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Examining the Acceptance of Siblings with Down Syndrome through a Positive Psychological Lens

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Title: Examining the Acceptance of Siblings with Down Syndrome through a Positive Psychological Lens
Language: English
Authors: Raaya Alon (ORCID 0000-0002-8047-7807)
Source: Research and Practice for Persons with Severe Disabilities. 2026 51(2):94-106.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 13
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Descriptors: Down Syndrome, Siblings, Sibling Relationship, Psychological Patterns, Social Support Groups, Attitudes, Emotional Response, Coping, Personality Traits, Foreign Countries, Jews
Geographic Terms: Israel
DOI: 10.1177/15407969251350121
ISSN: 1540-7969
2169-2408
Abstract: Typically-developing siblings play an important role in the lives of their siblings with Down Syndrome (DS) and often develop a complex relationship with their sibling. Positive psychology focuses on the positive strengths of an individual and optimal coping with challenging situations, among which can be considered growing up with a sibling with a disability. Optimism, an important way of perceiving the world, may help shape the emotions toward the sibling with DS and how social support is perceived by the typically-developing sibling. As such, this study used structural equation modeling (SEM) to explore how optimism, social support, and negative emotions toward a sibling with DS related to the sibling's acceptance by the typically-developing sibling. Participants were 306 typically-developing siblings of individuals with DS (201 sisters and 105 brothers). SEM revealed that optimism did not directly relate to sibling acceptance, but did relate through the mediation of emotions and social support toward the sibling. The results highlight the need to promote positive strengths and coping skills such as optimism, increase social support, and encourage the expression and processing of the typically-developing siblings' emotions within the family system.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1504058
Database: ERIC
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  Value: <anid>AN0193276617;myx01jun.26;2026Apr29.02:19;v2.2.500</anid> <title id="AN0193276617-1">Examining the Acceptance of Siblings With Down Syndrome Through a Positive Psychological Lens </title> <p>Typically-developing siblings play an important role in the lives of their siblings with Down Syndrome (DS) and often develop a complex relationship with their sibling. Positive psychology focuses on the positive strengths of an individual and optimal coping with challenging situations, among which can be considered growing up with a sibling with a disability. Optimism, an important way of perceiving the world, may help shape the emotions toward the sibling with DS and how social support is perceived by the typically-developing sibling. As such, this study used structural equation modeling (SEM) to explore how optimism, social support, and negative emotions toward a sibling with DS related to the sibling's acceptance by the typically-developing sibling. Participants were 306 typically-developing siblings of individuals with DS (201 sisters and 105 brothers). SEM revealed that optimism did not directly relate to sibling acceptance, but did relate through the mediation of emotions and social support toward the sibling. The results highlight the need to promote positive strengths and coping skills such as optimism, increase social support, and encourage the expression and processing of the typically-developing siblings' emotions within the family system.</p> <p>Keywords: acceptance; siblings; optimism; emotions; structural equation model</p> <p>Sibling relations are meaningful in that they can provide a platform for the development of reciprocal relationships, shared experiences, cognitive and communication development, and training in social interactions ([<reflink idref="bib23" id="ref1">23</reflink>]; [<reflink idref="bib45" id="ref2">45</reflink>]; [<reflink idref="bib54" id="ref3">54</reflink>]). Growing up with a sibling with a disability can be considered stressful and challenging, all while siblings play an important role in the lives of individuals with disabilities and often will become the future caregiver for much of their lives (e.g., [<reflink idref="bib7" id="ref4">7</reflink>]; [<reflink idref="bib30" id="ref5">30</reflink>]). Down Syndrome (DS) is a congenital chromosomal syndrome with a unique external appearance and characterized by numerous physiological difficulties and intellectual disabilities of varying degrees of severity ([<reflink idref="bib12" id="ref6">12</reflink>]; [<reflink idref="bib33" id="ref7">33</reflink>]). There is evidence that siblings may develop a complex relationship with a sibling with DS (e.g., [<reflink idref="bib15" id="ref8">15</reflink>]; [<reflink idref="bib22" id="ref9">22</reflink>]; [<reflink idref="bib37" id="ref10">37</reflink>]). On one hand, societal perceptions of DS tend to be more favorable, and families of individuals with DS may experience fewer negative outcomes compared with families of children with other intellectual and developmental disabilities–a theory known as the Down Syndrome Advantage (e.g., [<reflink idref="bib21" id="ref11">21</reflink>]). On the other hand, despite these comparative benefits, studies show that siblings of individuals with DS face increased stress and risk for mental illnesses, and it can impact their day-to-day life ([<reflink idref="bib10" id="ref12">10</reflink>]; [<reflink idref="bib31" id="ref13">31</reflink>]; [<reflink idref="bib58" id="ref14">58</reflink>]).</p> <p>Positive psychology focuses on optimal coping with stressful or challenging situations ([<reflink idref="bib39" id="ref15">39</reflink>]), particularly by building individuals' positive characteristics. Through the lens of positive psychology, the current study explored siblings' internal strengths such as optimism, the social support they receive, and the emotions they experience toward their siblings, and how these relate to their acceptance of their siblings with DS. Gaining a deeper understanding of how they accept their sibling with DS can help promote a more positive outlook among typically-developing siblings, who are likely to be involved in the future care of their siblings ([<reflink idref="bib29" id="ref16">29</reflink>]).