Single-session interventions (SSIs) are an innovative, scalable approach for addressing the unmet behavioral and mental health needs of pediatric patients and their families. Specifically, digital SSIs, which are self-guided and delivered online, offer a low-cost and accessible approach but are currently underutilized in pediatric psychology. This topical review aims to describe SSIs broadly and the specific need for digital SSIs, explore potential applications within pediatric psychology, outline future directions and considerations, and present two examples of community-engaged digital SSI design. SSIs evidence small to medium effects across a range of mental health concerns, including distress, anxiety, and depression, supporting their broad applicability. Incorporating community voices during the development process is essential to ensure SSIs are contextually relevant in pediatric populations. Two illustrative SSIs currently in development within pediatric psychology are described: (1) an intervention supporting adolescent siblings of children with cancer and (2) a program targeting depression in adolescents with type 1 diabetes. Both examples incorporate input from key community members, underscoring the value of participatory design in enhancing intervention relevance and impact. SSIs offer a brief and scalable strategy to help address gaps in psychological care, particularly for youth and families with limited access to services. Pediatric psychologists are well positioned to develop, evaluate, and implement SSIs across diverse populations and intervention targets. Ensuring the effectiveness, equity, and sustainability of SSIs will require ongoing collaboration with community partners and integration across pediatric care settings.

This study investigated factors associated with socioemotional outcomes in preschool-aged siblings of children and adolescents/youth with chronic conditions and special care needs (CYSHCN) and examined whether parenting influences these outcomes. This cross-sectional study included 123 healthy preschool-aged siblings of CYSHCN receiving care in Brazil. Socioemotional outcomes were assessed using the Strengths and Difficulties Questionnaire (SDQ), and parenting was measured using the Parenting Sense of Competence Scale (PSOC). Data analysis included bivariate tests to explore associations between predictors and socioemotional outcomes followed by structural equation modeling (SEM) to examine direct and mediated pathways via parental sense of competence. Final model demonstrated satisfactory fit (χ2/df = 2.24, CFI = 0.969, TLI = 0.950, SRMR = 0.073, RMSEA = 0.082). Half of the preschoolers scored in the "abnormal" range (according to SDQ classification) for socioemotional difficulties, with conduct problems most prevalent. Socioemotional problems were associated with greater clinical severity of the CYSHCN. The analysis using SEM showed that parental competence mediated the relationship between CYSHCN clinical severity and healthy sibling's socioemotional outcomes (indirect effect a*b = 0.075, p = .046; 21.3% mediation). This study focused on preschool-aged children, a sensitive period for socioemotional development that remains underexplored in research on siblings of CYSHCN, and demonstrated that they are at an increased risk for socioemotional difficulties, especially when the condition of the CYSHCN is more severe. Parental competence plays a mediating role and may buffer this association, highlighting the need for interventions that strengthen parenting to promote better child outcomes.

Adolescent siblings of children with cancer are at elevated risk for psychosocial problems. Unfortunately, various barriers such as limited family time and resources, conflicting schedules, and psychosocial staffing constraints at cancer centers hinder sibling access to support. Digital, self-guided, single-session interventions (SSIs)-brief, low-cost, scalable mental health tools-have shown promise for surmounting such barriers and providing support to adolescents. This qualitative study aimed to gather perspectives from adolescent siblings, parents, and professionals to inform the development of a digital, self-guided Sibling SSI tailored to siblings' needs. Semi-structured interviews were conducted with adolescent siblings (n = 22), parents (n = 21), and psychosocial providers and community leaders (n = 14). Drawing on existing evidence-based SSIs that use a solution-focused brief therapy framework, interviews explored content, language, timing, and delivery preferences for a Sibling SSI. Content analysis was used to summarize key recommendations. Participants viewed a digital Sibling SSI as a promising approach to promote coping. Content suggestions included acknowledging common cancer-related and adolescent struggles, highlighting siblings' existing coping strategies, and offering personalized action plans. Participants emphasized the importance of sibling-centric language and creating a space exclusively for siblings. Early dissemination within 3months of diagnosis via psycho-oncology teams and community channels was recommended. Findings provide community-informed guidance to inform the development of a digital Sibling SSI aimed at surmounting barriers to care and enhancing psychosocial support for adolescent siblings of children with cancer.

