The family roles of siblings of people diagnosed with a mental disorder: Heroes and lost children

In order to cope with the diagnosis of mental illness in a family member, siblings may be forced to adjust their roles in the family. Taking into account the crucial role that some siblings play in caregiving for the mentally ill especially when the parents are no longer available, it is imperative to develop awareness of their unique needs and address them. Thirty‐three adult siblings of people diagnosed with a mental disorder completed the Role Behaviour Inventory (RBI) and a general questionnaire including open‐ended questions regarding the roles they played in their families of origin. Findings from the inventory and general questionnaire suggest that the well siblings score higher on two roles, the Hero and Lost Child, and lower on the Mascot and Scapegoat roles relative to a comparison group (N = 33). Being a sibling caregiver emerged as a risk factor to assume certain dysfunctional roles in the family. Implications for future research and therapy are discussed.     

Caregiver Demand and Parent Distress in Juvenile Rheumatic Disease: The Mediating Effect of Parent Attitude Toward Illness

Parents of youth with juvenile rheumatic diseases (JRD) often take on illness management responsibilities that can become burdensome, potentially resulting in poor parent adjustment outcomes. However, not all caregivers will experience increased distress as a result of variability in stress appraisals. The current study examined the role of parent illness attitudes in the relation between perceived caregiver demand and parental distress. Youth (N = 70) ages 7–18 years diagnosed with a JRD and their parents were recruited from a pediatric rheumatology clinic. Parents completed measures of caregiver demand, parental distress, and illness attitudes. Hierarchical regression revealed a relationship between caregiver demand and parental distress. A significant relationship was also found between caregiver demand and parent illness attitudes, as well as parent illness attitudes and parental distress. Thus, parent illness attitudes mediated the relationship between caregiver demand and parental distress. Techniques aimed at altering negative illness attitudes may help parents cope with their caregiving responsibilities.     

Ethnicity,Life Satisfaction,Stress, Familiarity,and Stigma Toward Mental Health Treatment

The authors examined the relative contribution of ethnicity, life satisfaction, level of stress, familiarity with mental health treatment, and self- and public stigma on attitudes toward mental health treatment among a diverse sample (N = 632) of adults. Results indicated that ethnicity, stress, familiarity, and self-stigma of mental illness were significant predictors of attitudes. Additionally, familiarity with mental health treatment moderated the relationship between public stigma and attitude.     

Justice Beliefs,Personal Well-Being and Harsh Social Attitudes: Initial Demonstration of a Polynomial Regression and Response Surface Methodology

Tendencies to believe in justice are multidimensional and include beliefs that the world is fair to one’s self (personal justice beliefs) as well as to others (general justice beliefs). Previous research suggests that personal and general justice beliefs are divergently linked to well-being and harsh social attitudes, respectively. However, whether and how these justice tendencies conjointly affect well-being and harsh social attitudes is less well known. Guided by equity theory, the current study used polynomial regression and surface response methodology to demonstrate how specific discrepancies between justice beliefs for self and others predict personal well-being and harsh social attitudes. Participants (N?=?1079) completed measures of tendencies to believe in personal and general justice, as well as measures of physical symptoms associated with illness and attitudes towards the poor. Results suggested that discrepancy between personal and general justice beliefs had detrimental effects on these outcomes (i.e., higher number of illness symptoms and harsher attitudes towards the poor). Moreover, discrepancy resulting from a strong belief in general justice and a weak belief in personal justice (i.e., other-favorable discrepancy) was more strongly negatively associated with well-being and positively associated with harsh attitudes towards the poor than discrepancy resulting from a strong personal justice belief and a weak general justice belief (i.e., self-favorable discrepancy). The current research highlights the potential for personal and general justice beliefs to conjointly predict well-being and social attitudes, while simultaneously demonstrating the capacity to better understand these interactive relationships through the use of surface response methodology.     

