The effect of one child's chronic illness on two children in the same family: A within-family investigation of sibling relationships and social/emotional adjustment

Abstract

One hundred twenty-two mothers, 89 children with chronic illnesses, and 56 of their brothers and sisters participated in a study designed to elucidate the processes by which one child's chronic illness affects two children in the same family. The investigation was guided by assumptions of a phenomenological approach, behavioral geneticists' findings on nonshared environment and by Lazarus' and Folkman's (1984) transactional perspective on stress and coping. This study had four purposes. The first was to describe and compare three different levels of influence on children's developmental context: individual child characteristics, dyadic influences, and family level influences. The individual characteristic was each child's illness appraisals, while dyadic and family level influences were represented by sibling relationship quality and maternal differential treatment, respectively. The second goal was to examine the direct associations among these influences and social emotional adjustment. The third aim was to examine the effect of illness burden and maternal differential treatment on each child's perceptions of sibling relationship quality. The final goal was to examine the influence of these two variables and sibling relationship quality on each child's social-emotional adjustment. Families were recruited through a clinic in Southern Arizona by mail and were sent questionnaires to complete if they expressed interest. For the present study, mothers provided demographic information, and information on objective illness burdens and each child's behavioral adjustment. Children provided illness appraisals and information about their sibling relationships and social emotional adjustment. Children's illness appraisals, perceptions of sibling relationship quality, maternal differential treatment, and social emotional adjustment were remarkably similar to each other. Maternal differential treatment, illness appraisals, and objective illness burdens accounted for significant portions of the variance in siblings' perceptions of sibling relationship quality, but not in the perceptions of children with illnesses. A significant regression equation for social emotional adjustment was obtained for siblings. A significant beta weight indicated that conflict was associated with more negative outcomes.