Predictors of Sibling Relationship Characteristics in Youth With Juvenile Chronic Arthritis

Relationships between 20 children with juvenile chronic arthritis (JCA) and their siblings were compared with relationships among 20 comparison sibling pairs. Participants ranging in age from 7 to 21 years were interviewed using the Sibling Relationships Questionnaire-Revised. Parents completed ratings of their families' and children's behavior and an illness activity rating scale. Siblings in the JCA and comparison groups did not differ in perceptions of their relationships or in their family structure. Age, sex, birth order, and age difference between siblings were associated with sibling relationship variables, whereas adaptive behavior was not a significant factor. Among JCA patients, severity of illness was positively associated with perceived conflict with siblings.     

An expanded Transactional Stress and Coping Model for siblings of children with sickle cell disease: family functioning and sibling coping, self-efficacy and perceived social support

Aim   To investigate the application of an expanded Transactional Stress and Coping Model for the psychological adjustment of non-chronically ill, African-American siblings of children with sickle cell disease (SCD).
Methods   Ninety-seven siblings (M = 11.24 years) from 65 families who care for a child with SCD participated. Primary caregivers completed the Coping Health Inventory for Parents, the Family Relations Scale and the Child Behaviour Checklist, while siblings completed the Kidcope, the Children's Self-Efficacy for Peer Interaction Scale, and the Social Support Scale for Children.
Results   Family processes were predictive of sibling adjustment, revealing that family coping, expressiveness and support improved adjustment, while family conflict predicted poor adjustment.
Conclusion   Findings suggest that family-centered interventions stressing family expressiveness and support, while minimizing conflict, will contribute to sibling psychological adjustment.     

Expressed emotion in children: associations with sibling relationships

Objective   To investigate the reliability and validity of the expressed emotion (EE) measure, the Pre-school Five Minute Speech Sample (PFMSS), in child-to-child sibling relationships.
Method   A total of 106 boys aged 7–11 were recruited from 12 mainstream primary schools in North Wales. The children completed the PFMSS regarding their sibling and two self-report measures of sibling relationship: the Sibling Relationship Questionnaire (SRQ) and a Child Visual Analogue Scale (CVAS). The parents of 60 participants completed the Strengths and Difficulties Questionnaire regarding the behavioural problems of the participating child and his younger sibling.
Results   The PFMSS demonstrated good inter-rater and code–recode reliability. The significant associations between EE dimensions such as relationship, positive comments and critical comments with various components of the SRQ and CVAS provided support for the concurrent validity of the PFMSS. Significantly higher levels of Conflict and Rivalry and significantly lower levels of Warmth/Closeness on the SRQ were reported by children with high EE, demonstrating good discriminant validity for the PFMSS. There was no significant association between the child's EE profile and the behavioural difficulties of both siblings as reported by parents.
Conclusions   The study found that the PFMSS is a valid and reliable measure of child EE. Future research is needed to clarify the concurrent validity of the warmth and initial statement components of the measure as well as the association between EE dimensions and behaviour.     

Sibling separation and psychological problems of double AIDS orphans in rural China – a comparison analysis

Objective   We investigated the psychological impact of sibling separation among children who lost both of their parents to AIDS and were placed in group care or kinship care settings in rural China.
Methods   Comparative analysis of cross-sectional survey data among 155 children among whom 96 experienced sibling separation. Trauma symptoms (Anxiety, Depression, Anger, Post-traumatic stress, Dissociation, Sexual concerns) were compared between the AIDS orphans who experienced sibling separation and those who did not using analysis of variance and multivariate analysis of covariance.
Results   Among the participants (47.7% girls) with an average age of 12.4 years, univariate and multivariate analyses showed that separation from siblings was associated with significantly higher scores in anxiety, depression, anger and dissociation before or after controlling for gender, age, care arrangement, number of household replacement, trusting relationship with the current caregivers and perceived quality of current living condition. Sibling separation among orphans was not associated with level of post-traumatic stress and sexual concerns.
Conclusion   AIDS orphans separated from their siblings suffered from increased psychological distress compared with those who remained with their siblings. The data in the current study suggest that care arrangement for AIDS orphan should include accommodating the siblings together or providing them with opportunities for frequent contact and/or communication with each other. Appropriate psychological counselling should be given to those orphans experiencing sibling separation.     

