Differential Outcomes of Adolescents with Chronically Ill and Healthy Parents

Abstract

Approximately 10% of children grow up with a parent who has been diagnosed with a chronic medical condition (CMC) and seem to be at risk for adjustment difficulties. We examined differences in behavioral, psychosocial and academic outcomes between 161 adolescents from 101 families with a chronically ill parent and 112 adolescents from 68 families with healthy parents, accounting for statistical dependence within siblings. Children between 10 and 20 years and their parents were visited at home and filled in questionnaires. Multilevel analyses showed that 20–60% of the variance in most adolescent outcomes was due to the family cluster effect, especially in internalizing problem behavior, caregiving variables and quality of parent attachment. Conversely, the variance in stress and coping variables and grade point average (GPA) was mainly due to individual characteristics. Adolescents with parents affected by CMC displayed more internalizing problems than the comparison group and scored higher on frequency of household chores, caregiving responsibilities, activity restrictions, isolation, daily hassles and stress. In addition, their grade point average was comparatively worse. No group differences in externalizing problems, coping skills and quality of parent attachment were found. In conclusion, the family cluster effect largely explains adolescent outcomes and should be accounted for. Adolescents with parents affected by CMC are subject to an increased risk for internalizing problems, adverse caregiving characteristics, daily hassles, stress and a low GPA. According to a family-centered approach, school counselors and health care practitioners should be alert to adjustment difficulties of children with a chronically ill parent.

Children with ill parents: extent and nature of caring activities

“…In contrast to previous studies’ findings, such as mothers as the caregiving recipient , in single‐parent, and low‐income household , the parents demographics did not have a significant impact on the children's caring activities. Considering the low explanation power, the only exception was the significant association between the children's responsibility for health care and the families’ low income.…”

“…Lack of access to formal care such as home‐based services, or informal care within the family or network, was other significant factors described in several studies (). Essentially, children were placed into the role of caring when there were no other alternatives .…”

“…A variety of demographic variables related to children and parents have been shown to be associated with the extent and nature of caring activities done by children. Mothers with illness received more caring activities than fathers . Some studies of young carers found that children reported higher extents of caring activities, specifically domestic and personal care, as their ages increased .…”

Primary school achievement and socioeconomic attainment in individuals affected by parental cancer in childhood or adolescence: a Danish nationwide register-based study

“…Lack of social support and caregiving from parents and lack of a proper safety net to compensate for missed schoolwork and learning have also been associated with attenuated academic performance 29–33. Our results regarding GPA are in accordance with a study among children aged 10–20 years old of chronically ill parents suggesting a lower self-reported GPA compared with children of healthy parents 33. However, in our study the attenuation in GPA was mostly profound in subgroups of children whose parent had a severe cancer type or if the parent died of cancer.…”

Childhood household dysfunction, school performance and psychiatric care utilisation in young adults: a register study of 96 399 individuals in Stockholm County

“…The eight indicators: familial death, parental substance abuse and psychiatric morbidity, parental somatic disease, parental criminality, parental separation/single-parent household, public assistance recipiency and residential instability, occurring between birth and age 14 years, are defined in table 1. The selection of conditions constituting the indicator parental severe somatic disease is based on earlier research 25 26. To assess cumulative exposure to the study indicators, the total number was summed.…”