Problem Behavior in Children of Chronically Ill Parents: A Meta-Analysis

Abstract

The aim of this meta-analysis is to examine whether children of chronically ill parents differ from norm groups in problem behavior. We report moderator effects and overall effect sizes for internalizing, externalizing and total problem behavior assessed by children and parents. In fixed effect models, we found a significant overall effect size for internalizing problem behavior (number of studies k = 19, total sample size N = 1,858, Cohen’s d = .23, p < .01) and externalizing problem behavior (k = 13, N = 1,525, d = .09, p < .01) but not for total problem behavior (k = 7; N = 896). Effects for internalizing and externalizing problem behavior were larger in non-cancer studies, in samples including younger children and younger ill parents, in samples defined by low average SES and in studies including parents with longer illness duration. In addition, effects for externalizing problem behavior were larger in studies characterized by a higher percentage of ill mothers and single parents. With exclusive self-report, effect sizes were significant for all problem behaviors. Based on these results, a family-centered approach in health care is recommended.

The well-being of children impacted by a parent with cancer: an integrative review

“…Their distress is likely due to their vulnerability and reliance on positive family functioning [8,9] and concerns about the parent's survival and the family's future [7]. Distress can lead to emotional and psychosocial problems [6], such as problematic internalization (e.g., depressive mood states) or externalization (e.g., aggression, delinquency) of behavior [9,10]. A child's age, gender, and cognitive maturity has been found to effect the way in which children respond to stressful situations [11].…”

Chronic Childhood Stress: Psychometric Properties of the Chronic Stress Questionnaire for Children and Adolescents (CSQ-CA) in Three Independent Samples

“…So, feelings of chronic stress are indications of the impact of stressors and insufficient coping responses or resources on the child due to stressful circumstances during an extended period. These feelings may develop gradually, are unacknowledged or accepted as 'normal' by the child (Dufour et al 2006;Forehand et al 1998;Sieh et al 2010a;Verhaeghe et al 2005).…”

Limiting long-term illness and subjective well-being in families

“…We found that it made no difference which parent was ill, although another study found that mothers' health had a greater impact on young children's SDQ scores than fathers' health (Kelly and Bartley 2010). A recently published meta-analysis by Sieh et al (2010) also found that children of chronically ill parents had more problem behaviours than children of healthy parents, especially among girls and if the mother was ill. However, it was not possible to ascertain if parental gender had different effects for younger or older children.…”

“…Exploring intrapersonal changes in well-being in response to different stressors or events has long been a subject of research (Diener 2000 ;Clark et al 2001 ;Lucas et al 2003 ;Cronin de Chavez et al 2005 ;Lucas 2005 ;Luhmann and Eid 2009 ;Clarke and Georgellis 2010). More recently however researchers have begun to look at intrapersonal changes in SWB due to events experienced by others in their familial or social networks (Berg and Upchurch 2007 ;Fekete et al 2007 ;Giannakopoulos et al 2009 ;Pruchno et al 2009 ;Dorros et al 2010 ;Sieh et al 2010).…”

“…We found no published data on the impact of a parent's limiting long-term illness with respect to adult children living in the same household. Younger children on the other hand, do seem to be affected by parental ill health, with decreases in quality of life and increases in problem behaviours (Giannakopoulos et al 2009 ;Kelly and Bartley 2010 ;Sieh et al 2010). This raises the question of whether adult children living with an ill parent will have poorer well-being or not.…”