This accelerated longitudinal study investigated how the COVID-19 pandemic, associated disruptions, and other risk/protective factors shaped youths' alcohol and cannabis use trajectories. Data were collected from 682 Midwestern U.S. families, each with two adolescent siblings (M = 14.44 years, SD = 1.54; 49.8% female) and one parent (M = 45.15 years, SD = 5.37; 85% mothers; 87% of participating parents identified as White, 9% as Black or African American, and 4% as another racial group; 5% were Latinx) across four waves preceding and coinciding with the pandemic (from March 2019 through May 2023). Across the full age span modeled (11.25 to 20.75 years), in addition to "non-users," two trajectory classes were identified for both alcohol and cannabis reflecting patterns of "later onset, infrequent use" and "earlier onset, more frequent use". Comparing equivalent aged youth, substance use frequency was higher during than before the pandemic in both trajectory classes and for both substances, with greater differences among earlier frequent users. Across pandemic-related experiences and risk/protective factors, substance use trajectory group membership was most consistently predicted by parent, sibling, and friend substance use, and also by family chaos and financial strain. Overall, the pandemic amplified trajectories of use among substance-using youth. As heavier substance use trajectories negatively impact role transitions, substance problems, and health, continued support across the transition to adulthood may help mitigate ongoing impacts of the pandemic.

Emerging literature suggests that neurocognitive traits commonly observed in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are present, albeit to a lesser degree, in their non-ADHD siblings. This meta-analytic review aimed to quantitatively summarize intellectual and cognitive performance differences between children and adolescents without ADHD and both their ADHD-diagnosed siblings and unrelated peers without ADHD. We implemented strategic search algorithms in four indexing databases (PubMed/MEDLINE, Web of Science, PsycINFO, and ProQuest) to retrieve potentially eligible reports published up to 5th June 2025. Meta-analyses were conducted using three-level hierarchical models to account for the dependency among effect sizes derived from the same study. Between-group differences in intellectual and cognitive scores were quantified using standardized mean differences (SMD). Moreover, we assessed the robustness of the findings by testing for potential small-study effects. Based on 404 unique effect sizes derived from 32 studies, involving a total of 8873 participants, the current results demonstrate that the overall cognitive-intellectual performance of siblings surpasses their ADHD-affected siblings (SMD=0.30, 95% CI [0.23, 0.38]), but falls short of unrelated peers (SMD=-0.28, 95% CI [-0.35, -0.21]). This suggests that non-ADHD siblings exhibit an intermediate neurocognitive profile between their ADHD-affected siblings and peers without ADHD. Notably, we observed this pattern of results consistently across the major cognitive categories examined (intellectual functioning, attention and perceptual-temporal processing, memory, and executive functions). Importantly, no evidence of small-study effects was found. The current findings provide robust support for cognitive-intellectual vulnerabilities in siblings of ADHD-diagnosed children and adolescents, possibly accounted for by genetic inheritance, shared environmental influences, and gene-environment interactions.