</p> <hd id="AN0193276617-2">Accepting Siblings with DS</hd> <p>Accepting an individual with a disability recognizes that the characteristics related to the disability are an inseparable part of the individual, not trying to change the individual, and understanding the need to relate to the individual "as they are" ([<reflink idref="bib25" id="ref17">25</reflink>]). Family systems theory emphasizes the connection between family members, and their influence on one another's well-being ([<reflink idref="bib9" id="ref18">9</reflink>]). Although under-researched compared with other family subsystems ([<reflink idref="bib47" id="ref19">47</reflink>]), the sibling subsystem holds great importance because it "can be the first and most intense peer relationship" throughout one's life ([<reflink idref="bib4" id="ref20">4</reflink>], p. 1). This is in part due to time spent together, which is typically greater than time spent with other companions ([<reflink idref="bib38" id="ref21">38</reflink>]). In the context of siblings with a disability, this theory can contribute to the understanding of the variables that may impact sibling relationships, and more particularly, the typically-developing sibling's acceptance of their sibling with a disability.</p> <p>In a systematic review, acceptance of a sibling with intellectual and developmental disabilities aided in the typically-developing siblings' adjustment, and positive outlook ([<reflink idref="bib40" id="ref22">40</reflink>]). As acceptance can impact the nature of sibling relations (e.g., [<reflink idref="bib2" id="ref23">2</reflink>]; [<reflink idref="bib20" id="ref24">20</reflink>]), it is important to explore what variables may contribute to it. One study found that internal resources such as optimism and sense of coherence predicted acceptance of sibling of individuals with autism ([<reflink idref="bib2" id="ref25">2</reflink>]). The present study examined siblings of individuals with DS, and the unique characteristics of this disability and considering the importance of how acceptance may affect the future care of the sibling.</p> <p>Understanding the factors that may influence sibling relationships can provide insight into how to promote sibling growth ([<reflink idref="bib17" id="ref26">17</reflink>]). For many years, prevailing therapeutic approaches emphasized disability and illness, and in doing so, focused on the difficulty and the negative effects of the individual's disability on their family members. This approach often undermined the ability, mental health, and functioning of the family of a child with a disability, including siblings ([<reflink idref="bib32" id="ref27">32</reflink>]). More recently, positive psychology has gained prominence in therapeutic models, focusing on the necessity of understanding and promoting resilience characteristics.</p> <hd id="AN0193276617-3">Positive Psychology</hd> <p>Positive psychology focuses on attempting to find and nurture people's personal resources and central inherent strengths ([<reflink idref="bib14" id="ref28">14</reflink>]). Martin Seligman, considered the father of the theory, defines positive psychology as a psychological approach whose aim is to deal with the health and positive side of the person, and the growth and strengthening of the person to create happiness, mental well-being, and positive outcomes ([<reflink idref="bib13" id="ref29">13</reflink>]). Positive psychology concentrates on building the positive qualities of the person, looking ahead toward their growth and development, as well as their optimal coping with stressful or crisis situations, or challenging situations, such as growing up with a sibling with a disability in the family ([<reflink idref="bib39" id="ref30">39</reflink>]). There is a growing body of literature focusing on the strengths and optimal functioning of people with intellectual disabilities, based on positive psychology, with the aim of reaching strengths-based interventions ([<reflink idref="bib1" id="ref31">1</reflink>]). Extending the positive psychological approach to siblings of individuals with DS, and looking at strengths and emphasizing coping resources, the current study examined siblings' strengths, such as optimism ([<reflink idref="bib55" id="ref32">55</reflink>]), when exploring how they accept their sibling with DS.</p> <hd id="AN0193276617-4">Optimism</hd> <p>Optimism is a human personality resource that relates to internal expectations that there will be positive outcomes and success; it is the tendency to see the positive side of situations ([<reflink idref="bib35" id="ref33">35</reflink>]). The mechanism underlying optimism is the way the individual interprets life events and not just the challenge itself, such as how the person perceives and interprets their sibling having a disability. Optimism reflects a positive thinking process, which can aid the individual when contending with challenging situations and stress ([<reflink idref="bib42" id="ref34">42</reflink>]; [<reflink idref="bib51" id="ref35">51</reflink>]). People with greater optimism can cope more effectively with life's events and with stress, because of their ability to interpret what happens to them in a positive light, and an optimistic perspective is one of the most effective ways to influence positive coping ([<reflink idref="bib55" id="ref36">55</reflink>]). Indeed, optimism has been found to help with the therapeutic stress in families with a child with a disability ([<reflink idref="bib19" id="ref37">19</reflink>]). Similarly, the use of optimism as a coping mechanism, and finding positive aspects in caring for a child with intellectual and developmental disabilities, related to improved relationships, increased personal growth, and more positive perceptions ([<reflink idref="bib6" id="ref38">6</reflink>]; [<reflink idref="bib24" id="ref39">24</reflink>]). [<reflink idref="bib43" id="ref40">43</reflink>] found that siblings of individuals with DS who were less pessimistic about their siblings' future had closer sibling relationships. In addition, families that adopted a more optimistic worldview saw more future options for their children with DS ([<reflink idref="bib26" id="ref41">26</reflink>]).