Siblings of children with a chronic illness: a meta-analysis.

OBJECTIVE To review the literature pertaining to the siblings of children with a chronic illness. METHODS Fifty-one published studies and 103 effect sizes were identified and examined through meta-analysis. RESULTS We found (1) a modest, negative effect size statistic existed for siblings of children with a chronic illness relative to comparison participants or normative data; (2) heterogeneity existed for those effect sizes; (3) parent reports were more negative than child self-reports; (4) psychological functioning (i.e., depression, anxiety), peer activities, and cognitive development scores were lower for siblings of children with a chronic illness compared to controls; and (5) a cluster of chronic illnesses with daily treatment regimes was associated with negative effect statistics compared to chronic illnesses that did not affect daily functioning. CONCLUSIONS More methodologically sound studies investigating the psychological functioning of siblings of children with a chronic illness are needed. Clinicians need to know that siblings of children with a chronic illness are at risk for negative psychological effects. Intervention programs for the siblings and families of children with a chronic illness should be developed.

[1]  M. Sawyer,et al.  Psychological adjustment of families of children and adolescents treated for leukemia. , 1986, The American journal of pediatric hematology/oncology.

[2]  Judith A. Hall,et al.  Testing for moderator variables in meta‐analysis: Issues and methods , 1991 .

[3]  K. Knafl,et al.  Well siblings of children with chronic illness: parents' reports of their psychologic adjustment. , 1992, Pediatric nursing.

[4]  J. Lavigne,et al.  Psychological adjustment to pediatric physical disorders: a meta-analytic review. , 1992, Journal of pediatric psychology.

[5]  Blair T. Johnson.  DSTAT : software for the meta-analytic review of research literatures , 1992 .

[6]  I. B. Pless,et al.  Effects of nephrotic syndrome on the family: a controlled study. , 1980, Pediatrics.

[7]  P. Lachenbruch.  Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[8]  R. Moos,et al.  Psychosocial risk and resistance factors among children with chronic illness, healthy siblings, and healthy controls , 1987, Journal of abnormal child psychology.

[9]  A. B. Thompson,et al.  The Psychosocial Adjustment of Well Siblings of Chronically Ill Children , 1994 .

[10]  F. Wamboldt,et al.  Role of the family in the onset and outcome of childhood disorders: selected research findings. , 2000, Journal of the American Academy of Child and Adolescent Psychiatry.

[11]  P. Williams,et al.  Siblings and pediatric chronic illness: a review of the literature. , 1997, International Journal of Nursing Studies.

[12]  J. Auerbach,et al.  Behavioural problems of children with chronic physical illness and their siblings , 1997, European Child & Adolescent Psychiatry.

[13]  I. Martinson,et al.  Behavioral responses of healthy Chinese siblings to the stress of childhood cancer in the family: a longitudinal study. , 1996, Journal of pediatric nursing.

[14]  R. Mulhern,et al.  Sibling adaptation to childhood cancer collaborative study : Cross-cultural aspects , 1997 .

[15]  N. Breslau,et al.  Psychologic functioning of siblings of disabled children. , 1981, Pediatrics.

[16]  E. Silver,et al.  Brief report: psychological symptoms in healthy female siblings of adolescents with and without chronic conditions. , 2000, Journal of pediatric psychology.

[17]  Brad J. Bushman,et al.  Using the normal quantile plot to explore meta-analytic data sets. , 1998 .

[18]  D. Sharpe,et al.  Of apples and oranges, file drawers and garbage: why validity issues in meta-analysis will not go away. , 1997, Clinical psychology review.

[19]  S. Lamorey.  Parentification of Siblings of Children with Disability or Chronic Disease , 1999 .

[20]  M. Corey,et al.  Psychologic adjustment of the family with a member who has cystic fibrosis. , 1986, Pediatrics.

[21]  B. Tew.,et al.  Mothers, Brothers and Sisters of Patients with Spina Bifida , 1973, Developmental medicine and child neurology. Supplement.

[22]  R. Mulhern,et al.  Sibling adaptation to childhood cancer collaborative study: health outcomes of siblings of children with cancer. , 1996, Medical and pediatric oncology.

[23]  N. Breslau,et al.  Siblings of disabled children. Effects of chronic stress in the family. , 1987, Archives of general psychiatry.

[24]  H. Cooper.  Synthesizing Research: A Guide for Literature Reviews , 1998 .

[25]  D. Offord,et al.  The Ontario Child Health Study: Social Adjustment and Mental Health of Siblings of Children with Chronic Health Problems , 1988, Journal of developmental and behavioral pediatrics : JDBP.

[26]  S. Sexson,et al.  Family adaptation and coping among siblings of cancer patients, their brothers and sisters, and nonclinical controls , 1993 .

[27]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[28]  L. Esses,et al.  Psychosocial adaptation of siblings of children with chronic medical illnesses. , 1988, The American journal of orthopsychiatry.

[29]  J. Varni,et al.  Family resources as resistance factors for psychological maladjustment in chronically ill and handicapped children. , 1989, Journal of pediatric psychology.

[30]  S. Stewart,et al.  Adaptation of Siblings of Children Awaiting Liver Transplantation , 1993 .

[31]  E. Zimand,et al.  Sibling Psychological Status and Style as Related to the Disease of Their Chronically III Brothers and Sisters: Implications for Models of Biopsychosocial Interaction , 1988, Journal of developmental and behavioral pediatrics : JDBP.