BackgroundWhen adolescents develop anorexia nervosa (AN), this impacts the family system and puts healthy siblings at risk of mental health problems. Siblings need support and age-appropriate information about the diagnosis to prevent negative mental health outcomes. However, evidence-based support for siblings is limited. The current study aimed to explore siblings’ perceptions of AN and parents’ beliefs about siblings’ understanding expressed within an intervention programme for siblings and parents.MethodsThis qualitative study employed a hybrid approach, integrating deductive thematic analysis using the common sense model of self-regulation as a coding framework with inductive thematic analysis. The data materials comprised (1) interviews conducted by clinicians with siblings about the AN diagnosis, (2) siblings’ understanding of AN as expressed in sibling groups, (3) parents’ beliefs about what siblings understand expressed in parent groups, and (4) parent-sibling conversations about AN. Video and audio recordings of the data were transcribed and analysed. The sample comprised nine siblings of European descent, aged 8 to 15 years, and their parents. All siblings had a sister with clinically confirmed AN.ResultsThe siblings had limited knowledge and expressed uncertainties about AN across the five themes identity (label and symptoms), causes, consequences, treatment, and timeline. In the inductive analysis, two additional themes were identified. The first, Parental perspectives on siblings’ understanding, had two sub-themes: AN as a confusing and complex disorder, and Discrepancy between siblings’ understanding of AN and parents’ beliefs about their understanding. The second theme was Barriers to communication about the diagnosis.ConclusionsThe results extend knowledge about informational support needs in siblings of adolescents with AN. Insights into what siblings and parents of adolescents with AN share about the diagnosis in different contexts can be used to guide the adaptation of interventions and policies.Trial registrationClinicalTrials.gov NCT04056884.

Although positive sibling relationships are associated with better developmental outcomes for children and adolescents, it is unknown whether siblings may be effective social buffers of physiological stress. In addition, there is little research on whether depressive symptoms may moderate the effectiveness of social buffering. The current study examined (1) whether siblings, compared to strangers, buffered the cortisol response to a social evaluative stressor in children and adolescents, (2) whether depressive symptoms moderated this effect, and (3) whether self-reported sibling relationship quality influenced sibling buffering effectiveness. A total of 72 children (9-11 years) and 65 adolescents (15-17 years) were randomly assigned to complete the Trier Social Stress Test-Online with a same-age or older sibling versus a stranger. Participants provided saliva samples to measure cortisol reactivity and recovery across the session and reported on their depressive symptoms and sibling relationship quality. The sibling versus stranger buffering effect varied based on participants' developmental stage (child vs. adolescent) and level of depressive symptoms. Specifically, adolescents with high depressive symptoms who prepared with a sibling showed lower cortisol reactivity than those who prepared with a stranger (b = 0.70, SE = 0.32, p < .05). In contrast, there were no significant differences by condition for children or adolescents with low depressive symptoms. For individuals who prepared with a sibling (n = 69), higher alienation predicted impaired cortisol recovery post-stressor (b = 0.32, SE = 0.18, p < .05). These findings are in line with research on normative development of sibling relationships and cortisol activity in the context of depression from childhood to adolescence.

Associations between cannabis use frequency and suicidal thoughts and behaviors: A clinical longitudinal sibling study

Longitudinal models typically represent change as a function of a single time metric. However, the COVID-19 pandemic prompted researchers to consider whether changes are a function of phases of the pandemic while simultaneously accommodating age. This paper proposes an extension of the discrete-time latent change score modeling framework to model wave-to-wave changes while accounting for time more precisely by including continuous time metrics via regressing out initial age and using definition variables instead of bins. The approach is motivated by and applied to data involving adolescent sibling influence in expectations about marijuana. A simulation study shows how our approach compares to models that use wave without regressing out initial age or using definition variables.