</p> <p>It seems that optimism is related to positive outcomes in terms of perceiving and caring for individuals with disabilities. This is further supported by [<reflink idref="bib51" id="ref42">51</reflink>], who found that optimism predicted perceiving the benefit of having a child with developmental disabilities. Regarding siblings, [<reflink idref="bib2" id="ref43">2</reflink>] found that optimism predicted the acceptance of their sibling with autism. At the same time, the relation of optimism as a positive personal resource to acceptance of siblings with DS has yet to be explored. As such, the current study focused on the relations between these variables. In addition, internal variables such as the emotions toward the sibling with disabilities, and perceived external social support, may be shaped by an optimistic outlook ([<reflink idref="bib2" id="ref44">2</reflink>]; [<reflink idref="bib16" id="ref45">16</reflink>]; [<reflink idref="bib51" id="ref46">51</reflink>]).</p> <hd id="AN0193276617-5">Emotions and Social Support Mediating Between Optimism and Acceptance</hd> <p>Positive psychology believes in people's positive strengths and the need to reinforce these strengths ([<reflink idref="bib57" id="ref47">57</reflink>]). Siblings' emotions help them feel more connected with, and supportive of, each other ([<reflink idref="bib54" id="ref48">54</reflink>]). In this way, more positive emotions and fewer negative emotions can reflect more optimal sibling functioning. Yet, siblings of individuals with DS and other intellectual disabilities often experience complex and mixed emotions toward their sibling with a disability, including both positive emotions such as happiness, and negative emotions such as guilt and embarrassment ([<reflink idref="bib30" id="ref49">30</reflink>]; [<reflink idref="bib50" id="ref50">50</reflink>]; [<reflink idref="bib52" id="ref51">52</reflink>]; [<reflink idref="bib53" id="ref52">53</reflink>]). Moreover, while there are often negative emotions involved in the relationship, positive emotions can serve as a protective factor against stress and crisis situations that may emerge from coping with a sibling with a disability in the family. Furthermore, having greater optimism can help foster more positive emotions ([<reflink idref="bib3" id="ref53">3</reflink>]; [<reflink idref="bib46" id="ref54">46</reflink>]), which in turn, can influence acceptance of the sibling ([<reflink idref="bib4" id="ref55">4</reflink>]).</p> <p>Aside from shaping emotional outlooks, optimism also relates to perceptions of social support ([<reflink idref="bib16" id="ref56">16</reflink>]), which has been linked to the well-being and functioning of families of individuals with a disability (e.g., [<reflink idref="bib11" id="ref57">11</reflink>]; [<reflink idref="bib27" id="ref58">27</reflink>]). For example, greater perceived social support was related to caregivers' increased belief in their ability to provide care ([<reflink idref="bib44" id="ref59">44</reflink>]). Regarding siblings, those who receive social support reported feeling less alone as they were not the only ones in their situations ([<reflink idref="bib36" id="ref60">36</reflink>]). Furthermore, among siblings of individuals with intellectual and developmental disabilities, increased social support was related to lower levels of stress ([<reflink idref="bib50" id="ref61">50</reflink>]), and lower levels of perceived social support predicted more mental health difficulties ([<reflink idref="bib36" id="ref62">36</reflink>]). [<reflink idref="bib2" id="ref63">2</reflink>] found that social support predicted acceptance of siblings with autism, beyond the contribution of optimism.</p> <p>In sum, research suggests that optimism may help foster positive emotions as well as shape perceptions of social support as positive and helpful. In this way, both emotions and social support can serve as mechanisms through which optimism can influence typically-developing siblings' acceptance of the sibling with DS.</p> <hd id="AN0193276617-6">Current Study</hd> <p>Based on existing research, siblings play a significant role in the lives of their sibling with DS, and while these typically-developing siblings may experience positive outcomes, they also may experience potential challenges ([<reflink idref="bib10" id="ref64">10</reflink>]). It is also clear from the research that siblings' acceptance of the sibling with DS is important for the sibling relationship. Relying on prior models demonstrating that optimism relates to positive outcomes such as finding positive benefits and acceptance of family members with disabilities ([<reflink idref="bib2" id="ref65">2</reflink>]; [<reflink idref="bib51" id="ref66">51</reflink>]), the current study utilized a positive psychological lens to examine how optimism relates to typically-developing siblings' acceptance of their sibling with DS. Furthermore, in light of evidence that both emotions and perceived social support may serve as mechanisms through which optimism relates to positive outcomes ([<reflink idref="bib24" id="ref67">24</reflink>]; [<reflink idref="bib37" id="ref68">37</reflink>]; [<reflink idref="bib51" id="ref69">51</reflink>]), these variables were included as mediators between optimism and acceptance, as seen in the model presented in Figure 1.</p> <p>Graph: Figure 1. The research model.</p> <p>The following research questions and hypotheses guided the study.</p> <p></p> <ulist> <item> 1. What the is the nature of the relationship between optimism, social support, emotions, and acceptance? It was hypothesized that optimism and social support would positively correlate with acceptance, and negative emotions would negatively correlate with acceptance.</item> <p></p> <item> 2. Will the mediation model (social support and emotions mediating the relation between optimism and acceptance) be found valid and reliable?</item> <p></p> <item> a. The mediation model will be found valid and reliable, according to appropriate indicators.</item> <p></p> <item> b. Optimism will directly relate to siblings' acceptance.</item> <p></p> <item> c. Social support and negative emotions will each mediate the relation between optimism and acceptance.