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JPP Student Journal Club Commentary: Toward a More Complete Understanding of Disruption and Resilience Among Latino and Non-Latino White Youth With Spina Bifida.

In the current issue, Papadakis and her colleagues present a stimulating study, entitled “Psychosocial and Family Functioning among Latino Youth with Spina Bifida” (Papadakis et al., 2017) Their study examined how Latino and non-Latino White youth with spina bifida function psychosocially, as well as how family functioning, in the context of the resilience–disruption framework, impacts psychosocial functioning differentially for these youth. The resilience–disruption framework posits a culturally responsive model, where Latino youth with spina bifida may experience disruptions to typical functioning, but may also experience resilience in the midst of this chronic illness because of culturally specific factors, such as familismo (i.e., family unity, where respect and loyalty are shown to the family unit). It is within this context that the authors present their findings illustrating that Latino youth with spina bifida had lower family conflict, externalizing symptoms, and social competence that their non-Latino White counterparts. Further, the relationship between family functioning and psychosocial outcomes 2 years later varied as a function of youths’ ethnicity. Specifically, among Latino youth greater family conflict predicted lower friendship quality, while for nonLatino White youth greater family cohesion predicted more peer acceptance; higher family stress predicted more internalizing symptoms; and greater family conflict predicted lower internalizing symptoms. This commentary extends relevant discussion to consider the following issues: (1) operationalization and measurement of culturally relevant constructs, (2) importance of study design, and (3) clinical implications. Given these differences across ethnic groups, this study underscores the value of moving beyond exploration of basic ethnic differences to more culturally specific variables that may explain why these ethnic differences occur among children with chronic illness (Helms, Jernigan, & Mascher, 2005). Although this article did not directly measure familismo via a culturally tailored measure, the utilization of a proxy variable (i.e., family cohesion/conflict) highlighted the pivotal role families play in youth psychosocial wellbeing across cultures. Thus, studies that fail to examine such underlying processes may miss opportunities to examine nuanced and potentially mutable factors that could lead to a deeper understanding of both disruption and resilience, as well as contribute to novel strategies for intervention development. Findings from this study also underscore the importance of addressing socioeconomic factors and intellectual functioning when examining family and psychosocial functioning in the context of chronic illness, culture, and ethnicity. Given the well-established association between race/ethnicity and socioeconomic status in the United States, examining one without controlling for or examining the other may lead to inaccurate study conclusions. Specifically, it is possible that socioeconomic status and intellectual functioning may drive certain racial/ethnic differences. Therefore, the inclusion of these two variables is an important strength