Family functioning and behavioral adjustment in children with leukemia and their healthy peers

In this study we investigated differences in child adjustment and family functioning of 33 children with leukemia and 32 healthy children, examined unique relationships between familial factors and adjustment within each group, and used demographic and family variables to predict child adjustment for both groups. Results indicated that the families of children with leukemia rated themselves as less cohesive and more conflictual than did the families of healthy children. We found no differences in child adjustment between children with leukemia and healthy children; both groups scored well within normal ranges. However, we found different associations between family functioning and child adjustment for the two groups. For the children with leukemia, greater family conflict and less encouragement of autonomy were associated with greater child externalizing symptoms, whereas lower family cohesion, less open expression, and higher levels of control within the family were associated with more child internalizing problems. For the healthy children, family personal growth was associated with better adjustment (i.e., fewer child internalizing problems). We predicted child adjustment using hierarchical. multiple regression analyses and we discuss implications of these findings for a family systems approach in pediatric psychology.