</item> </ulist> <hd id="AN0193276617-7">Method</hd> <p></p> <hd id="AN0193276617-8">Participants</hd> <p>Participants were 306 Israeli–Jewish siblings of individuals with DS, including 201 sisters (66%) and 105 brothers (34%). Participants ranged in age from 18 to 27 (<emph>M</emph> = 21.5, <emph>SD</emph> = 2.5). Israel has mandatory military service at the age of 18. There is an option for those who are religiously observant (and for some others with medical conditions) to engage in national service instead, working with children at-risk, children in schools, in hospitals, or the like. Following their 2- to 3-year service (2 years national service, 3 years military service), individuals often take some time off and then begin studying in higher education. Of the participants, 18.4% were in their military or national service, 48.4% of the participants were students, and 31.3% were working full-time. Most of the siblings were single (61.1%), about 37.3% were married, and the remainder were separated or divorced (1%). Information regarding socioeconomic status was not solicited in detail given that participants are in a stage where they are first gaining financial independence. Those who are in military/national service and full-time students are most likely in a low-earning category. Of the individuals with DS, 60% were male and 40% were female, and they ranged in age from 6 to 43-years-old (<emph>M</emph> = 14.9, <emph>SD</emph> = 7.2). Individuals with co-morbid DS and autism were not included in the current study. According to the participants' report, the functionality of the sibling with DS was independent (38%) or somewhat to not independent (62%).</p> <hd id="AN0193276617-9">Measures</hd> <p></p> <hd id="AN0193276617-10">Demographic Questionnaire</hd> <p>This 27-item questionnaire included items related to both the participating sibling and the sibling with DS. First, items requested information on the participants' age, gender, education, and the like. Following these were items related to the sibling with DS: age, gender, degree of independence of functionality, and living location.</p> <hd id="AN0193276617-11">Sibling Acceptance Questionnaire</hd> <p>This questionnaire ([<reflink idref="bib8" id="ref70">8</reflink>]; [<reflink idref="bib28" id="ref71">28</reflink>]) examined the typically-developing sibling's level of acceptance of the sibling of their sibling with disability (e.g., "Some people think that a child with DS causes a lot of problems in the family," "Some sibling avoid being around unfamiliar people when they are with their sibling with DS"). Participants rated 25 items on a scale of 1 (<emph>disagree completely</emph>) to 5 (<emph>agree completely</emph>). Average scores were calculated, with higher scores indicating a greater degree of acceptance. Reliability for the current study was Cronbach's <emph>α</emph> =.81.</p> <hd id="AN0193276617-12">Optimism</hd> <p>To examine participants' optimism, the 8-item Life Orientation Test ([<reflink idref="bib49" id="ref72">49</reflink>], Hebrew translation; [<reflink idref="bib59" id="ref73">59</reflink>]) was used, which measured participants' expectations of future outcomes. Items were phrased in both positive (e.g., "I always look at the positive side of things") and negative terms (e.g., "I rarely count on good things happening to me"). Items were ranked on a scale ranging from 1 (<emph>disagree</emph>) to 5 (<emph>agree very much</emph>). After reversing negative items, the scores were averaged, such that higher scores reflected greater optimism. Reliability for the current study was Cronbach's <emph>α</emph> =.70.</p> <hd id="AN0193276617-13">Multidimensional Scale of Perceived Social Support</hd> <p>This scale ([<reflink idref="bib60" id="ref74">60</reflink>]) examined participants' subjective view of the social support they receive from three sources: family, friends, and meaningful others (e.g., "I can talk about my problems with my family," "I have friends with whom I can share in my joys and sorrows"). Participants scored 12 items on a 5-point scale ranging from 1 (<emph>strongly disagree</emph>) to 5 (<emph>strongly agree</emph>). Higher averaged scores reflected greater levels of support. Reliability for the current study was Cronbach's <emph>α</emph> =.89.</p> <hd id="AN0193276617-14">Negative Emotions Toward Siblings</hd> <p>This questionnaire ([<reflink idref="bib5" id="ref75">5</reflink>]) examined the composition and intensity of participants' negative emotions toward their sibling with DS. Participants responded to 15 items exploring internally-focused negative emotions (e.g., "How much do you experience these feelings toward your sibling with DS: Sadness, helplessness, guilt, pity, disappointment, and fear") and externally-focused negative emotions (e.g., "How much do you experience these feelings toward your sibling with DS: Distrust, fear of association, suspicion, hostility, jealousy, rejection, and shame") on a 5-point scale, ranging from 1 (<emph>not at all</emph>) to 5 (<emph>very much</emph>). Higher scores indicated more negative emotions toward the sibling with DS. Reliability of the questionnaire was Cronbach's <emph>α</emph> = 0.79.</p> <hd id="AN0193276617-15">Procedure</hd> <p>The study received the approval of the institutional ethical review board. The survey was sent to various Facebook and WhatsApp groups for siblings of individuals with disabilities. These groups have roughly 1,000 members. It is impossible to know if every member saw the posts with the surveys. However, assuming 1,000 members, and 306 respondents, this is roughly a 31% response rate. In addition, to adhere with the ethics requirements, no information was collected on those who did not respond or on those who stopped responding in the middle. As such, it is only possible to detail the demographic information about those who completed the survey in full, and not possible to determine whether differences existed between respondents and non-respondents. The study and its goals were explained to each sibling who expressed an initial interest in participating. Participation in the research was voluntary, and no compensation was received by participants. Siblings completed a consent form wherein standards of ethics and confidentiality were guaranteed. Measures were completed primarily, digitally, and occasionally by hand, where they were collected by the researchers.