Caitlin Mccombs Prentice

• Prentice, Caitlin Mccombs; Orm, Stian; Kirchhofer, Solveig Melanie; Fredriksen, Trude; Botta, Matteo & Zahl, Erica [Show all 8 contributors for this article] (2026). Family Factors Associated with Teacher-Rated Mental Health for Siblings of Children with Chronic Disorders. School Mental Health. ISSN 1866-2625. doi: 10.1007/s12310-026-09866-2. Full text in Research Archive Show summary

  Siblings of children with chronic disorders are at risk of mental health problems, with risk factors including both individual-level characteristics and home-based, family-level factors. Such risk factors tend to inter-correlate, making non-family perspectives, such as those of teachers, an important part of a multi-informant approach to assessing sibling mental health. We investigated whether sibling-, mother- and father-reported family-level factors were associated with teacher-rated mental health of siblings in Norway. We used data from 127 teachers reporting on siblings’ mental health (sibling M age = 10.3 years, SD  = 2.0, 53.4% girls, 46.5% boys) to examine associations with familial factors reported by 113 mothers, 85 fathers, and 118 siblings of children with chronic disorders. We found that sibling-reported difficulties with adjustment to living with their brother or sister with a chronic disorder was moderately associated with more teacher-rated internalizing problems for siblings. Lower father-reported family social support was moderately associated with more teacher-rated externalizing problems for siblings. These associations remained significant in multivariate analyses examining all factors simultaneously as predictors of teacher-rated mental health and controlling for sibling age and sex. Emotional and behavioral problems of the child with a chronic disorder, parental mental health, and age difference between the sibling and the child with the disorder were not associated with teacher-rated mental health. Our findings suggest that teachers can detect mental health difficulties in siblings and therefore can be valuable informants on sibling mental health as part of a broader multi-informant approach.

• Prentice, Caitlin Mccombs; Wehrli, Susanne; Zahl, Erica; Orm, Stian; Botta, Matteo & Vatne, Torun Marie [Show all 9 contributors for this article] (2026). Parent–Teacher Discrepancies About the Mental Health of Siblings of Children With Chronic Disorders: A Latent Profile Analysis. Journal of Emotional and Behavioral Disorders. ISSN 1063-4266. 34(2), p. 106–116. doi: 10.1177/10634266261417609. Full text in Research Archive Show summary

  Siblings of children with chronic disorders are at an increased risk of internalizing and externalizing problems, but the extent to which this is true varies depending on who rates sibling mental health. We examined interrater discrepancies between teachers and parents who rated the behavior of siblings of children with chronic disorders on the Strengths and Difficulties Questionnaire (SDQ) and investigated possible predictors of these discrepancies. We used Latent Profile Analysis (LPA) to identify classes of siblings with higher and lower levels of discrepancy between raters. Predictors of interrater discrepancy were also examined, including sibling age and sex, and the impact of the disorder. We identified four distinct classes of siblings with differing levels of interrater discrepancy and internalizing and externalizing problems. Sibling sex had a small effect on classes, with girls less likely to be included in the discrepant classes. Neither sibling age nor the impact of the disorder predicted being included in discrepant classes. Our findings reflect previous research showing that sibling experiences and outcomes tend to vary between individuals and across settings and that teachers tend to report fewer problems of different types than parents. Further research is needed to better understand predictors of these interrater discrepancies.

• Prentice, Caitlin Mccombs; Aanesen, Anna; Syverstad, Amalie Kirkedelen; Vatne, Torun Marie & Fjermestad, Krister Westlye (2025). Communication quality between parents and siblings of children with chronic disorders. PEC Innovation. 7. doi: 10.1016/j.pecinn.2025.100419. Full text in Research Archive Show summary

  Objective This study examines parent-sibling communication during a manual-based group intervention (SIBS) that aims to improve communication quality and well-being for siblings of children with a chronic disorder diagnosis. Methods Audio recordings and transcripts of 20 parent-sibling conversations were analyzed using the manual-based tool Verona Coding Definition of Emotional Sequences (VR-CoDES). We measured siblings' negative expressions and parental responses, focusing on how parents applied the SIBS target behaviours of listening, exploring and validating responses. Results Siblings raised topics such as heritability of the chronic disorder, differential treatment, and instances of violence and temper tantrums. Siblings' negative expressions were 53 % cues (implicit expressions) and 47 % concerns (explicit expressions). Parents provided space in 74 % of the responses to cues and concerns, meaning they gave space for further disclosure. Within these responses, parents applied the SIBS target behaviours, including exploration (59 %), validation (33 %), and listening (8 %). Conclusion Parents mainly provided space and used a warm tone when responding to siblings in the SIBS sessions. Responses included a higher proportion of validation responses and a lower proportion of listening responses compared with previous studies. Innovation Parents and siblings of children with chronic disorders face unique challenges that can negatively impact the quality of parent-sibling communication and psychological adjustment in siblings. This study contributes new insight into how parents and siblings communicate in an intervention setting, and how characteristics of the intervention may influence the quality of this communication.