Young Women’s Accounts of Caregiving,Family Relationships,and Personal Growth When Mother Has Mental Illness

Family members often serve as the primary source of care and support for loved ones living with mental illness. Although existing research has examined the role of parents and well siblings in providing care to adult children with mental illness, relatively little is known about the caregiving experiences of adult children with a parent with a psychiatric disability. Guided by a life course perspective, the present qualitative study examined first-person accounts of 10 young women attending college (ages 18–22) who were raised by a mother living with mental illness (depression, bipolar, or schizophrenia). Participants completed individual semi-structured interviews in which they described their experiences of caregiving, role reversal, and felt obligation towards mother, their ties to father and siblings, and their views of the impact of maternal mental illness on their lives. Overall, young adults’ accounts of their relationship with mother could be characterized as either predominately positive or predominately negative. In general, participants’ accounts of their caregiving experiences, views of felt obligation, and supportiveness of family ties differed depending on their reports of the overall quality of the mother–daughter relationship. Adult daughters described positive impacts of maternal mental illness on their own lives, regardless of their accounts of relationship quality with their mothers.     

Parentification of Adult Siblings of Individuals with Autism Spectrum Disorder

Many typically-developing (TD) siblings provide care for their siblings with autism spectrum disorder (ASD), both as children and as adults. Research on parentification (i.e., when children assume responsibilities typically reserved for adults) has been mixed, with some studies supporting positive outcomes for TD siblings and others indicating negative outcomes. Some of these discrepancies may be due to inconsistencies in differentiating types of parentification. The current study examined how different types of parentification during childhood (retrospectively-reported) related to distress outcomes and attitudes about sibling relationships among 41 TD adult siblings of individuals with ASD. Results indicated that parent-focused parentification was positively related with anxiety and stress among TD siblings. Sibling-focused parentification was positively related to stress but was also related to more positive sibling relationship attitudes. Accounting for demographic variables and the other form of parentification, parent-focused parentification was a unique predictor of distress, whereas sibling-focused parentification was a unique predictor of positive sibling relationship attitudes. Although parentification is often viewed negatively, sibling-focused parentification and perceived benefits of parentification may predict positive outcomes. Results suggest that parentification may prove important in understanding the complex nature of sibling relationships. Specifically, strengthening the sibling bond and reducing parent-focused parentification during childhood may curtail sibling relationship problems and general distress in TD siblings later in life.     

Personal Loss,Parental Relationships,and Caregiving Intentions among Adult Siblings of Individuals with Mental Illness

Journal of Child and Family Studies - Although parents often provide care for adult children coping with serious mental illness, adult siblings are typically expected to assume caregiving...     

Siblings’ Perceptions of Differential Treatment,Fairness, and Jealousy and Adolescent Adjustment: A Moderated Indirect Effects Model

Youth’s perception of parents’ differential treatment (PDT) are associated with maladjustment during adolescence. Although the direct relations between PDT and youth’s maladjustment have been well established, the mechanisms underlying these associations remain unclear. We addressed this gap by examining whether sibling jealousy accounted for the links between PDT and youth’s depressive symptoms, self-worth, and risky behaviors. Additionally, we examined whether youth’s perceptions of fairness regarding their treatment as well as the gender constellation of the dyad moderated these indirect relations (i.e., moderated-indirect effects). Participants were first- and second-born adolescent siblings (M = 15.96, SD = .72 years for older siblings, M = 13.48, SD = 1.02 years for younger siblings) and their parents from 197 working and middle class European American families. Data were collected via home interviews. A series of Conditional Process Analyses revealed significant indirect effects of PDT through sibling jealousy to all three adjustment outcomes. Furthermore, perceptions of fairness moderated the relations between PDT and jealousy, such that the indirect effects were only significant at low (?1 SD) and average levels of fairness. At high levels of fairness (+1 SD) there was no association between PDT, jealousy, and youth adjustment. Taken together, results indicate that youth and parents would benefit from engaging in clear communication regarding the reasoning for the occurrence of differential treatment, likely maximizing youth and parent perceptions of that treatment as being fair and in turn mitigating sibling jealousy and maladjustment.     