Siblings of children with cystic fibrosis: quality of life and the impact of illness

Objective To asses self‐reported quality of life (QoL) and perception of impact of illness on siblings of children with cystic fibrosis (CF). Methods The Child Health Questionnaire was used to assess QoL. The Sibling Perception Questionnaire was used to assess impact of illness. Results Siblings of children with CF (n= 39) rated their QoL higher than siblings of healthy children on most QoL domains (e.g. Physical Functioning, Behavior, Mental Health). Siblings older than the child with CF reported a higher impact of CF than younger siblings. Perceived impact of illness was higher when the child with CF had been hospitalized or was intermittent or chronically infected with Pseudomonas aeruginosa. Conclusions Siblings of children with CF reported a good QoL. QoL and impact of illness were related to indices of CF severity. Insight into sibling‐issues helps CF teams to provide family‐oriented care.     

Discordance Between Sibling and Parent Reports of the Impact of Chronic Illness and Disability on Siblings

This study compared sibling and parent reports of sibling adjustment to chronic illness/developmental disability (CI/DD) in 51 siblings (ages 8 to 13). Discordance between sibling and parent reports on the Sibling Perception Questionnaire was common, with parents tending to report more sibling adjustment problems than did siblings. Siblings who reported more problems than parents tended to be younger and male. There was a trend for parents who reported more problems than siblings to also report greater negative impact of CI/DD on family social functioning than other parents. Findings highlight the importance of obtaining sibling self-reports in research and clinical settings.     

Discordance Between Sibling and Parent Reports of the Impact of Chronic Illness and Disability on Siblings

This study compared sibling and parent reports of sibling adjustment to chronic illness/developmental disability (CI/DD) in 51 siblings (ages 8 to 13). Discordance between sibling and parent reports on the Sibling Perception Questionnaire was common, with parents tending to report more sibling adjustment problems than did siblings. Siblings who reported more problems than parents tended to be younger and male. There was a trend for parents who reported more problems than siblings to also report greater negative impact of CI/DD on family social functioning than other parents. Findings highlight the importance of obtaining sibling self-reports in research and clinical settings.     

Quality of life, health satisfaction and family impact on caregivers of children with developmental delays

Objective   To study the quality of life, health satisfaction and family impact on caregivers of children with developmental delays in Taiwan.
Design   Cross-sectional study.
Subjects   The caregivers of children with diagnoses of developmental delays recruited from a teaching hospital in northern Taiwan.
Methods   The main caregivers of 48 male and 22 female children with developmental delays were recruited. WHOQOL-BREF for health-related quality of life (HRQOL), PedsQL-Health Satisfaction for health satisfaction, PedsQL-Family Impact Module and Impact on Family Scale for family impact were evaluated. The correlation of caregivers' HRQOL, health satisfaction and family impact were also studied.
Results   Caregivers in nuclear families had higher health satisfaction scores (78.2 for nuclear families vs. 66.9 for extended families, P  < 0.05) when assessed by the PedQL-Health Satisfaction questionnaire. Children's age was negatively correlated with family impact, including parent (−0.272, P  = 0.023), family (−0.262, P  = 0.029) and total scores (−0.281, P  = 0.018) as assessed using the PedsQL-Family Impact Module.
Conclusion   A negative relation between impact of burden and child's age suggests that family members gradually adapt to the delayed developmental status in their children as they grow. Caregivers in nuclear families having higher health satisfaction than those in extended families may be due to Chinese cultural effects.     

Effects of childhood chronic illness on families.

This study examined the intellectual ability, academic performance, behavior, and social perceptions of children with a seizure disorder and their nonafflicted siblings. These data suggest the children are at risk for developmental lag and related problems. Impact of the illness on the family differentiated the sibling pair on many tasks and on parents' feelings towards their children. Although parents reported providing a normal environment for their children, the children reported their perceptions of the home environment to be further from the (population norm) than their parents. These results provide evidence for the whole family being affected by the chronic illness thus supporting social work's inherent holistic view. It also underscores the need for a secondary preventive approach with all families containing a child with a handicapping condition.     

Siblings of a child with cancer

Summary A total of 21 healthy siblings were interviewed about their experiences when a brother or sister is diagnosed with cancer. Information about the illness, opinions about who should inform siblings, social support, specific worries and worst memories were studied, as well as perceptions of any differences in the way they were treated by their parents. A short General Impact Scale was developed to assess the extent to which the siblings felt their lives had been disrupted by the illness. Results on these measures were compared with scores on four dimensions of the Sibling Perception Questionnaire (Carpenter & Sahler 1991). Siblings who reported some positive effects as a consequence of the illness (they had become more empathic toward others, or valued life more) perceived their interpersonal relations to be more negatively affected, i.e. there were greater difficulties in their relationships with others especially their parents. Higher scores on communication were related to less of an impact of the illness on life generally. However, these siblings also reported heightened concerns that their brother or sister might die. The data suggested that siblings should have opportunities to talk about implications of the disease, especially worries about death, and more efforts should be made to prepare siblings for visits to hospital and seeing the sick child.     