• Kirchhofer, Solveig Melanie; Fredriksen, Trude; Orm, Stian; Botta, Matteo; Zahl, Erica & Moreira, Hugo Cogo [Show all 11 contributors for this article] (2025). Effectiveness of a group intervention to improve mental health in siblings of children with chronic disorders: a cluster randomized controlled trial. Journal of Pediatric Psychology. ISSN 0146-8693. 50(6), p. 443–453. doi: 10.1093/jpepsy/jsaf021. Full text in Research Archive Show summary

  Objective: We evaluated the effectiveness of SIBS, a preventive intervention for siblings and parents of children with chronic disorders (CDs). Methods: This two-arm, unmasked cluster randomized controlled trial registered on ClinicalTrials.gov (NCT04056884), included 288 siblings (M age ¼ 10.4 years, SD ¼ 1.9) and parents of children with CDs (mainly neurodevelopmental disorders) randomly assigned to intervention (k ¼ 34, n ¼ 137) or waitlist control (k ¼ 35, n ¼ 151) groups. Eligible siblings were aged 8–16 years and had a sibling diagnosed with a CD. SIBS is manual-based and was delivered as five sessions over 2 weeks in primary care and hospital settings across Norway. Three sessions are separate for siblings and parents, and two are integrated sibling–parent dialogues. The primary outcome was sibling mental health, rated by siblings, parents, and teachers. The secondary outcome was parent–child communication, rated by siblings and parents. Analyses included intention-totreat (ITT) and complier average causal effects (CACE). Results: Although not statistically significant, at 3-month follow-up, the intervention group showed fewer mental health problems (ITT: siblingrated d ¼ −0.16, 95% CI [−0.49, 0.17]; parent-rated d ¼ −0.10, 95% CI [−0.48, 0.12]; teacher-rated d ¼ −0.18, 95% CI [−0.50, 0.29]) and higherquality parent–child communication (ITT: sibling-rated d ¼ 0.21, 95% CI [−0.10, 0.52]; parent-rated d ¼ 0.24, 95% CI [−0.07, 0.55]) compared to waitlist. Conclusions: The SIBS intervention demonstrated small, consistent positive effects on sibling mental health and parent–child communication. This suggests SIBS is a promising preventive program for siblings of children with CDs. Keywords: siblings, parents, intervention, prevention, randomized controlled trial.

• Fredriksen, Trude; Orm, Stian; Prentice, Caitlin Mccombs; Kirchhofer, Solveig Melanie; Zahl, Erica & Botta, Matteo [Show all 8 contributors for this article] (2025). Disorder Type and Severity as Predictors of Mental Health in Siblings of Children with Chronic Disorders. Journal of Autism and Developmental Disorders. ISSN 0162-3257. doi: 10.1007/s10803-025-06771-6. Full text in Research Archive Show summary

  Siblings of children with chronic disorders are at risk of developing mental health problems. Studies are inconclusive about whether sibling mental health is best predicted by the specific diagnoses of the child with disorder or by transdiagnostic factors. The aims of the present study were (1) to examine if specific diagnoses predicted sibling mental health, and (2) to examine if disorder severity in the child with the chronic disorder predicted sibling mental health. Baseline data from a randomized controlled trial were used. Siblings (aged 8 – 16 years) of children with chronic disorders and their parents were recruited from eight municipality and hospital clinics (N = 288). The children with chronic disorders were placed in ICD-10 diagnostic categories based on combined parent report and clinical records. Regression analyses with the most frequent primary diagnoses (ADHD, Asperger syndrome, autism, down syndrome, rare disorders) and a measure of disorder severity as predictors of sibling mental health were run. Father-reported disorder severity predicted sibling-reported internalizing problems and father-reported internalizing and externalizing problems in siblings. Mother-reported disorder severity predicted mother-reported sibling internalizing problems. No single primary diagnosis predicted sibling internalizing or externalizing problems. Disorder severity does to an extent predict sibling mental health, whereas single diagnostic categories do not. Disorder severity may be used to identify siblings at risk and/or in need of interventions. Fathers should be included in assessment and health care for siblings as their reports seem to predict sibling mental health better than the mothers.

