Psychosocial risk and resistance factors among children with chronic illness,healthy siblings,and healthy controls

Psychosocial risk and resistance factors within the domains of parental functioning, family Stressors, and family resources were examined as predictors of psychological adjustment and physical problems in juvenile rheumatic disease patients (N=93), their healthy siblings (N=72), and demographically matched healthy controls (N=93). Family socioeconomic status and background variables showed few consistent relationships with child functioning. However, a constellation of risk and resistance factors tended to show comparable associations with functioning for patients, siblings, and controls. Higher parental depression and medical symptoms and more family Stressors, sibling problems, and burden of illness on the family predicted more problems among the patients. These relationships held when disease duration and severity were controlled. For the siblings, increased parental and patient dysfunction, more family Stressors, and less family cohesion and expressiveness were associated with more problems. Although the associations were not as strong, mothers' depression and lack of family cohesion and expressiveness also were related to more adjustment problems among the control children. These findings imply that there may be a general association between certain risk and resistance factors and childhood adaptation.This research was supported in part by NIH Multipurpose Arthritis Center Grant AM20610, NIMH Grant MH16744, and Veterans Administration Medical and Health Services Research and Development Service Research funds. Jan Gottlieb provided valuable help in all phases of the research. We appreciate the help of the staff of the Pediatric Rheumatology Clinic at Children's Hospital at Stanford and the families who participated in this study.