Academic journal article Health and Social Work

Psychological Adjustment of Siblings to a Child with Diabetes

Academic journal article Health and Social Work

Psychological Adjustment of Siblings to a Child with Diabetes

Article excerpt

This article presents results of a study examining the psychological adjustment of well child siblings living in the same household as siblings with diabetes. A sample of 28 well siblings between the ages of eight and 12 were studied. Psychological adjustment was assessed by measuring self-concept, behavioral difficulties and competence, anxiety, and depression on standardized tests. A semistructured interview reported data gathered on the well siblings' emotional feelings and their communication patterns. The well siblings demonstrated significant internal psychological stressors and maintained high levels of behavioral competence. The internal stressors originated from anxiety and low self-concept. Recommendations based on the findings are offered to professionals who work with children with diabetes and their families.

Keywords diabetes family illness sibling adjustment sibling relationships

A growing body of literature acknowledges the influence siblings have on each other's emotional development. The introduction of a chronic illness into this relationship complicates its negotiations. The chronic illness of one child introduces stressors into the sibling relationship, which may interfere with the psychological growth of the well sibling.

There is a growing interest in studying the effects of a chronically ill child on family members. Because of the success of modern medicine, many children handicapped with illness are living longer and with their families. According to Derouin and Jessee (1996), 10 percent of children in the United States grew up with a brother or sister who suffered from a chronic illness. Most research on the psychosocial adjustment of family members to a child's illness focused on the ill children and their parents rather than healthy siblings (Bendor, 1990; Bluebond-Langer, 1996; Brody & Stoneman, 1990; Carlson, Leviton, & Mueller, 1993; Ferrari, 1984; Gogan & Koocher, 1977; Iles, 1979; Kramer, 1981; McKeever, 1983; Seligman, 1987). Research identifies well siblings as a population at risk of psychological distress. Several studies suggest that many well siblings develop higher risks of anxiety, depressive symptoms, and somatic complaints and suffer from lower self-esteem (Binger, 1973; Bluebond-Langer, 1996; Cairns & Cl ark, 1979; Daniels, Miller, Billings, & Moos, 1986; Ferrari, 1984, 1987; McKeever, 1983; Spinnetta, 1981. In explaining the presence of these stressors in well children living with ill siblings, semistructured interviews suggest that the well sibling's experience of resentment toward the ill child, exaggerated sibling rivalry, strong sense of responsibility, and social and emotional isolation may be contributing factors (Bendor, 1990; Bluebond-Langner, 1996; Chesler, Allswede, & Caeran, 1991; Grain, Sussman, & Weil, 1966; Davies, 1993; Tritt & Esses, 1988).

The study discussed in this article investigated well children living with a child sibling diagnosed with diabetes. Juvenile diabetes is the most frequently reported chronic childhood disease in the United States. Approximately 1.7 per 1,000 children develops diabetes in the United States. There are approximately 13,000 new cases of juvenile diabetes each year (National Institutes of Health, 1995). The vast majority of children who are diagnosed with diabetes suffer from Type 1 diabetes. This results from the body's failure to produce insulin, a hormone that unlocks the cells of the body, which allows glucose to enter and fuel cells. Insulin does not cure the disease but prevents the disease from causing ongoing damage to the body. Untreated diabetes can lead to blindness, heart problems, strokes, nerve damage, amputation, and kidney failure. Because diabetes is life threatening, daily monitoring of the child's injections, diet, and blood sugar levels is necessary to prevent diabetes from becoming life threa tening.

Few studies have investigated the well sibling who lives with a child diagnosed with diabetes. …

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