This study examined similarities in adolescent sibling and friend relationship quality over an 8-month period during COVID-19. We hypothesized that youth would perceive the qualities of their friendships and sibships in similar ways and that these patterns would remain stable during this period. Participants included 312 adolescents ( M = 15.75, SD = 1.20) who rated positive (e.g., companionship) and negative (e.g., conflict) aspects in both relationships at both times. Cross-sectional latent profile analyses supported two profiles, namely an ambivalent sibship/harmonious friendship (i.e., moderate sibling warmth and conflict, high friendship positivity, low friendship negativity) profile and an affect-intense (i.e., high positivity, high negativity) profile that were similar across both relationships. Latent transition analyses demonstrated that most adolescents fit into the ambivalent sibship/harmonious friendship profile (89% at T1, 91% at T2) relative to the affect-intense profile (11% at T1, 9% at T2). Most (97%) adolescents in the ambivalent sibship/harmonious friendship profile at T1 remained in the profile at T2, whereas 57% of youth in the affect-intense profile remained in the same profile at T2. Adolescents who remained in the affect-intense profile reported more frequent sibling and friend aggression perpetration and friend, but not sibling, aggression victimization than those who remained in the ambivalent sibship/harmonious friendship profile. These results highlight the contextual dynamics of adolescent relationships, especially the importance in recognizing the similarities among sibships and friendships.

The presence of a child with a disability significantly affects family dynamics introducing new responsibilities and altering roles. However, research also highlights the positive outcomes, such as increased family cohesion and stronger bonds among family members. Siblings face unique challenges, including emotional burdens and adjustment difficulties, which are influenced by factors such as age, severity of the disability, and parental attitudes. While some siblings develop empathy and nurture traits, others struggle with internalizing and externalizing problems. This study investigated whether families exhibit distinct interaction patterns based on the presence and type of a child's disability, considering the perspectives of healthy siblings and parents. The study comprised 179 dyads, each consisting of a healthy adolescent sibling of a child with a disability or chronic illness and one of their parents (N = 358). The sample included 49 families of children with diabetes, 49 with intellectual disabilities, 28 with motor disabilities, and 53 healthy children. To assess interaction patterns within families, the following measures were used: the Questionnaire of Relationships with Siblings to evaluate relationships between healthy adolescents and their siblings, the Parentification Questionnaire for Youth to measure emotional and instrumental parentification, the KidScreen-27 to assess quality of life, the Parental Attitude Scale-2 to assess parental attitudes, and the Family Rating Scales to evaluate family dynamics, including the structure and quality of family interactions. Latent Profile Analysis (LPA) was used to analyze data. We identified two latent profiles: "Strained Families" profile, which featured lower-quality family interactions with parents displaying greater rejection, inconsistent, and overdemanding attitudes, and the "Resilient Families" profile reflected balanced functioning with greater cohesion and flexibility. The "Strained Families" profile was more prevalent (57%). No significant differences in profile frequencies were found across the groups. Both profiles included families with children with motor disabilities, intellectual disabilities, or diabetes and healthy children. Therefore, the results suggest that family interaction patterns varied independently of the presence of a child with a disability. Notably, 64% of the families with healthy children exhibited the "Strained Families" profile, marked by lower-quality interactions and family functioning, suggesting that such interactions are not exclusive to families of children with disabilities.

This study explores the lived experiences of neurotypical siblings who have a brother or sister on the autism spectrum. Drawing on qualitative case studies of three adolescent siblings, the research investigates the emotional, social, and developmental impacts of these relationships. Through semi-structured interviews, the study identifies themes such as caregiving responsibilities, the emotional burden of unequal attention, and future caregiving concerns. The findings highlight both the challenges and growth opportunities associated with these sibling relationships. By examining these experiences within the unique cultural context of Malta, this study contributes to the broader discourse on inclusion and family dynamics in autism spectrum disorder (ASD). Implications for educational systems, family support programmes, and future policy developments are discussed.

Experiences of siblings of individuals with developmental disabilities: A meta-synthesis of qualitative studies.

Pediatric cancer diagnoses disrupt not only patients and their parents' lives, but also siblings' lives and functioning. The purpose of this study was to investigate the lived adolescent experience within the family after a sibling was diagnosed with pediatric cancer. Eight adolescent siblings of pediatric cancer survivors participated in this descriptive qualitative study. In-depth interviews and qualitative analytic method were used. The semi-structured question consisted of "experiences when the sick sibling was in treatment," "the difficulties faced as a sibling of a sick child," and "the causes of stress and how to relieve stress in the relationship with the sibling." Three themes and nine subthemes were developed from the data. The three themes comprised "worried about family," "feeling excluded," and "becoming a supporter for family." The findings of this study indicated that adolescents tended to experience worry about their family and a feeling of exclusion, but also became a supporter for their family. Healthcare providers need to suggest that parents provide emotional support for children remaining at home and express gratitude to healthy children who are overcoming a difficult situation.

