: b7d521e52dd6ee0e6d69e04532717e5b (MD5) / Made available in DSpace on 2017-10-13T13:02:58Z (GMT). No. of bitstreams: 1 Daiana Fernandez Garcia_.pdf: 543125 bytes, checksum: b7d521e52dd6ee0e6d69e04532717e5b (MD5) Previous issue date: 2017-10-01 / HCPA - Hospital de Clínicas de Porto Alegre / O estímulo ao vínculo familiar deve ser iniciado antes mesmo do nascimento, não podendo ser interrompido ou atrasado em razão de uma internação que, algumas vezes, ocorre por um longo período, dependendo da doença do recém-nascido. Por esse motivo e para a criação de um vínculo precoce, a separação dos irmãos, em razão da internação, deve ocorrer de forma branda apenas minimizando a convivência. Acolher o irmão visitante de maneira orientada permite que a relação não seja interrompida. A pesquisa teve como objetivo descrever a percepção do irmão ou irmã na visita ao recém-nascido internado no contexto da unidade de cuidados intermediário neonatal em um hospital universitário de Porto Alegre no Rio Grande do Sul. Como meta do estudo, elaborou-se uma cartilha de orientação para crianças e pais sobre a visita na unidade neonatal. Trata-se de um estudo qualitativo, exploratório-participativo realizado em uma unidade de terapia intensiva neonatal. Foram realizadas seis entrevistas semiestruturadas com irmãos e irmãs visitantes de pacientes internados em leitos de cuidados intermediários, uma vez que esses pacientes estão em preparação para alta hospitalar. Após transcrição das falas, e uma vez estas submetidas a análise de conteúdo, foram identificadas, quatro categorias emergentes: visita, espaço físico, cuidadores e motivo da internação. Através do estudo, ocorreu uma sensibilização da equipe assistencial acerca da visita. Evidenciou-se que todos os participantes consideraram a experiência como positiva, não somente os irmãos visitantes. O ambiente hospitalar não causa medo aos participantes, já que comparam a internação da mãe (de curta permanência) com a do bebê e não associam prematuridade e nascimento a doença. Também se identificou que é necessária uma maior integração da equipe assistencial com a inserção da família na unidade para a formação de vínculos e em relação a orientações básicas, como rotinas da unidade e higienização de mãos. / The stimulus to family bonding must be initiated even before birth, without being interrupted or delayed due to hospitalization, once that, it might occur for a long period depending on the disease of the newborn. For this reason and for the creation of an early bond, the separation of the siblings, due to hospitalization, must happen softly, only minimizing the familiarity. Welcome the visiting sibling in an guided way allows the relationship not to be interrupted. The research aimed to describe the perception of the sibling in the visit to the hospitalized newborn in the context of the neonatal intermediate care in an university hospital of Porto Alegre in Rio Grande do Sul. As a goal of the study, an orientation booklet for children and parents was prepared about visiting the NICU. This is a qualitative study, performed in an intensive care unit. Six semi-structured interviews were conducted with the visiting brother or sister of the patient admitted to intermediate care beds, since that these patients are in preparation for discharge from hospital. After the transcriptions of the speeches and submitted to content analysis, four categories: visiting, physical space, caregivers and reason for hospitalization. Through the study, there was an awareness of the care team regards to the visit. It was concluded that all participants considered the experience as positive, not only to the visiting siblings as the parents and nursing team. The hospital environment does not cause fear to the participants since they compare the hospitalization of the mother (short stay) with the baby’s and do not associate prematurity and birth to the disease. Also, it was identified that it’s needed greater integration of the assistance team with the insertion of the family in the unit, in the creation of bonds and regards to basic orientation such as unit routine and hands hygiene.

This study developed a comprehensive framework for understanding the process of sibling adjustment to pediatric acquired brain injury (ABI). Grounded theory methodology was employed to inductively explore the issues siblings perceived to be their main concerns and how they managed these concerns. Fifty-three interviews were conducted recursively with twenty child and adolescent siblings of individuals with an ABI, four adult siblings of individuals with an ABI and four child and adolescent siblings of individuals with congenital disability. Observational and secondary data from hospital staff and parents were also analyzed. The framework was developed and verified through simultaneous data collection and analysis (Glaser, 1978; Strauss & Corbin, 1990). The main issue of concern for siblings following their brother or sister's ABI was the loss of equilibrium in their lives. Losing equilibrium was defined by the concepts of vulnerability and emotional turmoil. Specifically, following ABI, siblings were confronted with the vulnerability of their assumptive world, which was influenced by their exposure to unforeseen circumstances, mortality, the enduring nature of their brother or sister’s injury, and the perceived vulnerability of their family unit. In response to these losses, siblings experienced emotional turmoil, including acute anxiety, chronic worry, ambivalent emotions and disenfranchised grief. Losing equilibrium was an ongoing concern for siblings that threatened their sense of security, safety, predictability and control for many years post injury. To manage these ongoing concerns, siblings employed a variety of interrelated strategies to regain equilibrium. These strategies were conceptualized by the concepts, navigating and sacrificing. The purpose of these strategies was to restore safety, predictability and control in the siblings' environment. Navigating required siblings to negotiate the enduring disequilibrium in their lives, by challenging new rules with old tools, withdrawal, trying and buying, merging the familiar and the unfamiliar and integrating. Sacrificing required siblings to relinquish their needs and desires to regain equilibrium and was illustrated through the concepts, surrogate parent, surrendering parental attention, emotional repression, and self-blame. These self-sacrificing strategies appeared to influence siblings' long-term personal development. For instance, siblings believed that they became more responsible, understanding, tolerant, and cautious in everyday activities. The data indicated that these personal changes subsequently maintained siblings sacrificing behaviors. Although sacrificing strategies were employed by some siblings from the time of the ABI, most siblings mastered their loss of equilibrium through the navigating process. Like the non-finite nature of losing equilibrium, regaining equilibrium was an ongoing cyclical process. Rather than focusing on adjustment outcomes only, the current study has extended previous research by providing a framework for understanding the process of sibling adjustment to ABI. This framework provides a set of integrated categories, concepts, hypotheses and propositions to inform future research and practice.