Sibling adaptation to childhood cancer collaborative study: Parental views of pre- and postdiagnosis adjustment of siblings of children with cancer

In open-ended interviews, parents of 254 siblings of children with cancer evaluated the pre- and postdiagnosis adjustment of their children. One-fourth of the siblings were asymptomatic both before and after the diagnosis. Behavior and emotional problems were the most frequently reported problems arising after the diagnosis. Before the diagnosis, less than 12 percent of the siblings had either behavioral or affective symptoms, whereas 26 percent had such symptoms after the diagnosis. Type of maladjustment was unrelated to sex, birth order, or severity of the patient's illness. On the positive side, parents also reported favorable changes because of the illness in siblings' maturity, supportiveness, and independence. These positive effects were more likely to occur among adolescent and first-born siblings and when the patient's prognosis was poorer.