Siblings of chronically ill adolescents: does chronic illness have effects on their development potentials?

Sibling relationships have been studied by developmental psychologists for a long time. Whereas previous research on this topic was focused on examining variables such as gender, age differences and sibling sequence, recent research efforts have directed more attention towards understanding the functions siblings perform for one another and what kinds of emotional relationships exist between them. In this regard, we became interested in identifying the special burdens which siblings of chronically sick children and adolescents must deal with. Two case studies are presented here selected from the research findings obtained from investigation in our research project. Coping with chronic illness as seen in juvenile diabetes. These case studies demonstrate that healthy siblings of chronically sick adolescents may be subjected to considerable burdens and illustrate, as well, the kinds of coping mechanisms siblings adopt in order to deal with them.     

A retrospective study of risk to siblings in abusing families.

Relatively little research has considered the risk to siblings within maltreating families. The sample in the present study consisted of the 795 siblings from a cohort of 400 "index" children who had been referred to police child protection units in England for abuse and/or neglect. In 44% of families (valid cases), the index child was scapegoated, in 37% maltreatment was nonspecific to all siblings, and in 20% maltreatment was specifically directed at some but not all siblings. Scapegoated children were more likely to be older and to experience physical or sexual abuse, whereas younger children and index child referrals for neglect, emotional abuse, or mixed abuse were associated with risk to some or all siblings. Parental difficulties and family stressors increased the risk of maltreatment to all siblings. There was no evidence of increased risk to stepsiblings or children with difficulties, suggesting that the special victim model has limited application. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disentangling the indirect links between socioeconomic status and health: The dynamic roles of work stressors and personal control.

Prior research has documented an indirect link between socioeconomic status (SES) and health, and the goal in this study was to help unravel this phenomenon from a dynamic perspective. The authors hypothesized that SES would be positively related to feelings of personal control and negatively related to perceived work stressors. Drawing on dynamic conceptualizations of these psychosocial factors, they suggest that these psychosocial factors relate to one another over time. Individuals who have higher levels of personal control experience increasingly fewer work stressors over time than do those with lower levels of personal control, and those who experience greater work stressors increasingly perceive less personal control over time than do those with fewer work stressors. Finally, the authors argue that trajectories of personal control and work stressors are associated with the accumulation of health problems over the same period. Their model was tested with 3-wave data (over 4 years) from a nationally representative sample of Canadian employees (N = 3,419). Latent curve modeling provides support for the proposed dynamic model. Conceptual and practical implications are drawn, and suggestions for future research are outlined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective four-year follow-up study of children at risk for ADHD: psychiatric, neuropsychological, and psychosocial outcome

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a familial disorder that places the siblings of ADHD children at high risk for ADHD, conduct, mood, and anxiety disorders. Although the pattern of psychiatric risk has been well documented by prior family studies, neither the short- nor long-term outcome of these high-risk siblings has been prospectively examined. OBJECTIVE: To document the 4-year psychiatric, psychosocial, and neuropsychological outcome of the siblings of children with ADHD. METHOD: DSM-III-R structured diagnostic interviews and blind raters were used to conduct a 4-year follow-up of siblings from ADHD and control families. The siblings were also evaluated for cognitive, achievement, social, school, and family functioning. RESULTS: At follow-up, significant elevations of behavioral, mood, and anxiety disorders were found among the siblings of ADHD children. The high-risk siblings had high rates of school failure and showed evidence of neuropsychological and psychosocial dysfunction. These impairments aggregated among the siblings who had ADHD. CONCLUSIONS: The siblings of ADHD children are at high risk for clinically meaningful levels of psychopathology and functional impairment. In addition to supporting hypotheses about the familial transmission of ADHD, the results suggest that the high-risk siblings might be appropriate targets for primary preventive interventions.     

Family therapy with intellectually and creatively gifted children

Few family therapists have expertise in the psychology of giftedness, and little research has been conducted to determine the effectiveness of family therapy with talented children and their families. The purposes of this paper are: (1) to provide family therapists with information on the unique psychosocial stressors associated with giftedness and (2) to stimulate further research and development on the efficacy of family therapy in alleviating distress and actualizing potential in gifted and talented children and their families. The paper provides a critical overview of the existing research literature on gifted children and their families. First, current conceptualizations of giftedness are described. Then the research literature on the characteristics of intellectually and creatively gifted children and their families is reviewed with an emphasis on the endogenous (individual) and exogenous (systemic) factors that can create or exacerbate psychosocial problems. Finally, we suggest an eclectic, eco-systemic approach to three common concerns that bring gifted children and their families to therapy.     

Psychosocial working conditions and well-being among immigrant and German low-wage workers.