</p> <hd id="AN0193276617-16">Data Analysis</hd> <p>A power analysis was conducted to justify the sample size. As the model was simple, the Monte Carlo method ([<reflink idref="bib41" id="ref76">41</reflink>]; [<reflink idref="bib56" id="ref77">56</reflink>]) for the power analysis revealed a minimum sample size of 200 participants, and the study sample was more than 300. Descriptive analyses were conducted for the primary study variables (acceptance, optimism, social support, emotions), followed by correlations. Finally, a structural equation model (SEM) with maximum likelihood estimation was conducted using <emph>R</emph> with the Lavaan package to examine the model of the relations between optimism and acceptance, and whether social support and negative emotions toward the sibling with DS mediate this relation, controlling for the age of the siblings with DS considering the large age range of these individuals.</p> <hd id="AN0193276617-17">Results</hd> <p></p> <hd id="AN0193276617-18">Descriptive Analysis</hd> <p>Table 1 presents the descriptive results of the main study variables (acceptance, optimism, and social support.). As can be seen in Table 1, participants reported above-average levels of acceptance, optimism, and social support. At the same time, they reported below average levels of negative emotions toward their sibling with DS.</p> <p>Table 1. Means, SD, and Correlations Between Primary Study Variables.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th align="left">Variables</th><th align="center"><italic>M</italic></th><th align="center"><italic>SD</italic></th><th align="center">Acceptance</th><th align="center">Optimism</th><th align="center">Social support</th></tr></thead><tbody><tr><td>Acceptance</td><td>4.0</td><td>0.47</td><td /><td /><td /></tr><tr><td>Optimism</td><td>4.1</td><td>0.58</td><td>.32<xref ref-type="table-fn" rid="tfn2">**</xref></td><td /><td /></tr><tr><td>Social support</td><td>4.2</td><td>0.62</td><td>.39<xref ref-type="table-fn" rid="tfn2">**</xref></td><td>.44<xref ref-type="table-fn" rid="tfn2">**</xref></td><td /></tr><tr><td>Negative emotions toward sibling</td><td>1.8</td><td>0.44</td><td>−.49<xref ref-type="table-fn" rid="tfn2">***</xref></td><td>−.35<xref ref-type="table-fn" rid="tfn2">***</xref></td><td>−.31<xref ref-type="table-fn" rid="tfn2">***</xref></td></tr></tbody></table> </ephtml> </p> <p>1 <emph>Note</emph>. Acceptance, optimism, social support, and emotions were ranked on a scale of 1 to 5.</p> <p>2 <emph>p</emph><.05, **<emph>p</emph><.01, ***<emph>p</emph><.001.</p> <p>Addressing research question 1, Table 1 shows that statistically significant positive correlations emerged between acceptance of the sibling with DS, optimism, and social support. In addition, significant negative relations emerged between negative emotions toward the sibling with acceptance, optimism, and social support. That is, having more negative emotions toward the sibling with DS was associated with lower levels of acceptance, optimism, and social support.</p> <hd id="AN0193276617-19">Structural Equation Model</hd> <p>To explore Research Question 2 examining the direct and indirect paths from the latent optimism factor to the latent sibling acceptance factor via the latent siblings' emotions factor and the latent social support factor, controlling for the age of siblings with DS, SEM using <emph>R</emph> (Lavaan package) was conducted, with the parceling technique. This technique involves combining individual items into parcels, which simplifies the model and can improve model fit by reducing the number of items and degrees of freedom. The parceling used in this model combined items based on their relations to other items in the same questionnaire. The model provided a good fit to the data, (<emph>x</emph><sups>2</sups>(<reflink idref="bib59" id="ref78">59</reflink>) <emph>=</emph> 96.53, <emph>p =</emph>.001, <emph>x</emph><sups>2</sups>/<emph>df =</emph> 1.64, Tucker-Lewis Index [TLI] =.938, comparative fit index [CFI] =.953, root mean square error of approximation [RMSEA][90% confidence interval [C.I.] = 0.046 [0.028, 0.062], standardized root mean square residual [SRMR] =.044). All factor loadings of the indicator variables for each latent variable were significant at <emph>p</emph> <.001. Bootstrapping coefficients, based on 5,000 resamples, and the lower and upper bounds of 95% CI are presented in Table 2 and Figure 2.</p> <p>Table 2. Mediation of the Relation Between Optimism and Acceptance via Social Support and Emotions.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th align="left">Outcome variables</th><th align="center">Correlates</th><th align="center"><italic>B</italic></th><th align="center"><italic>SE</italic></th><th align="center">LLCI</th><th align="center">ULCI</th></tr></thead><tbody><tr><td colspan="6">Direct effects</td></tr><tr><td rowspan="2"> Siblings' emotions</td><td>Optimism</td><td>−0.378</td><td>0.1</td><td>−0.573</td><td>−0.182</td></tr><tr><td>Individuals with DS' age</td><td>0.001</td><td>0.005</td><td>−0.008</td><td>0.01</td></tr><tr><td> Social support</td><td>Optimism</td><td>0.579</td><td>0.115</td><td>0.354</td><td>0.804</td></tr><tr><td rowspan="4"> Siblings' acceptance</td><td>Optimism</td><td>−0.087</td><td>0.113</td><td>−0.309</td><td>0.136</td></tr><tr><td>Siblings' emotions</td><td>−0.602</td><td>0.135</td><td>−0.866</td><td>−0.337</td></tr><tr><td>Social support</td><td>0.341</td><td>0.096</td><td>0.152</td><td>0.53</td></tr><tr><td>Individuals with DS' age</td><td>0.007</td><td>0.004</td><td>−0.001</td><td>0.016</td></tr><tr><td colspan="6">Indirect effects</td></tr><tr><td colspan="2"> Optimism > siblings' emotions > sibling acceptance</td><td>0.227</td><td>0.081</td><td>0.068</td><td>0.386</td></tr><tr><td colspan="2"> Optimism > Social support > sibling acceptance</td><td>0.197</td><td>0.074</td><td>0.053</td><td>0.341</td></tr></tbody></table> </ephtml> </p> <p>3 <emph>p</emph><.05, **<emph>p</emph><.01, ***<emph>p</emph><.001.</p> <p>Graph: Figure 2. Mediation of the Relation Between Optimism and Acceptance via Social Support and Emotions.