• Kirchhofer, Solveig Melanie; Orm, Stian; Briggs, Nancy E.; Fredriksen, Trude; Zahl, Erica & Prentice, Caitlin Mccombs [Show all 11 contributors for this article] (2025). Siblings in families of children with chronic disorders: a model of risk and protective factors. Journal of Pediatric Psychology. ISSN 0146-8693. 50(6), p. 488–499. doi: 10.1093/jpepsy/jsaf017. Full text in Research Archive Show summary

  Objective We empirically tested a family systems model’s ability to explain variance in psychosocial adjustment among siblings of children with chronic developmental and physical disorders (CDs). The model included the impact of CD severity, family social support, parental mental health, and parent–sibling communication quality. We hypothesized that family social support would moderate the relationship between CD severity and parent mental health, and that sibling-reported communication quality with their parents would mediate the relationship between parent mental health and sibling psychosocial adjustment. Methods We used baseline data from a sibling intervention trial (SIBS-RCT) comprising 288 families with siblings aged 8–16 years and their parents, recruited from health services and user organizations. Parents reported CD severity, parental mental health, and family social support. Siblings self-reported their psychosocial adjustment, including mental health, CD-related adjustment, quality of life, and prosocial behavior. We employed structural equation modeling to test the hypothesized relationships. Results Higher parent–sibling communication quality was significantly associated with better sibling-reported quality of life and more prosocial behavior. Lower levels of paternal depression were significantly associated with better sibling-reported quality of life and mental health, whereas maternal depression was not. We did not find support for the hypothesized mediating and moderating pathways for family social support and parent–sibling communication. Conclusions The findings highlight the importance of addressing paternal mental health and parent–sibling communication in promoting sibling psychosocial adjustment. Future studies should use comprehensive, multi-informant approaches and consider the complex interplay of family factors in the context of childhood CD.

• Prentice, Caitlin Mccombs; Fjermestad, Krister Westlye; Haukeland, Yngvild Bjartveit & Vatne, Torun Marie (2025). Psychosocial Functioning for Preschool-Aged Siblings of Children With Chronic Disorders: A Scoping Review. Child: Care, Health and Development. ISSN 0305-1862. 51(2). doi: 10.1111/cch.70039. Full text in Research Archive
• Zahl, Erica; Willemen, Agnes M.; Fredriksen, Trude; Kirchhofer, Solveig Melanie; Vatne, Torun Marie & Orm, Stian [Show all 9 contributors for this article] (2024). Mental health in mothers and fathers of children with chronic disorders. PEC Innovation. 5. doi: 10.1016/j.pecinn.2024.100331. Full text in Research Archive Show summary

  Objective This study applied the Family Systems Illness Model to examine how child disorder severity influences mental health in mothers and fathers of children with chronic (mainly developmental) disorders (CD). Methods We measured parental mental health and perceived child disorder severity among 204 mothers and 125 fathers of 220 children with CD and compared the mental health scores with norms. We analyzed how much of the variance in parental mental health was explained by child disorder severity, including discrepancy between maternally and paternally perceived severity. Results Compared to norms, we found elevated mental health problems in both mothers (d = 0.45) and fathers (d = 0.20) of children with CD. Mothers had higher scores than fathers on both mental health problems (d = 0.63) and severity (d = 0.43). Perceived disorder severity was similarly associated with mental health problems for mothers (β = 0.23) and fathers (β = 0.34). Discrepancy between maternal and paternal perceived disorder sever

• Vergunst, Francis; Prentice, Caitlin Mccombs; Orri, Massimiliano; Berry, Helen L.; Paquin, Vincent & Vitaro, Frank [Show all 9 contributors for this article] (2024). Association of youth climate change worry with present and past mental health symptoms: a longitudinal population-based study. Climatic Change. ISSN 0165-0009. 177(10). doi: 10.1007/s10584-024-03807-1. Full text in Research Archive Show summary