Despite a steady increase of immigrant workers in Germany in the past decades, occupational health research has only peripherally addressed psychosocial working conditions and immigrant worker well-being. This study has two aims: (1) to investigate differences in psychosocial stressors and resources between immigrant and German low-wage workers, and (2) to examine group differences in their association with well-being using a structural equation modeling multiple group analysis approach. Eighty-nine immigrant and 146 German postmen of a German mail service company were surveyed. Results reveal more stressors in the social work environment for the immigrant workers than for their German coworkers but similar levels of task-related stressors in both groups. Stressors are more strongly associated with psychological distress among the German workers. In terms of resources, job control serves as a resource only among German workers, whereas supervisor and coworker support are more important for immigrant workers. These differences suggest that cultural factors, previous work experiences, and expectations influence the worker's experience of psychosocial working conditions and have a direct impact on worker health. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Information booklet for parents of children surviving cancer

With increasing survival rates in pediatric oncology, the medical and psychosocial costs of cure are becoming apparent for the child and his family. The focus of our concern is now how to prevent and to reduce these adverse late effects of cancer and its treatment. To reduce the late psychosocial consequences for the child and its family a booklet was written for parents. We decided to address parents because of the young age of many children when treatment is completed, the essential role of parents in alleviating late effects for the child and his siblings, and the possibility to discuss the whole range of psychosocial late effects: those for the patient, the siblings, and for the parents themselves. The booklet acknowledges the specific emotional problems in patients, parents, and siblings that results from surviving childhood cancer and provides information and support on how to deal with them. The booklet can enhance open communication with the health care team about late consequences. In this way the booklet supports the further integration of medical and psychosocial aftercare.     

Need for psycho-oncologic management in Germany--a comparison of present status and future needs

A comparison of acute care, inpatient rehabilitation and outpatient aftercare in Germany reveals significant differences in the quality and spreading of psychosocial services for cancer patients. Planning psychosocial care for cancer patients, we have to consider patients' need for psychosocial care as well as the health professionals' estimation of patients' needs and the demand for health care services. Analyses of patients' requirements have shown that the needs which patients defined themselves differ from the needs estimated by experts. Therefore, decisions made in health care must be based on systematic data acquired by various approaches. Within the frame of evaluation performed in the research program "Rehabilitation of Cancer Patients" funded by the German Ministry of Research (the former BMFT), data from two studies are presented investigating the need for psychosocial care in oncology using two different approaches. In one study we investigated the status quo of psychosocial care for cancer patients in acute hospitals (n = 585) and rehabilitation centers (n = 42). By use of the Delphi technique, the second study focuses on an analysis of patients' need estimated by health professionals (n = 34). Comparing both studies, deficits in psychosocial care for cancer patients were found especially in acute hospitals and outpatient aftercare services. Methodological problems of the two approaches are discussed and further research strategies are suggested.     

Professionally-led support groups for cancer patients: an intervention in search of a model

OBJECTIVE: The objective of this review was to evaluate the clinical and research literature on professionally-led support groups for cancer patients and to propose an approach that would address patients' needs from diagnosis through survivorship. METHOD: Computerized and manual searches, including Medline and Psychlit searches, were completed for reviews of the literature. Twelve research studies were identified that met our criteria for in-depth review. A clinical model emerged from discussions of an oncology study group based on theoretical formulations and clinical experience with oncology patients. RESULTS: We found that recent research suggests that professionally-led support groups are increasing in number and that participation in such groups seems to enhance patients' quality, and possibly even quantity, of survival. Despite this, little effort has been made to determine what type of group may be appropriate for which patients and when in their course of care. CONCLUSIONS: If psychosocial intervention, in the form of professionally-led support groups for cancer patients, is to be more effective, it should be guided by a model which takes into consideration the changing needs and concerns of patients over the course of illness and, in many cases, recovery. The authors present an outline delineating what such a model might entail.     

Regulation of nitric oxide production by rat alveolar macrophages in response to silica exposure

Research conducted primarily over the past 5-8 years on the psychosocial effects of pediatric chronic physical disorders on children and their families is reviewed. A large body of studies show that both children and their mothers, as groups, are at increased risk for psychosocial adjustment problems compared to peers, but that there is considerable individual variation in outcome. Since the last review on this topic (Eiser, 1990a), many studies have been conducted to identify risk and resistance factors associated with differences in adjustment among these children and their mothers. Improvements are noted in the theoretical basis for this work, programmatic nature of some of the research, and efforts at producing clinically relevant information. Evaluations of interventions, however, are lagging. Critical issues and future directions regarding developmental approaches, theory, method, measurement, and intervention are discussed.     