Chronic illnesses in Canadian children: what is the effect of illness on academic achievement,and anxiety and emotional disorders?

Background   Survival rates of children with a chronic illness is at an all-time high. Up to 98% of children suffering from a chronic illness, which may have been considered fatal in the past, now reach early adulthood. It is estimated that as many as 30% of school-aged children are affected by a chronic illness. For this population of children, the prevalence of educational and psychological problems is nearly double in comparison with the general population.
Methods   This study investigated the educational and psychological effects of childhood chronic illness among 1512 Canadian children (ages 10–15 years). This was a retrospective analysis using data from the National Longitudinal Survey of Children and Youth, taking a cross-sectional look at the relationships between childhood chronic illnesses, performance on a Mathematics Computation Exercise (MCE) and ratings on an Anxiety and Emotional Disorder (AED) scale.
Results   When AED ratings and educational handicaps were controlled for, children identified with chronic illnesses still had weaker performance on the MCE. Chronic illness did not appear to have a relationship with children's AED ratings. The regression analysis indicated that community type and illness were the strongest predictors of MCE scores.
Conclusions   The core research implications of this study concern measurement issues that need to be addressed in future large-scale studies. Clinical implications of this research concern the need for co-ordinated services between the home, hospital and school settings so that services and programmes focus on the ecology of the child who is ill.     

Emotional and behavioural problems in subgroups of children with chronic illness: results from a large-scale population study

Background   Children with chronic illness are known to have an increased risk of emotional and behavioural problems. In the present population-based study children with asthma, neurological disorders and other chronic illnesses were compared with children without chronic illnesses to assess differences in psychological presentation across illness groups.
Methods   A total of 537 children with parent-reported chronic illness in the Bergen Child Study were categorized into three groups: asthma, neurological disorders and other chronic illnesses. Emotional and behavioural problems were assessed by the Strengths and Difficulties Questionnaire.
Results   All three illness groups had an increased rate of emotional and behavioural problems, as well as increased probability of a psychiatric disorder compared with children without a chronic illness. Most children with asthma and other chronic illnesses did not have emotional and behavioural problems, and effect sizes were small in both groups. In children with neurological disorders the effect sizes ranged from moderate to large, with emotional problems, inattention hyperactivity and peer problems being the most frequent problems.
Conclusions   The increased rate of emotional and behavioural problems in children with chronic illness, especially neurological disorders, emphasizes the importance of early detection of mental health problems in these children.     

Looking after well siblings of adolescent girls with anorexia: an important parental role

BACKGROUND: Research has suggested that well siblings of children with chronic and life-threatening illnesses are at risk for negative outcomes and that parents' responses to the illnesses can influence the adaptation of well siblings. Yet, parents' efforts to look after well siblings in the context of illness are rarely considered in literature about sibling adaptation. The importance of attending to the needs of well siblings was a major theme to emerge from a qualitative analysis of the experiences of parents of adolescent girls with anorexia nervosa. METHODS: In-depth interviews were conducted with 24 parents of adolescent girls with anorexia and analysed using grounded theory method. RESULTS: The data indicated that parents viewed caring for well siblings in the context of anorexia as an important role and responsibility. Parents reported making conscious and active efforts to look after well siblings by: maintaining normality; compensating for changes to routines; protecting siblings; providing emotional support; and managing the consequences. CONCLUSIONS: This paper provides a picture of the actions parents take to help well siblings adapt to anorexia in the family. Further research is needed to develop and expand this understanding to families experiencing a wide range of chronic and life-threatening illnesses. The findings underline the importance of clinical attention and further research into the critical parental role of caring for well siblings.     

Adaptation of Siblings of Children Awaiting Liver Transplantation

Pediatric liver transplantation is becoming increasingly common, but specific information regarding the adaptation of the families of these children, particularly of siblings, is lacking. We examined 64 siblings from 45 families of children and adolescents evaluated for liver transplantation using the Child Behavior Checklist and the Impact-on-Family Scale. As a group, the sibling subjects did not show deficits on measures of social competence or behavioral maladjustment. However, 15 siblings showed behavioral maladjustment. These children were not distinguishable from the pool of siblings based on sex, birth order, or age spacing relative to their sibling (the patient), socioeconomic status, or duration of the patient's illness. However, these behaviorally maladjusted children came from families in which the mothers reported significantly greater personal strain than did the other parents in the study. Suggestions are made for interventions to reduce stress in families facing liver transplantation.     