This study explores the lived experiences of neurotypical siblings who have a brother or sister on the autism spectrum. Drawing on qualitative case studies of three adolescent siblings, the research investigates the emotional, social, and developmental impacts of these relationships. Through semi-structured interviews, the study identifies themes such as caregiving responsibilities, the emotional burden of unequal attention, and future caregiving concerns. The findings highlight both the challenges and growth opportunities associated with these sibling relationships. By examining these experiences within the unique cultural context of Malta, this study contributes to the broader discourse on inclusion and family dynamics in autism spectrum disorder (ASD). Implications for educational systems, family support programmes, and future policy developments are discussed.

Adolescent siblings of children and young people (CYP) with cancer are at increased risk of psychosocial difficulties, yet many remain overlooked and unsupported. This project aimed to explore the experiences and perceived needs of adolescent siblings of paediatric oncology inpatients to inform service improvement recommendations for sibling support. Semi-structured interviews were conducted with 10 siblings of CYP previously admitted to a paediatric oncology ward. Interviews were transcribed verbatim and analysed using reflexive thematic analysis. The findings were reviewed in consultation with staff and used to identify pragmatic/feasible recommendations for improving sibling support, organized using the three-tier 'Pediatric Psychosocial Preventative Health Model'(PPPHM; Families, Systems & Health, 2006, 24, 381). An overarching narrative of siblings wanting to feel part of the cancer journey was found, including their family's experience on the ward, with three key themes: (i) "what about me?": overlooked and unseen, (ii) "always changing, never knowing": the challenge of uncertainty and (iii) "let me be part of it all": togetherness, communication and connection. These findings informed sibling support recommendations. Such recommendations included providing psychosocial screening, resources and opportunities for family time/communication and developmentally appropriate information to all siblings (universal support), monitoring psychosocial difficulties, siblings having someone to talk to and fostering family and peer connection for siblings requiring additional support (targeted support) and offering one-to-onepsychological support and family therapy for persistent and/or escalating distress (clinical/treatment support). Based on the experiences of siblings, a range of sibling support recommendations have been identified. Implementation and evaluation of these recommendations are warranted.

Joubert Syndrome (JS) is a congenital cerebellar ataxia typically inherited in an autosomal recessive pattern, although rare X-linked inheritance can occur. It is characterized by hypotonia evolving into ataxia, global developmental delay, oculomotor apraxia, breathing dysregulation, and multiorgan involvement. To date, there are 40 causative genes implicated in JS, all of which encode proteins of the primary cilium. Primary cilia play a crucial role in the normal development and function of many organs, including parts of the brain (cerebellum and brainstem), kidneys, and the retina. This likely explains the multiorgan involvement seen in JS. In this report, we present the first genetically confirmed case of JS in two Filipino adolescent siblings who had early onset ataxia, hepatomegaly, and global developmental delay. A cranial CT scan revealed the Molar Tooth Sign (MTS). Whole Exome Sequencing (WES), performed via buccal swab, showed biallelic pathogenic variants at NM_153704.6:c.2086C > T (NP_714915.3:p.Leu696Phe) and NM_153704.6:c.431del (NP_714915.3:p.Leu144CysfsTer19) in TMEM67, which are associated with Joubert Syndrome 6 (OMIM:610688) in a compound heterozygous state. The prevalence of NM_153704.6:c.2086C > T (NP_714915.3:p.Leu696Phe) in TMEM67 variant is very rare (< 0.001%), and the NM_153704.6:c.431del (NP_714915.3:p.Leu144CysfsTer19) has not been recorded. This case contributes valuable information to the expanding knowledge of JS and its related disorders.