</p> <p>Results indicated that when controlling for the age of siblings with DS, the test of the indirect effect of optimism on the latent sibling acceptance factor via siblings' emotions was significant. The test of the indirect effect of optimism on the latent sibling acceptance factor via social support was statically significant. Thus, the siblings' emotions mediated the association between optimism and siblings' acceptance. That is, higher optimism related to lower negative emotions, which, in turn, related to higher sibling acceptance. In addition, social support mediated the association between optimism and siblings' acceptance, such that higher optimism related to higher social support, which, in turn, related to higher sibling acceptance.</p> <hd id="AN0193276617-20">Discussion</hd> <p>Rooted in positive psychological approaches, and based on prior models that demonstrated that optimism relates to positive outcomes ([<reflink idref="bib2" id="ref79">2</reflink>]; [<reflink idref="bib51" id="ref80">51</reflink>]) and that emotions and social support may serve as mechanism through which optimism relates to these positive outcomes ([<reflink idref="bib24" id="ref81">24</reflink>]; [<reflink idref="bib37" id="ref82">37</reflink>]; [<reflink idref="bib51" id="ref83">51</reflink>]), the current study utilized SEM to examine typically-developing siblings' acceptance of individuals with DS. A model was explored where acceptance was predicted by optimism, with negative emotions and social support serving as mediating variables, controlling for the age of the individuals with DS. Although optimism is an innate quality, it can also be developed ([<reflink idref="bib42" id="ref84">42</reflink>]). A study by [<reflink idref="bib18" id="ref85">18</reflink>] demonstrated that a program with only 12 sessions and working on perceptions was able to promote adolescents' optimism. Furthermore, a meta-analysis by [<reflink idref="bib34" id="ref86">34</reflink>] found that psychological interventions can promote optimism. It can be beneficial to cultivate this quality among siblings of individuals with disabilities through various means–at home, at school, and others. At the same time, while optimism carries considerable importance, the study's results indicated that it was not sufficient to directly predict acceptance of the sibling with DS; rather, this relationship was mediated by negative emotions and social support.</p> <p>The mediation model revealed that fewer negative emotions toward the sibling with DS increased the connection between optimism and acceptance. Previous studies indicated that siblings experience a wide variety of emotions toward their sibling with a disability ([<reflink idref="bib2" id="ref87">2</reflink>], [<reflink idref="bib3" id="ref88">3</reflink>]; [<reflink idref="bib48" id="ref89">48</reflink>]). The current study's results highlight the extent that emotions influence siblings' perceptions of their sibling with DS, and the centrality of emotions in sibling relations with a sibling with DS ([<reflink idref="bib3" id="ref90">3</reflink>]). This indicates that there is a need to reduce the negative emotions to increase acceptance. These results support a previous study that found that positive emotions predict acceptance of a sibling with autism ([<reflink idref="bib2" id="ref91">2</reflink>]), further indicating the need to reduce negative emotions and increase positive emotions as a way of promoting acceptance of a sibling with a disability. The results of the present study emphasize the extensive influence and the great weight that emotions have toward a sibling with a disability. As optimism alone does not seem to directly influence the acceptance of the sibling, rather only through the processing of the emotions, emotions are one of the channels through which acceptance occurs. Furthermore, the tendency toward optimism may influence the way in which the negative feelings toward the sibling are experienced; because optimism is the positive form of looking at life events, it reduces those negative emotions.</p> <p>The SEM also indicated that social support mediated the relation between optimism and acceptance. Perceived social support expresses the person's belief that they can receive help or empathy when needed, which can help protect the person from stressful situations and challenges they encounter. Previous findings illustrated that higher levels of optimism predicted higher levels of social support among parents of children with developmental disabilities ([<reflink idref="bib51" id="ref92">51</reflink>]). The study extends the relation between optimism and perceived social support among siblings of individuals with DS. It may be that the tendency to view life events in a positive light–which is the basis for optimism–also influences the perception that they receive support from those around them, and that if they need, they will continue to receive this support in the future. It seems that accepting the sibling with DS, with all the accompanying challenges, cannot rest solely on optimism, but also depends on social support. While optimism may help shape the perceptions of social support as positive, the actual support plays a necessary role in sibling acceptance. As in other studies ([<reflink idref="bib53" id="ref93">53</reflink>]), this study emphasizes the importance of social support for siblings of individuals with intellectual or developmental disabilities.</p> <p>The current study adds to the research in positive psychology regarding the coping of siblings of individuals with DS. The results indicate two different channels through which optimism can affect acceptance: the reduction of the sibling's negative feelings toward their sibling with DS, and the way in which the sibling perceives the social support they receive. As such, promoting optimism can help decrease siblings' negative emotions toward the sibling with DS while also promoting social support, hopefully resulting in greater acceptance of the sibling with DS. At the same time, the positive psychological framework might be a better fit for exploring siblings of individuals with DS, in light of the Down Syndrome Advantage ([<reflink idref="bib21" id="ref94">21</reflink>]), and the potential comparative benefit of DS compared with other intellectual and developmental disabilities.