Typical configurations of psychosocial stress factors of psychiatrically conspicuous children and adolescents

Typical configurations of psychosocial stressors in children and adolescents with psychiatric disorders. Abnormal psychosocial situations are strongly associated with psychiatric disorders in children and adolescents. They are significant risk factors, and sometimes play a causative role. Information about such situations can therefore serve as a basis for planning and implementation of therapeutic interventions. Up till now, however, there has been little evidence for the specificity of the relationship between psychosocial factors and psychiatric disorders. Therefore, in the present study cluster analysis was used to group a psychiatric population of children and adolescents by typical configurations of psychosocial stressors, and the subjects in these clusters were then compared with regard to age, gender, psychiatric disorders and level of intelligence. Five clusters were formed, with qualitative and quantitative differences. One cluster consists of cases with various psychiatric disorders but few psychosocial stressors or none at all. In the other four clusters, "parental handicap, mental disorder or deviation" and "anomalous parenting situation" are variables of key importance as one of them occurs in each cluster, together with different combinations of other psychosocial factors. In the one cluster where both of the previously mentioned key variables occur all of the additional factors also occur.     

Children of depressed mothers: Maternal strain and symptom predictors of dysfunction.

Because of both methodological and theoretical limitations, previous studies of offspring of parents with affective disorders have rarely tested psychosocial models of depressive vulnerability. The current research is part of a longitudinal investigation of psychosocial risk for disorder in 8- to 16-year-old children of unipolar, bipolar, medically ill, and normal mothers. High rates of psychopathology, including depression, were found in children in the high-risk groups. The current study evaluated the separate contributions of maternal depressive history, current self-reported depressive symptoms (Beck Depression Inventory scores), and chronic strains to observe relations between these ordinarily confounded variables and children's psychiatric diagnoses and current functioning. Hierarchical regression analyses indicated that chronic strain added significantly to the prediction of several outcomes and that current depressive symptoms were more predictive of children's scores than was maternal history of affective disorder. Both chronic strains and current Beck Depression Inventory scores are viewed as concomitants of affective disorder but are not specific to it. Therefore studies of the risk to children conferred by parental disorder cannot assume that diagnostic status as such is a single risk factor and must attend to the effects of ongoing stressors and nonspecific symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of traumatic brain injury on the family: A critical review.

Presents a critical overview of the literature of family psychosocial outcome after traumatic brain injury (TBI). Thirty-seven family outcome studies were reviewed. Most of the data presented were on psychosocial outcome of primary caregivers, most often parents and spouses. A smaller amount of outcome literature on siblings and children of a parent with TBI was also considered. In the studies reviewed, 23 different standardized psychosocial outcome measures were used in addition to semistructured, in-depth interviews and indexes such as medication usage and counseling uptake. A clear bias was evident in the literature whereby family outcome was likely to be viewed by researchers in terms of stress and burden on relatives. Recommendations were made for future family outcome research to develop a more theoretically coherent framework of family adaptation post-TBI to expand our understanding of relatives' psychosocial outcome and to shift the research focus to the resilience of families and their ability to work toward positive outcomes. There is a need to use standardized, TBI-specific measures with cross-cultural validity to have less variability in outcome measurement and more consensus in operationalizing outcome in order to enhance comparability between studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does contiguity breed similarity? A within-family analysis of nonshared sources of IQ differences between siblings.

Hypothesized that highly contiguous siblings experience a family environment that is more alike than that experienced by siblings who are separated within the family structure (i.e., siblings with consecutive birth orders should be more alike in IQ than siblings separated by 1 or more birth orders). A dataset from the Fels Research Institute that included 538 children in 173 families (72 2-child families, 44 3-child families, 39 4-child families, and 18 families with 5 or more children). Analytic models based on a simplex birth order correlation structure and on a multiple regression model of IQ differences were developed to test the family structure relationships. Results indicate no family structure effects. It is suggested that genetic sources and 1-time events appear to be more plausible causes of the differences between siblings. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, emotion, and human immune function.

This article provides a review of empirical evidence linking emotional processes to immune function in humans. Acute stressors have produced mixed effects on immunity, presumably through differential activation of physiological stress systems. Chronic stress has been associated with suppression of immune function, and there is evidence that the immune system may not adapt over time. Effects of stress accompanying social disruption and psychological depression, when demonstrated, have been consistently adverse. Certain personality styles may enhance or degrade immune response. Relationships between psychosocial factors and immunity have been identified for several diseases, including cancer, acquired immune deficiency syndrome (AIDS), and autoimmune diseases; psychosocial interventions have been tested with variable results. Theoretical and methodological considerations are summarized and directions for future research suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial impact of illness from a developmental-systems perspective: New directions for health psychology.

