Psychosocial Interventions and Support Groups for Siblings of Individuals with Neurodevelopmental Conditions: A Mixed Methods Systematic Review of Sibling Self-reported Mental Health and Wellbeing Outcomes

Clinical Child and Family Psychology Review https://doi.org/10.1007/s10567-022-00413-4 Psychosocial Interventions and Support Groups for Siblings of Individuals with Neurodevelopmental Conditions: A Mixed Methods Systematic Review of Sibling Self‑reported Mental Health and Wellbeing Outcomes Brittany Wolff1,2 · Iliana Magiati1 · Rachel Roberts3 · Rachel Skoss2,4,5 · Emma J. Glasson2,6 Accepted: 9 September 2022 © The Author(s) 2022 Abstract Siblings of persons with neurodevelopmental conditions (NDCs) have increased risk of poorer psychosocial functioning. This systematic review evaluated quantitative and qualitative evidence on sibling mental health and wellbeing outcomes following psychosocial interventions and the risk and protective factors associated with post-intervention outcomes. From 2025 identified studies published from 1991 to 2022 across ten databases, 24 studies were included. The largest immediate post-intervention improvements were in self-esteem, social wellbeing and knowledge of NDCs. The most sustained improvements in intervention groups at follow-up periods were in emotional and behavioural adjustment and NDC knowledge. There were positive, but small, differences in favour of the intervention groups on knowledge of NDCs, self-esteem, coping and the sibling relationship as compared to waitlist control groups. Psychosocial interventions for siblings are heterogeneous, and more data, including consideration of unique family circumstances, are needed to improve reporting and replicability, to measure effectiveness and tailor necessary supports. Keywords Neurodevelopment · Disability · Sibling · Mental health · Wellbeing · Intervention · Outcome Introduction In the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013) individuals with neurodevelopmental disorders (hereafter neurodevelopmental conditions; NDCs) include those with intellectual disabilities, autism spectrum disorder, * Brittany Wolff 1 School of Psychological Science, The University of Western Australia, Perth, Australia 2 Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia 3 School of Psychology, The University of Adelaide, Adelaide, Australia 4 Institute for Health Research, The University of Notre Dame Australia, Perth, Australia 5 School of Population and Global Health, The University of Western, Perth, Australia 6 Discipline of Psychiatry, Medical School, The University of Western Australia, Perth, WA, Australia attention-deficit/hyperactivity disorder (ADHD)1 and specific learning, communication and motor disorders (American Psychiatric Association, 2013). NDCs are a group of conditions with onset in the developmental period, characterised by developmental difficulties that produce impairments of personal, social, academic and/or occupational functioning. Many siblings of individuals with NDCs face unique individual and family challenges associated with their sibling’s condition (Hayden et al., 2019; Marquis et al., 2019).2 Meta-analyses indicate that, overall as a group, siblings of persons with NDCs experience a small yet significant overall 1 We have included in this review neurodevelopmental conditions (NDCs) based on the DSM-5 and DSM-5-TR (text revision, APA, 2022) and the ICD Classification of Mental and Behaviour Disorders, 10th and 11th edition (ICD-10/11; World Health Organisation, 1993). Using these diagnostic criteria, ADHD in organised under the category of an NDC. 2 Although we appreciate and respect that different groups and individuals prefer personalised language conventions, this review adopts person-first language (i.e., person with disability; (Folkins, 1992; Research and Training Center on Independent Living, 2008; Smart, 2001). This decision was made after consultation with sibling consumers and the Sibling Advisory Panel. However, for autism-related discussion, identity-first language will be used (i.e., autistic sibling; see Bottema-Beutel et al., 2021). For the purposes of this review, the 13 Vol.:(0123456789) Clinical Child and Family Psychology Review negative impact on psychological and neurocognitive development and functioning compared to siblings without disabilities (Rossiter & Sharpe, 2001; Vermaes et al., 2012), with negative impact greatest for siblings of autistic children (Shivers et al., 2019). Siblings may experience increased risk of stress, anxiety, depression and related adjustment difficulties (Sharpe & Rossiter, 2002; Shivers et al., 2019; Vermaes et al., 2012), overall poorer mental health and wellbeing (Giallo et al., 2012; Marquis et al., 2019) and lower selfconcept and more behaviour problems (Fisman et al., 2000) than comparison groups of siblings of individuals without NDCs, the general population or normative samples (Lin et al., 2021; Marquis et al., 2020). Reviews on outcome studies of siblings of individuals with heterogeneous disabilities including mixed groups of participants with chronic physical or psychiatric conditions as well as NDCs report both negative and positive effects of having a sibling with a disability (Knecht et al., 2015; Mandleco & Webb, 2015; Marquis et al., 2020; McKenzie Smith et al., 2018), while qualitative syntheses emphasise positive effects more prominently, finding that siblings may experience increased empathy, maturity, understanding, patience and love (Cridland et al., 2014; Lamsal & Ungar, 2021; Leedham et al., 2020; Lummer-Aikey & Goldstein, 2021; Watson et al., 2021). Previous sibling studies have identified a range of individual, family and structural level risk and resilience-promoting factors that may influence sibling wellbeing outcomes. Examples include low socioeconomic status, single parent families, belonging to a non-Western or non-Caucasian minority group (Marquis et al., 2019; Viswanathan et al., 2021), parental mental health conditions or stress (Chen et al., 2019), higher NDC severity, more externalizing behavioural problems (Pollard et al., 2013) and reduced access to services (Pavlopoulou & Dimitriou, 2020). Conversely, protective factors include higher perceived social support (Koukouriki et al., 2021), more effective family communication and cohesion (Okashah et al., 2015; Pavlopoulou & Dimitriou, 2019), better family knowledge of NDCs (Hastings & Petalas, 2014; Haukeland et al., 2020) and the quality of the sibling relationship (Pollard et al., 2013), amongst others. These factors may influence both sibling outcomes more broadly as well as influence the extent to which some siblings may benefit more from interventions and supports as compared to others (Tudor & Lerner, 2015). Footnote 2 (continued) term sibling refers to a sibling of an individual with a neurodevelopmental condition/disability (NDC) or developmental disability; individual with an NDC or disabled sibling refers to the individual in the sibling dyad who has been diag (...truncated)