</p> <hd id="AN0193276617-21">Limitations</hd> <p>The study relied on data collection through social media groups; however, it was impossible to know exactly how many group members saw the posts. Future studies should more carefully incorporate algorithms that can determine the precise numbers of viewers who see the posts to better determine response rate. In addition, the study utilized siblings' self-report, which is subject to social desirability bias. Future research should use additional sources of information such as the siblings' parents or partners. Future research may also consider other variables as mediators/moderators of the relationships that were explored. This may include family, parenting, stress levels, typically-developing siblings' personality characteristics, as well as other characteristics of the sibling with DS such as behavior problems or other psychiatric diagnoses. Furthermore, it is important to examine other variables that feature prominently in positive psychology, such as resilience. Finally, it is worthwhile to utilize the positive psychological framework to explore these variables among siblings of individuals with other intellectual and developmental disabilities and compare with siblings of individuals with DS.</p> <hd id="AN0193276617-22">Implications</hd> <p>This study's findings have both research and practical implications. Demonstrating that positive strengths such as optimism can help shape emotions and perceptions of social support when relating to acceptance, this study can serve as a launchpad for research that can both broaden and deepen the exploration of acceptance of siblings with disabilities. Exploring how acceptance impacts the dynamic between sibling by examining specific interactions or outcomes (e.g., greater involvement in their care, spend more time in activities with the sibling with DS) can expand the understanding of this important variable. Furthermore, longitudinal studies can be conducted to determine how acceptance varies developmentally (both for the typically-developing sibling and the sibling with DS). To deepen the understanding, qualitative research can be undertaken that can conduct in-depth interview to gain insights into the experiences of the typically-developing siblings, what may impact their acceptance of their sibling with DS, and how acceptance is expressed by the siblings and is reflected in their relationships with their sibling with DS.</p> <p>From a practical standpoint, the study's results are particularly relevant to therapists and those who support siblings of individuals with DS. While it is important to invest in promoting and developing optimism, and more generally, in understanding positive strengths and additional coping capabilities, other variables seem to serve as mechanisms through which optimism works. As such, providing the typically-developing siblings with opportunities to express their emotions, both independently and within the family system, can be beneficial. Having a platform within which to address the complexity of their emotions and having others who can legitimize the range of experiences and feelings that go along with them can help the siblings process their emotions. This can be accomplished through individual or group therapies. In addition, finding ways to increase social support and their perceptions of social support can help typically-developing siblings foster greater acceptance of their sibling with DS.</p> <hd id="AN0193276617-23">Conclusion</hd> <p>In sum, the current study focused on sibling acceptance of their siblings with DS through a positive psychological lens. 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Journal of Personality Assessment, 52(1), 30–41. https://doi.org/10.1207/s15327752jpa5201_2</bibtext> </blist> </ref> <ref id="AN0193276617-25"> <title> Footnotes </title> <blist> <bibtext> The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.</bibtext> </blist> <blist> <bibtext> The author disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research was supported by the Shelem Foundation (no research grant number)</bibtext> </blist> <blist> <bibtext> Ethics approval was obtained and all ethical procedures were followed, including obtaining consent forms from participants</bibtext> </blist> <blist> <bibtext> Raaya Alon</bibtext> </blist> <blist> <bibtext>Graph https://orcid.org/0000-0002-8047-7807</bibtext> </blist> <blist> <bibtext> Editor-in-Charge: Zach Rossetti</bibtext> </blist> </ref> <aug> <p>By Raaya Alon</p> <p>Reported by Author</p> <p></p> <p>Dr. Raaya Alon, Head of the Department of Special Education - Jerusalem College. Her research focuses on various aspects of the lives of family members (such as mothers and siblings) of people with disabilities.</p> </aug> <nolink nlid="nl1" bibid="bib23" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib45" firstref="ref2"></nolink> <nolink nlid="nl3" bibid="bib54" firstref="ref3"></nolink> <nolink nlid="nl4" bibid="bib30" firstref="ref5"></nolink> <nolink nlid="nl5" bibid="bib12" firstref="ref6"></nolink> <nolink nlid="nl6" bibid="bib33" firstref="ref7"></nolink> <nolink nlid="nl7" bibid="bib15" firstref="ref8"></nolink> <nolink nlid="nl8" bibid="bib22" firstref="ref9"></nolink> <nolink nlid="nl9" bibid="bib37" firstref="ref10"></nolink> <nolink nlid="nl10" bibid="bib21" firstref="ref11"></nolink> <nolink nlid="nl11" bibid="bib10" firstref="ref12"></nolink> <nolink nlid="nl12" bibid="bib31" firstref="ref13"></nolink> <nolink nlid="nl13" bibid="bib58" firstref="ref14"></nolink> <nolink nlid="nl14" bibid="bib39" firstref="ref15"></nolink> <nolink nlid="nl15" bibid="bib29" firstref="ref16"></nolink> <nolink nlid="nl16" bibid="bib25" firstref="ref17"></nolink> <nolink nlid="nl17" bibid="bib47" firstref="ref19"></nolink> <nolink nlid="nl18" bibid="bib38" firstref="ref21"></nolink> <nolink nlid="nl19" bibid="bib40" firstref="ref22"></nolink> <nolink nlid="nl20" bibid="bib20" firstref="ref24"></nolink> <nolink nlid="nl21" bibid="bib17" firstref="ref26"></nolink> <nolink nlid="nl22" bibid="bib32" firstref="ref27"></nolink> <nolink nlid="nl23" bibid="bib14" firstref="ref28"></nolink> <nolink nlid="nl24" bibid="bib13" firstref="ref29"></nolink> <nolink nlid="nl25" bibid="bib55" firstref="ref32"></nolink> <nolink nlid="nl26" bibid="bib35" firstref="ref33"></nolink> <nolink nlid="nl27" bibid="bib42" firstref="ref34"></nolink> <nolink nlid="nl28" bibid="bib51" firstref="ref35"></nolink> <nolink