  Young people are worried about climate change but the association with current and past mental health symptoms is rarely examined in longitudinal population-based samples. Drawing on a population-based birth cohort from the Canadian province of Quebec (n = 1325), this study used a cross-over design to (1) test the association between climate change worry at age 23-years and concurrent mental health symptoms assessed on standardised instruments, and (2) test the association between adolescent (15 and 17 years) symptoms of anxiety, depression, inattention-hyperactivity, and aggression-opposition and climate worry at age 23-years. Participant sex, cognitive ability, socioeconomic status, and parental mental health were adjusted for. Descriptive statistics showed that most participants were worried about climate change: 190 (14.3%) were extremely worried, 383 (28.9%) were very worried, 553 (41.7%) were somewhat worried, and 199 (15.0%) were not at all worried. In analysis 1, worry about climate change was associated with significantly higher concurrent anxiety, depression, and self-harm symptoms, even after adjustment for adolescent symptoms. In analysis 2, anxious adolescents were significantly more likely to be extremely worried about climate change six years later (RRR = 1.51, 95%CI = 1.10–2.07), while aggressive-oppositional adolescents were significantly less likely to be somewhat worried (RRR = 0.79, 95%CI = 0.63–0.0.99), very worried (RRR = 0.61, 95%CI = 0.48–0.78), or extremely worried (RRR = 0.51, 95%CI = 0.37–0.72). Taken together, participants who were worried about climate change had more concurrent mental health symptoms but were also more likely to have prior symptoms. Adolescents with higher anxiety were more likely to worry about climate change in early adulthood, while those with higher aggression-opposition were less likely to worry. Future studies should track climate worry longitudinally alongside symptoms using prospective follow-up studies.

• Prentice, Caitlin Mccombs (2024). Education researchers who teach in schools: a braided river approach to enhancing research and practice. International Journal of Social Research Methodology: Theory and Practice. ISSN 1364-5579. doi: 10.1080/13645579.2024.2380995. Full text in Research Archive
• Prentice, Caitlin Mccombs; Vergunst, Francis; Minor, Kelton & Berry, Helen L. (2024). Education outcomes in the era of global climate change. Nature Climate Change. ISSN 1758-678X. p. 1–11. doi: 10.1038/s41558-024-01945-z. Full text in Research Archive
• Prentice, Caitlin Mccombs; Orm, Stian; Botta, Matteo; Vatne, Torun Marie; Fredriksen, Trude & Kirchhofer, Solveig Melanie [Show all 7 contributors for this article] (2024). Teacher-Rated Mental Health of Siblings of Children with Chronic Disorders. School Mental Health. ISSN 1866-2625. 16, p. 1183–1196. doi: 10.1007/s12310-024-09685-3. Full text in Research Archive Show summary

  Siblings of children with chronic disorders are at a heightened risk for internalizing and externalizing problems. Studies on sibling mental health typically use parent report, and sometimes sibling self-report, but do not include the perspectives of teachers. We investigated how teachers and parents in Norway rated sibling mental health to gain a more coherent picture of siblings’ well-being and functioning across the home and school contexts. We compared how siblings aged 8–16 years (45% boys, 54% girls) were scored on the strengths and difficulties questionnaire by teachers (n = 125), mothers (n = 115), and fathers (n = 81) with population norms and clinical cutoffs. For boys, the mean teacher scores did not indicate problems for total difficulties or any subscale except hyperactivity–inattention, but mean parent scores were higher for total difficulties and most subscales (d = .44 to .96). For girls, teachers indicated higher than norm scores for total difficulties, emotional problems, hyperactivity–inattention and peer problems (d = .26 to .46), while parents indicated higher total difficulties and problems across most subscales (d = .31 to .54). Prosocial behavior was as a relative strength of siblings across all raters. Siblings may not display the same level of mental health problems in school as at home, and teachers can offer an important perspective on siblings’ mental health and functioning.

