Alex Psihogios

Training Track: Clinical

Lab: CHAT Lab

Advisor: Grayson Holmbeck, Ph.D.

Masters Thesis Title

Agreement and Disagreement in Parent and Child Perception of Spina Bifida Medical Responsibilities during the Transition to Adolescence

Masters Thesis Abstract

Objective This study aimed to investigate relations between mother-child disagreements and agreements over SB medical tasks, family conflict, and medical adherence. Method One hundred forty youth with SB and their mothers participated. Youth with SB and mothers completed questionnaires regarding who is responsible for specific SB medical tasks and family conflict. An observational measure was also utilized to assess family conflict. Mothers completed a questionnaire regarding medical adherence. Results Although youth with SB generally viewed themselves as more independent than mothers viewed them, disagreements were not associated with family conflict or medical adherence. Interaction effects revealed that adherence was better when family conflict was low and when parents, rather than children, were responsible for managing SB medical tasks. Conclusions Parental involvement in SB medical care is essential for optimal medical adherence during pre- and early adolescence. Longitudinal work is needed to evaluate whether parental involvement in medical tasks and mother-child disagreements over such tasks are adaptive over time.

Masters Thesis Committee

Grayson Holmbeck and Amy Bohnert

Dissertation Title

A Concurrent and Longitudinal Examination of a Bio-neuropsychosocial Model for Predicting Medical Adherence and Responsibility in Youth with Spina Bifida

Dissertation Abstract

Objectives:The purpose of this longitudinal, multi-method, and multi-informant study was to examine biological, neuropsychological, and social (family and peer functioning) predictors of medical adherence and responsibility in a pediatric spina bifida (SB) sample. Methods: Youth with SB (N = 118; M age = 11.31 at Time 1) and their parents, close friend, and teacher participated in two, biennial study time points. Multinomial logistic regressions tested predictors of group membership (adherent/nonadherent and child responsible/not responsible with SB medical tasks; four groups total). Results: Consistent with the bio-neuropsychosocial model of adjustment, several risk factors emerged as important considerations for providers who work with children with SB. Impaired gross motor classification and low IQ were identified as barriers to obtaining medical responsibility, and high family stress and executive dysfunction as barriers to adherence and responsibility. Conclusions: This study offered targeted foci for medical interventions for youth with SB.

Dissertation Committee

Grayson Holmbeck, Kathy Zebracki, Tina Drossos, Catherine Haden