nlid="nl29" bibid="bib19" firstref="ref37"></nolink> <nolink nlid="nl30" bibid="bib24" firstref="ref39"></nolink> <nolink nlid="nl31" bibid="bib43" firstref="ref40"></nolink> <nolink nlid="nl32" bibid="bib26" firstref="ref41"></nolink> <nolink nlid="nl33" bibid="bib16" firstref="ref45"></nolink> <nolink nlid="nl34" bibid="bib57" firstref="ref47"></nolink> <nolink nlid="nl35" bibid="bib50" firstref="ref50"></nolink> <nolink nlid="nl36" bibid="bib52" firstref="ref51"></nolink> <nolink nlid="nl37" bibid="bib53" firstref="ref52"></nolink> <nolink nlid="nl38" bibid="bib46" firstref="ref54"></nolink> <nolink nlid="nl39" bibid="bib11" firstref="ref57"></nolink> <nolink nlid="nl40" bibid="bib27" firstref="ref58"></nolink> <nolink nlid="nl41" bibid="bib44" firstref="ref59"></nolink> <nolink nlid="nl42" bibid="bib36" firstref="ref60"></nolink> <nolink nlid="nl43" bibid="bib28" firstref="ref71"></nolink> <nolink nlid="nl44" bibid="bib49" firstref="ref72"></nolink> <nolink nlid="nl45" bibid="bib59" firstref="ref73"></nolink> <nolink nlid="nl46" bibid="bib60" firstref="ref74"></nolink> <nolink nlid="nl47" bibid="bib41" firstref="ref76"></nolink> <nolink nlid="nl48" bibid="bib56" firstref="ref77"></nolink> <nolink nlid="nl49" bibid="bib18" firstref="ref85"></nolink> <nolink nlid="nl50" bibid="bib34" firstref="ref86"></nolink> <nolink nlid="nl51" bibid="bib48" firstref="ref89"></nolink>
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Items – Name: Title
  Label: Title
  Group: Ti
  Data: Examining the Acceptance of Siblings with Down Syndrome through a Positive Psychological Lens
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Raaya+Alon%22">Raaya Alon</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-8047-7807">0000-0002-8047-7807</externalLink>)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Research+and+Practice+for+Persons+with+Severe+Disabilities%22"><i>Research and Practice for Persons with Severe Disabilities</i></searchLink>. 2026 51(2):94-106.
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  Label: Availability
  Group: Avail
  Data: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 13
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2026
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Down+Syndrome%22">Down Syndrome</searchLink><br /><searchLink fieldCode="DE" term="%22Siblings%22">Siblings</searchLink><br /><searchLink fieldCode="DE" term="%22Sibling+Relationship%22">Sibling Relationship</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+Patterns%22">Psychological Patterns</searchLink><br /><searchLink fieldCode="DE" term="%22Social+Support+Groups%22">Social Support Groups</searchLink><br /><searchLink fieldCode="DE" term="%22Attitudes%22">Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Emotional+Response%22">Emotional Response</searchLink><br /><searchLink fieldCode="DE" term="%22Coping%22">Coping</searchLink><br /><searchLink fieldCode="DE" term="%22Personality+Traits%22">Personality Traits</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Jews%22">Jews</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Israel%22">Israel</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1177/15407969251350121
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1540-7969<br />2169-2408
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Typically-developing siblings play an important role in the lives of their siblings with Down Syndrome (DS) and often develop a complex relationship with their sibling. Positive psychology focuses on the positive strengths of an individual and optimal coping with challenging situations, among which can be considered growing up with a sibling with a disability. Optimism, an important way of perceiving the world, may help shape the emotions toward the sibling with DS and how social support is perceived by the typically-developing sibling. As such, this study used structural equation modeling (SEM) to explore how optimism, social support, and negative emotions toward a sibling with DS related to the sibling's acceptance by the typically-developing sibling. Participants were 306 typically-developing siblings of individuals with DS (201 sisters and 105 brothers). SEM revealed that optimism did not directly relate to sibling acceptance, but did relate through the mediation of emotions and social support toward the sibling. The results highlight the need to promote positive strengths and coping skills such as optimism, increase social support, and encourage the expression and processing of the typically-developing siblings' emotions within the family system.
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  Data: 2026
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  Data: EJ1504058
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      – Type: doi
        Value: 10.1177/15407969251350121
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      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 13
        StartPage: 94
    Subjects:
      – SubjectFull: Down Syndrome
        Type: general
      – SubjectFull: Siblings
        Type: general
      – SubjectFull: Sibling Relationship
        Type: general
      – SubjectFull: Psychological Patterns
        Type: general
      – SubjectFull: Social Support Groups
        Type: general
      – SubjectFull: Attitudes
        Type: general
      – SubjectFull: Emotional Response
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      – SubjectFull: Coping
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      – SubjectFull: Personality Traits
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      – SubjectFull: Jews
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      – SubjectFull: Israel
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      – TitleFull: Examining the Acceptance of Siblings with Down Syndrome through a Positive Psychological Lens
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            NameFull: Raaya Alon
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            – D: 01
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              Type: published
              Y: 2026
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            – TitleFull: Research and Practice for Persons with Severe Disabilities
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