Introduces the papers appearing in this special section of the Canadian Journal of Behavioural Science/Revue canadienne des Sciences du comportement (1993[July], Vol 25[3]). Theory, research, and practice in health psychology have established that a variety of psychosocial stressors and adaptive demands are imposed by physical illness. This literature has documented that quality of life and psychosocial well-being can be dramatically affected. However, much of this work has been founded upon a static perspective in which it is assumed that the impact of ill health is universal across conditions, constant over the course of illness, and independent of developmental changes throughout the lifespan. This "uniformity myth" is challenged, however, by recent findings that a variety of psychosocial stressors and adaptive demands impact affected individuals differentially across conditions and stages of illness. The papers that comprise this special section provide a stimulating challenge to the uniformity assumption from diverse perspectives. In so doing, they provide thought-provoking new findings relevant to our theoretical understanding of the psychosocial impact of illness and useful practical suggestions relevant to clinical management. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, social support and pregnancy outcome: a reassessment based on recent research

We present an assessment of studies published in the last decade that consider the relationship of stress and social support to preterm delivery or fetal growth retardation. Included in the review are all reports on the direct effects of stressors or psychological distress; the indirect effects of stressors or distress through health behaviours such as smoking; and the direct and buffering effects of social support. Although an important stimulus for recent stress research has been the attempt to explain racial and social class differences in birth outcome, the recent data show that stressful life events during pregnancy, though more common in disadvantaged groups, do not increase the risk of preterm birth. In contrast, intimate social support from a partner or family member appears to improve fetal growth, even for women with little life stress. Questions unanswered by the research to date are whether elevated levels of depressive symptoms affect pregnancy outcome, either directly or by encouraging negative health behaviours, and whether chronic (vs. acute) stressors are harmful. Additional research is also needed to determine whether psychosocial factors interact with specific clinical conditions to promote adverse pregnancy outcomes. Focusing on intimate support and how it benefits pregnancy outcome could lead to the design of more effective interventions.     

Estimating test-retest reliability in functional MR imaging. II: Application to motor and cognitive activation studies

Research on children's coping with homesickness during relatively uncontrollable separations has suggested that secondary control coping (i.e., adjusting oneself to fit objective conditions) is often preferred over primary control coping (i.e., modifying objective conditions to fit oneself). Related research suggests that negative affect is associated with (a) relinquishing control or using primary control to cope with uncontrollable stressors and (b) perceiving low control over stressors. The convergence of these factors was examined for the stressor of homesickness. Among 1,032 boys and girls spending 2 weeks at residential summer camps, the most frequent and effective way of coping with homesickness was to exert secondary control by engaging in a distracting physical activity. Contrary to speculation, the use of secondary control coping rose in adolescence. Congruent with empirical predictions, the most homesick children perceived low control over homesickness and separation, and coped by relinquishing control.     

Symptoms of female survivors of child sexual abuse

Women who suffered sexual abuse as children often experience a variety of physical and psychosocial symptoms as adults. Identifying this pattern of symptoms might assist health professionals in recognizing and treating nonreporting survivors of child sexual abuse. In this study, the Adult Survivors of Incest (ASI) Questionnaire (Brown & Garrison, 1990) was used to determine the symptoms and contributing factors for 22 adult survivors of child sexual abuse. Six physical symptoms were experienced by 50% of the subjects, and over 75% of the subjects experienced 11 psychosocial symptoms. The number of physical symptoms correlated significantly with other victimizations (r = .59) and number of psychosocial symptoms (r = .56). The findings suggest that the ASI Questionnaire was effective in identifying patterns of symptoms and contributing factors of adult survivors of child abuse. Additional study is needed to determine the usefulness of this questionnaire in identifying nonreporting survivors in clinical situations.     

"You can try or you can just give up": The impact of perceived control and coping style on childhood homesickness.

Research on children's coping with homesickness during relatively uncontrollable separations has suggested that secondary control coping (i.e., adjusting oneself to fit objective conditions) is often preferred over primary control coping (i.e., modifying objective conditions to fit oneself). Related research suggests that negative affect is associated with (a) relinquishing control or using primary control to cope with uncontrollable stressors and (b) perceiving low control over stressors. The convergence of these factors was examined for the stressor of homesickness. Among 1,032 boys and girls spending 2 weeks at residential summer camps, the most frequent and effective way of coping with homesickness was to exert secondary control by engaging in a distracting physical activity. Contrary to speculation, the use of secondary control coping rose in adolescence. Congruent with empirical predictions, the most homesick children perceived low control over homesickness and separation, and coped by relinquishing control. (PsycINFO Database Record (c) 2010 APA, all rights reserved)