Impact of Well-being Interventions for Siblings of Children and Young People with a Chronic Physical or Mental Health Condition: A Systematic Review and Meta-Analysis

Siblings of children and young people with a chronic illness are at increased risk of poor psychological functioning. A number of studies have attempted to implement and evaluate interventions targeting the psychological well-being of this at-risk group. This systematic review summarises the evidence regarding psychological functioning of siblings following an intervention targeting their well-being. The meta-analysis considered behaviour and knowledge, two of the most frequently studied outcomes. The following databases were used: PsycINFO, EMBASE, CINAHL, PubMed, Scopus and Web of Science. Seventeen studies were eligible to be included in the systematic review and eight in the meta-analysis. Results from the systematic review reflected the inconsistency of intervention evaluations in this area with a high level of heterogeneity and a total of 23 outcomes considered across the 17 included studies. The meta-analysis estimated effect sizes using a standardised mean difference (SMD) approach. Pre-post analysis suggested significant improvement in behavioural outcomes and knowledge of their sibling’s health conditions with a SMD of ? 0.44 [95% CI (? 0.6, ? 0.29); p = 0.000] and 0.69 [(95% CI = 0.42, 0.96); p = 0.000], respectively. The SMD was not significant for behavioural outcomes when considering treatment–control studies. In conclusion, the findings suggest interventions for well-being have a positive effect on the psychological functioning of siblings of children and young people with a chronic illness, but their specificity needs to be established. There is a need for further, more methodologically robust research in this area.     

The Head,the Heart,and Hysteria in Jeanne Flore's <Emphasis Type="Italic">Tales and Trials of Love</Emphasis> (c. 1542)

This essay examines a challenge to common literary representations of female mental illness in the Early Modern period—the hysterical woman—in a collection of French short stories contemporary to Vesalius's De Fabrica: Jeanne Flore's Tales and Trials of Love (1542). Jeanne Flore's tales depict several mentally disturbed female protagonists, young women prone to paroxysms of madness and self-mutilation. This study maintains that while Tales and Trials of Love superficially participates in the literary tradition that grew out of those accepted social and medical beliefs, it also questions the long-accepted paradigm of female hysteria and points to a shift in the socio-medical climate. Jeanne Flore's fictional narratives suggest that mental illness no longer consists in the realignment of a uterine imbalance, but rather in the telling of personal stories, a precursor to psychoanalysis and narrative medicine.     

Evaluating Outcome Domains Assessing Caregivers of Individuals with Mental Illness: A Review

In this article, we describe the properties and consider the outcome dimensions of a collection of self‐administered questionnaires that assess caregivers of offspring with mental illness. To this end, we searched the MEDLINE, Web of Science, and PsycINFO databases, as well as reference lists of studies published between 1980 and 2012. We reviewed 43 instruments, and found multiple outcome domains, associated with either objective burden or subjective burden, or both. A number of tools captured additional negative aspects of caregiving (e.g., strain, stress, and worrying) as well as positive aspects (e.g., personal growth, strength, support, rewards, and satisfaction), supplemented by measures assessing caregivers' perceptions and attitudes toward their offspring with SMI (e.g., insight, stigma, and efficacy). This current review of existing measures and their specific domains contributes to a more comprehensive understanding of the caregiving experience and allows both clinicians and researchers to select the most appropriate measurement tools for their purposes.     