Sexual minority adolescents experience puberty earlier than their heterosexual peers. Early puberty is an indicator of premature aging and can be partly driven by chronic stress linked to discrimination. Nonetheless, the neural, cognitive, and social development linked to puberty enables adolescents to explore and understand their sexual identities. For sexual minority youth, does the stress from identity-based discrimination make them more likely to experience advanced pubertal timing, or is early pubertal timing the impetus for their self-identification with a sexual minority identity? To answer this research question, the present study leveraged longitudinal and national data to test the temporal ordering between sexual minority self-identification and pubertal timing among one sample of 7,818 unrelated adolescents and another sample of 4,050 adolescent siblings nested across 1,989 households in the United States. Across both samples, results illustrated significant bidirectional relations between pubertal timing and sexual minority self-identification. Adolescents who self-identified as sexual minorities experienced more advanced pubertal timing 1 year later, and adolescents who experienced more advanced pubertal timing were more likely to identify as sexual minorities 1 year later. While the longitudinal link between pubertal timing and later sexual minority self-identification may be a normal developmental process, the longitudinal link between sexual minority self-identification and subsequent advanced pubertal timing may be attributable to heterosexist stigma. The present findings underscore the need to mitigate prejudice so that all adolescents have the freedom to explore their identities without risks to their development. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Sibling aggression is the most common form of domestic violence, which can have a negative impact on both child and adolescent mental health. The few previous studies that investigated aggression between siblings, assessed aggression primarily through self- or parent-report, with the limitation of reporter bias. The current study examined whether an interactive Virtual Reality (VR) experiment can provide a valid assessment of adolescents’ aggressive responses towards their sibling by testing congruence with other similar measures and by examining associations of known risk factors for sibling aggression with the aggression observed in the VR experiment. Pairs of young adolescent siblings (N = 26; aged 8–15 years) were invited to the lab to complete several questionnaires and participate in a custom-made interactive VR experiment. In the VR experiment, participants interacted with their virtual sibling both verbally and physically. Participants’ responses to the virtual sibling’s behavior, designed to provoke anger and aggression, were observed during two different VR scenarios. Results showed that observed aggression as measured in the VR experiment was related to self-reported aggression, but not to parent- or sibling-reported aggression. Individual factors (e.g., behavioral problems) or sibling factors (e.g., age difference between siblings) were not related to observed aggression. Of the investigated family factors, only the perceived quality of the father-child relationship was associated with observed aggression. Despite the limited alignment with parent- and sibling-reported aggression, these findings highlight the potential of VR-based assessments to complement self-report methods, emphasizing the need for a multimethod approach to capture the complexities of sibling aggression.

Parents and typically developing (TD) youth siblings of individuals with intellectual and/or developmental disabilities (IDD) often experience greater caregiving burden, stress, and hardships in family functioning. They are at increased risk of family conflict and youth adjustment problems when TD siblings are adolescents since they need to balance caregiving responsibilities and various changes that naturally occur during adolescence. However, there is a lack of intervention research on parents and TD adolescent siblings that focuses on family conflict and family-wide participation. This study analyzed whether participating in a brief family intervention could improve families’ knowledge of marital and family-wide conflict and TD adolescents’ adjustment problems. We found that mothers and fathers significantly improved their knowledge of marital conflict and that TD adolescents significantly improved their knowledge of family-wide conflict. We also found that fathers reported significant reductions in internalizing and externalizing problems in TD adolescents. The findings support the impact of even brief evidence-based interventions targeting family-level improvements for families with both TD adolescent siblings and individuals with IDD. The findings also accentuate the significance of involving both mothers and fathers in family intervention research, suggesting that different caregivers may experience both shared and unique benefits from participating.