Sociodemographic factors and health-related, neuropsychological, and psychosocial functioning in youth with spina bifida.

Jaclyn Lennon Papadakis*, Grayson N. Holmbeck

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: Past research suggests that certain sociodemographic factors may put youth with spina bifida (SB) at risk for poor outcomes. The aims of this study were to examine (a) associations between ten sociodemographic factors and health-related, neuropsychological, and psychosocial functioning among youth with SB,(b) cumulative sociodemographic risk as a predictor of youth outcomes as moderated by age, and (c) SB-related family stress as a mediator of longitudinal associations between cumulative sociodemographic risk and youth outcomes. Method: Participants were youth with SB (N = 140 at Time 1; Mage at Time 1 = 11.43, 53.6% female) recruited as part of a larger, longitudinal study. The study included questionnaire (parent-, teacher-, and youth-report), neuropsychological testing, and medical chart data across three time points, spaced 2 years apart. Results: A subset of the sociodemographic factors and their cumulative risk were associated with study outcomes. Specifically, youth characterized by sociodemographic risk had greater pain and lower academic achievement, but also fewer urinary tract infections and fewer attention and executive function problems. Age did not moderate the association between cumulative risk and outcomes. Cumulative risk predicted lower SB-related family stress, which, in turn, predicted several outcomes. Conclusions: Examining a range of sociodemographic factors is warranted. Sociodemographic risk is linked to poorer outcomes for some risk indicators but similar or better outcomes for others. Results have implications for delivering evidence-based, diversity-sensitive clinical care to youth with SB. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact and Implications—The current study found that youth with spina bifida characterized by certain sociodemographic risk characteristics were more likely to have poorer outcomes in certain domains (e.g., pain, academic achievement). However, this was not a consistent finding, as many youth characterized by sociodemographic risk (e.g., low income) were found to have similar or better outcomes in other domains, compared with youth not characterized by risk. These findings suggest youth with spina bifida would benefit from thoughtful and comprehensive clinical assessments of the sociodemographic factors that may put youth at risk for adverse outcomes. These findings can also inform health care reform and social policies aimed at addressing healthcare disparities in youth with spina bifida.

Original languageEnglish (US)
Pages (from-to)286-299
Number of pages14
JournalRehabilitation Psychology
Issue number3
StatePublished - Aug 2021
Externally publishedYes


  • family stress
  • health disparities
  • longitudinal research
  • sociodemographic factors
  • spina bifida

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Psychology
  • Psychiatry and Mental health


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