[32]  J. Mims.  Self-Esteem, Behavior, and Concerns Surrounding Epilepsy in Siblings of Children With Epilepsy , 1997, Journal of child neurology.

[33]  D H Harvey,et al.  The self-concept of physically handicapped children and their non-handicapped siblings: an empirical investigation. , 1984, Journal of child psychology and psychiatry, and allied disciplines.

[34]  J. Lavigne,et al.  Psychologic adjustment of siblings of children with chronic illness. , 1979, Pediatrics.

[35]  A. Siegel,et al.  Developing conceptions of chronic disease: a comparison of disease experience. , 1994, Children's health care : journal of the Association for the Care of Children's Health.

[36]  F. Treiber,et al.  Psychological Adjustment of Sickle Cell Children and Their Siblings , 1987 .

[37]  P. Mckeever.  SIBLINGS OF CHRONICALLY ILL CHILDREN , 1983 .

[38]  W. Maclean,et al.  Children with chronic illness. The prevention of dysfunction. , 1988, Pediatric clinics of North America.

[39]  L. Hedges,et al.  The Handbook of Research Synthesis , 1995 .

[40]  Frank L. Schmidt,et al.  What do data really mean? Research findings, meta-analysis, and cumulative knowledge in psychology. , 1992 .

[41]  L. Hedges,et al.  Statistical Methods for Meta-Analysis , 1987 .

[42]  S. Faux.  Siblings of children with chronic physical and cognitive disabilities. , 1993, Journal of pediatric nursing.

[43]  J. Lavigne,et al.  Correlates of Psychological Adjustment to Pediatric Physical Disorders: A Meta‐analytic Review and Comparison with Existing Models , 1993, Journal of developmental and behavioral pediatrics : JDBP.

[44]  Ronald T. Brown,et al.  Psychological Adjustment and Adaptation of Siblings and Mothers of Children with HIV/AIDS , 1998 .

[45]  S. Beratis,et al.  Psychosocial adjustment of thalassaemic children's siblings. , 1995, Journal of psychosomatic research.

[46]  W. Bukowski,et al.  Social competence of siblings of children with sickle cell anemia. , 1995, Journal of pediatric psychology.

[47]  M. Steward,et al.  The role of cognitive level and sibling illness in children's conceptualizations of illness. , 1979, The American journal of orthopsychiatry.

[48]  R. Moos,et al.  Psychosocial functioning of siblings of children with rheumatic disease. , 1986, The Journal of pediatrics.

[49]  D. Copeland,et al.  Pediatric cancer: predicting sibling adjustment. , 1994, Journal of clinical psychology.

[50]  P. Stallard,et al.  Prevalence and morbidity associated with non-malignant, life-threatening conditions in childhood. , 2001, Child: care, health and development.

[51]  S. Faux.  Sibling relationships in families with congenitally impaired children. , 1991, Journal of pediatric nursing.

[52]  R. Mulhern,et al.  Effectiveness of psychological intervention for children and adolescents with chronic medical illness: a meta-analysis. , 1998, Clinical psychology review.

[53]  H. McGurk,et al.  Cerebral-palsied children's interactions with siblings--I. Influence of severity of disability, age and birth order. , 1993, Journal of child psychology and psychiatry, and allied disciplines.

[54]  I. Chasnoff,et al.  Parental Perceptions of the Psychological Adjustment of Children with Diabetes and Their Siblings , 1982, Diabetes Care.

[55]  M. W. Clark,et al.  STRESS IN FAMILIES OF CHILDREN WITH MYELOMENINGOCELE , 1986, Developmental medicine and child neurology.

[56]  D. Sharpe,et al.  The Siblings of Individuals with Mental Retardation: A Quantitative Integration of the Literature , 2001 .

[57]  M. Dewey,et al.  Children with end-stage renal failure: psychological effects on patients, siblings and parents. , 1985, Journal of psychosomatic research.

[58]  P. Newacheck,et al.  Childhood chronic illness: prevalence, severity, and impact. , 1992, American journal of public health.

[59]  R. Mulhern,et al.  Sibling Adaptation to Childhood Cancer Collaborative Study: Prevalence of Sibling Distress and Definition of Adaptation Levels , 1994, Journal of developmental and behavioral pediatrics : JDBP.

[60]  A. Stein,et al.  Psychosocial adjustment in siblings of children with chronic life-threatening illness: a research note. , 1992, Journal of child psychology and psychiatry, and allied disciplines.

[61]  D. Faust,et al.  Examining the effects of chronic disease and disability on children's sibling relationships. , 1988, Journal of pediatric psychology.

[62]  D. Cushway,et al.  Sibling response to childhood cancer: a new approach. , 1992, Child: care, health and development.

[63]  N. Gold.  Depression and social adjustment in siblings of boys with autism , 1993, Journal of autism and developmental disorders.

[64]  M. Ferrari.  The diabetic child and well sibling: Risks to the well child's self‐concept , 1987 .

[65]  M. Cuskelly.  Adjustment of siblings of children with a disability: Methodological issues , 1999 .

[66]  T. Boat,et al.  Psychosocial functioning of children with cystic fibrosis. , 1981, Pediatrics.

[67]  E. Midlarsky,et al.  Siblings of the Handicapped: A Literature Review for School Psychologists. , 1985 .

[68]  M. Cohen.  Families coping with childhood chronic illness: A research review. , 1999 .