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• Prentice, Caitlin Mccombs; Kirchhofer, Solveig Melanie; Vatne, Torun Marie & Fjermestad, Krister Westlye (2025). SIBS-RCT: Improving mental health for siblings of children with chronic disorders. Full text in Research Archive Show summary

  SIBS-RCT: Improving mental health for siblings of children with chronic disorders Caitlin Prentice, Solveig M. Kirchhofer, Torun M. Vatne, Krister W. Fjermestad Background The educational inclusion of children with chronic disorders – such as developmental and physical disabilities – is a well-studied area. The siblings of these children, however, are less studied, particularly in relation to their educational experiences and outcomes. Siblings of children with chronic disorders have divergent, and often adverse, life experiences, and are known to be at risk for negative psychological effects including emotional and behavioural problems (Havill et al., 2019; Vermaes et al., 2012). Reduced psychological well-being, in turn, can affect siblings’ educational experiences, functioning, and outcomes (Gan et al., 2017). “SIBS”, short for “siblings”, is a therapeutic intervention programme for siblings and parents of children with chronic disorders which aims to improve the emotional and behavioural well-being of siblings and to improve communication between parents and siblings (Fjermestad et al., 2020). In this presentation, I report findings from an evaluation of this programme, the SIBS-RCT, with a particular focus on teacher perspectives on siblings’ well-being and functioning at school. Methods Participants were recruited from healthcare services that provide support to children with chronic disorders and their families across Norway. The SIBS intervention consists of five sessions, with separate and joint sibling and parent components. Data were collected via questionnaire at baseline and at 3, 6, and 12 months following the intervention, and included the Strengths and Difficulties Questionnaire (SDQ). The SDQ is a measure of children’s behavioural and emotional functioning composed of 25 items organised into five subscales: emotional difficulties, conduct problems, hyperactivity and inattention, peer difficulties, and pro-social behaviour. Siblings’ parent-rated SDQ scores (n=288) were compared with controls using intention to treat (ITT) and complier average causal effects (CASE). A subsample of teacher reported SDQ scores (n=125) were compared with mother and father reported scores. Results The SIBS intervention was found to have a small positive effect on sibling mental health compared with the waitlist control group. Teachers rated siblings as having fewer problem behaviours on the SDQ than parents, both in a comparison with population norms and clinical cutoff levels. For boys, teachers rated only hyperactivity-inattention as higher than norms, while for girls, teacher scores were higher than norms for total difficulties, emotional problems, hyperactivity-inattention and peer problems. In contrast, mothers and fathers rated siblings as having higher levels of problems across almost every subscale of the SDQ. Prosocial behaviour was a relative strength of siblings across both teacher and parent ratings. Conclusions These findings suggest that siblings’ difficulties are less present in a school environment than at home, adding to an extant literature on children’s context specific behaviour (De Los Reyes & Kazdin, 2005), Our findings could also be partially the result of teachers being less able to spot “quieter” internalising problems than parents. Causes of the gender differences found in teacher-rated SDQ scores are unclear, but point towards potential differences in expectations for girl versus boy siblings in terms of care giving behaviours. References De Los Reyes, A., & Kazdin, A. E. (2005). Informant Discrepancies in the Assessment of Childhood Psychopathology: A Critical Review, Theoretical Framework, and Recommendations for Further Study. Psychological Bulletin, 131(4), 483–509. https://doi.org/10.1037/0033-2909.131.4.483 Fjermestad, K. W., Silverman, W. K., & Vatne, T. M. (2020). Group intervention for siblings and parents of children with chronic disorders (SIBS-RCT): Study protocol for a randomized controlled trial. Trials, 21(1), 851. https://doi.org/10.1186/s13063-020-04781-6 Gan, L. L., Lum, A., Wakefield, C. E., Nandakumar, B., & Fardell, J. E. (2017). School Experiences of Siblings of Children with Chronic Illness: A Systematic Literature Review. Journal of Pediatric Nursing, 33, 23–32. https://doi.org/10.1016/J.PEDN.2016.11.007 Havill, N., Fleming, L. K., & Knafl, K. (2019). Well siblings of children with chronic illness: A synthesis research study. Research in Nursing & Health, 42(5), 334–348. https://doi.org/10.1002/nur.21978 Vermaes, I. P. R., van Susante, A. M. J., & van Bakel, H. J. A. (2012). Psychological Functioning of Siblings in Families of Children with Chronic Health Conditions: A Meta-Analysis. Journal of Pediatric Psychology, 37(2), 166–184. https://doi.org/10.1093/jpepsy/jsr081

• Prentice, Caitlin Mccombs (2024). Teacher Ratings on the Strengths and Difficulties Questionnaire for Siblings of Children with Chronic Disorders. Full text in Research Archive
• Prentice, Caitlin Mccombs (2024). Teacher Ratings on the Strengths and Difficulties Questionnaire for Siblings of Children with Chronic Disorders. Full text in Research Archive

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