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Assessing Psychological Adjustment in Siblings of Children With Cancer: Parents’ Perspectives

Cordaro, Giulia MS; Veneroni, Laura MS; Massimino, Maura MD; Clerici, Carlo Alfredo MD

doi: 10.1097/NCC.0b013e3182182869
Articles: Online Only

Background: The siblings of children with neoplastic disease are at risk of emotional and behavioral problems, but few studies have focused on these risks, and findings across studies are inconsistent.

Objective: The objective of this study was to assess psychological adjustment in siblings of children with cancer and analyze the impact of several moderating variables.

Methods: Parents of children with cancer completed the Child Behavior Checklist (CBCL) on their healthy offspring (n = 30, aged 4–18 years), and a semistructured interview on potential risk factors to their child’s adaptation. Child Behavior Checklist scores were compared with those of a control sample of the same age (n = 33).

Results: Contrary to expectations, CBCL scores were better for the siblings of children with cancer. Healthy siblings’ sex and age, family size, understanding of the situation, and changes in daily routine had no influence on CBCL scores. Parent-reported scores indicated that older siblings of the child with cancer have more observable difficulties than do younger siblings.

Conclusions: Future research about healthy siblings will need to clarify whether these results are attributable to healthy siblings’ resilience or to parents’ difficulties in assessing their psychosocial difficulties. Directly measuring the siblings’ perceptions will be of special importance. Distinguishing short- and long-term adjustment will also be important.

Implications for Practice: It is essential to design support programs for all family members and to help parents be aware of their healthy children’s needs.

Author Affiliations: Department of Biomolecular Sciences and Biotechnology, Faculty of Medicine, Psychology Section, University of Milan (Mss Cordaro and Veneroni and Dr Clerici); and Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori (Drs Massimino and Clerici), Milan, Italy.

No funding was received for this study.

The authors have no conflicts of interest to disclose.

Correspondence: Giulia Cordaro, MS, Department of Biomolecular Sciences and Biotechnology, Faculty of Medicine, Psychology Section, University of Milan, Italy (

Accepted for publication February 26, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.