Cumulative family risk predicts sibling adjustment to childhood cancer

Authors

  • Kristin A. Long PhD,

    Corresponding author
    1. Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
    • Corresponding author: Kristin Long, PhD, Bradley/Hasbro Children's Research Center, 1 Hoppin Street, Suite 204, Providence, RI 02903; Fax: (401) 444-8742; kristin_long@brown.edu

    Search for more papers by this author
  • Anna L. Marsland PhD, RN,

    1. Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
    Search for more papers by this author
  • Melissa A. Alderfer PhD

    1. Division of Oncology, The Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
    Search for more papers by this author

  • We thank the participating families, the research staff, and Dr. Long's dissertation mentors: Sue Campbell, Kirk Erickson, Lin Ewing, and Bob Noll.

Abstract

BACKGROUND

Prolonged, intensive treatment regimens often disrupt families of children with cancer. Siblings are at increased risk for distress, but factors underlying this risk have received limited empirical attention. In this study, the authors examined associations between the family context and sibling distress.

METHODS

Siblings of children with cancer (ages 8-18 years; N = 209) and parents (186 mothers and 70 fathers) completed measures of sibling distress, family functioning, parenting, and parent post-traumatic stress. Associations between sibling distress and each family risk factor were evaluated. Then, family risks were considered simultaneously by calculating cumulative family risk index scores.

RESULTS

After controlling for sociodemographic covariates, greater sibling distress was associated with more sibling-reported problems with family functioning and parental psychological control, lower sibling-reported maternal acceptance, and lower paternal self-reported acceptance. When risk factors were considered together, the results supported a quadratic model in which associations between family risk and sibling distress were stronger at higher levels of risk.

CONCLUSIONS

The current findings support a contextual model of sibling adjustment to childhood cancer in which elevated distress is predicted by family risk factors, both alone and in combination. Cancer 2013;119:2503-2510. © 2013 American Cancer Society.

Ancillary