Adaptation of Siblings of Children Awaiting Liver Transplantation

Pediatric liver transplantation is becoming increasingly common, but specific information regarding the adaptation of the families of these children, particularly of siblings, is lacking. We examined 64 siblings from 45 families of children and adolescents evaluated for liver transplantation using the Child Behavior Checklist and the Impact-on-Family Scale. As a group, the sibling subjects did not show deficits on measures of social competence or behavioral maladjustment. However, 15 siblings showed behavioral maladjustment. These children were not distinguishable from the pool of siblings based on sex, birth order, or age spacing relative to their sibling (the patient), socioeconomic status, or duration of the patient's illness. However, these behaviorally maladjusted children came from families in which the mothers reported significantly greater personal strain than did the other parents in the study. Suggestions are made for interventions to reduce stress in families facing liver transplantation.     

Families of chronically mentally ill people: siblings speak to social workers

Twenty siblings of chronically mentally ill people discussed their emotional responses to the mental illness of their brother or sister. The findings were drawn from a study that was part of the author's practice experience as a social worker in a community mental health setting. The findings also paralleled the author's life experiences as a sibling of a chronically mentally ill person. Sibling emotional responses were categorized into grief and loss phases of denial, anger, bargaining, depression, relief/respite, and acceptance. Siblings believed that their expressions of grief and loss were impaired by characteristics of mental illness and by mixed messages from the mental health system. The siblings recommended inclusion of siblings in client treatment; support and education for siblings; clear communication between social worker and family; a social worker focus on family strengths; and, most of all, effective client intervention. The sibling perspective points out the salient need for social workers to use their ecological, person-in-environment training to facilitate healthier family support networks for chronically mentally ill people.     

Correlates of well-being in mothers of children and adolescents with cystic fibrosis

Fifty mothers and 44 well siblings of children and adolescents with cystic fibrosis (CF) participated in this study to identify correlates of maternal well-being. Participants completed postal questionnaires which assessed maternal well-being, problems experienced surrounding the illness and treatment and the nature of the sibling relationship. Due to the demanding nature of treatment and the fact that CF is both genetic and incurable at present we anticipate mothers of these children will experience higher levels of stress and consequently poorer well-being than the normal population. In addition, illness severity, problems with adherence to treatment, child communication, maternal support and the sibling relationship are expected to relate to maternal well-being. Mothers in this sample did not rate their well-being as any different to the normal population. Results suggest that mothers are likely to rate their own well-being as poor when they report more frequent problems surrounding the illness and treatment and well children rate their sibling relationship as having frequent disagreements and aggression. This study highlights factors that are related to maternal well-being in families where one child has CF. These mothers as a group do not appear to be experiencing more stress in their daily lives than the normal population but certain illness and family variables are related to their well-being when examining the mothers on certain dimensions.     

The experiences of Latino siblings of children with developmental disabilities

Objective This qualitative study explored the experiences of Latino siblings of children with developmental disabilities. Methods Parents and typically developing siblings from 15 Latino families with a child with a developmental disability participated in separate interviews. Results Using consensual qualitative research methodology, domains reflecting siblings' relationships, emotional experiences and communication about the disability were identified. The child's need for caregiving was a prominent topic in the sibling and parent narratives. Parents reported concerns about siblings' experience of differential treatment, whereas siblings reported concerns about restricted social activities because of their brother/sister. Conclusions Including multiple informants revealed commonalities and differences in parents' and siblings' perspectives on the impact of a child's disability. The importance of considering sibling adaptation in sociocultural context is discussed.     

Similarities in food preferences between children and their siblings and parents

Fifty-five Canadian women completed questionnaires about the food likes and dislikes of members of their families. Each family consisted of a mother, a father, a "target" child (24-83 months old) and the child's nearest-age sibling. The likes and dislikes of the target children were cross-tabulated with those of their mothers, fathers, and siblings, and phi-statistics were computed for the child-mother, child-father and child-sibling pairs as measures of similarity in food preferences. The results revealed that the target children resembled all three members of their families in their food preferences and that this resemblance was especially pronounced in the case of siblings.