Linking psychological need experiences to daily and recurring dreams

The satisfaction of individuals’ psychological needs for autonomy, competence, and relatedness, as conceived from a self-determination theory perspective, is said to be conducive to personal growth and well-being. What has been unexamined is whether psychological need-based experiences, either their satisfaction or frustration, manifests in people’s self-reported dream themes as well as their emotional interpretation of their dreams. A cross-sectional study (N?=?200; M age?=?21.09) focusing on individuals’ recurrent dreams and a three-day diary study (N?=?110; M age?=?25.09) focusing on daily dreams indicated that individuals experiencing psychological need frustration, either more enduringly or on a day-to-day basis, reported more negative dream themes and interpreted their dreams more negatively. The contribution of psychological need satisfaction was more modest, although it related to more positive interpretation of dreams. The discussion focuses on the role of dreams in the processing and integration of psychological need-frustrating experiences.     

Well Children Living with Diabetic Siblings

Abstract

This article examines the psychological adjustment of well children who live with diabetic siblings. A sample of 28 well siblings between the ages of 8 and 12 were studied, utilizing standard tests and a semi-structured interview. Standard tests demonstrated that well siblings had adjustment difficulties manifested by internal stressors that originated from anxiety and low self-concept. This report emphasized the qualitative results of well siblings living with diabetic siblings. The findings conclude that well siblings have difficulties negotiating emotions, communications, and activities with their diabetic siblings. The report interprets sibling issues from a psychodynamic orientation, suggesting that many of the healthy psychological functions performed by the sibling relationship are interrupted by the introduction of a chronic illness. Recommendations based on the findings are offered to professionals who work with diabetic children and their families.     

Predictors of Children's Emotional Distress in a Mother-Absent Situation: Implications for Caregiving Research

Although many factors have been found to be associated with caregiving behavior among preschool-age siblings, few studies have considered the older child's emotional responses to the distress of a younger sibling in the mother's absence. In this study, the authors considered both individual and family factors that predict older and younger sibling distress in a mother-absent situation designed to elicit caregiving behavior. For both older and younger siblings, the strongest predictor of distress following the mother's departure was distress in the other sibling, suggesting the importance of situational factors. Individual and family factors, however, were also found to predict child distress. Among older siblings, shy and sociable temperaments were associated with greater distress during the mother's absence. Higher levels of parenting stress were found to be associated with less distress among both older and younger siblings in the mother-absent situation. Results are discussed in terms of individual and family environment influences on the sibling relationship.     

Self-Disclosure and Spiritual Well-Being in Pastors Seeking Professional Psychological Help

Pastoral mental health is a topic that has only rarely been researched empirically in the psychological literature, yet a pastor’s mental health can have a significant impact on churches, communities, and even nations (Royal and Thompson, Journal of Psychology and Christianity, 31(3), 195–204, 2012). One of the thoughts prompting this research is that evangelical pastors might be expected to resist the findings of psychological research and lack understanding of specific mental illnesses they are potentially facing. Combined with historical and cultural dynamics that could influence resistance to professional psychological help, evangelical pastors have personal, internal factors that could also strengthen resistance, including the researched issues of self-disclosure flexibility and spiritual well-being. A correlational research design with multivariate regression was used to determine potentially significant or predictive relationships between the relevant factors. Among evangelical seminary students (N = 251) preparing for parish-based pastoral ministry, this research determined that no significant relationship, predictive or otherwise, existed between self-disclosure flexibility, spiritual well-being, and attitudes toward seeking professional psychological help. Implications include a shift in focus toward external factors influencing pastors’ help-seeking attitudes, such as the need for the mental health community to develop connections with evangelical pastors and the development of more support for Christian mental health professionals in the larger evangelical community.     

Possible Insomnia Predicts Some Risky Behaviors Among Adolescents When Controlling for Depressive Symptoms

Attachment theory asserts that secure attachment representations are developed through sensitive and consistent caregiving. If sensitive caregiving is a constant characteristic of the parent, then siblings should have concordant attachment classifications. The authors explored maternal attachment quality assessed by the Attachment Q-Set, maternal sensitivity, and specific mother–child interactions between siblings. Hour-long observations took place in the homes of 9 preschool sibling pairs and their immediate caregivers. The interactions were analyzed using a modified version of Bales’ Small Group Analysis. The results reveal attachment discordance in a third of sibling pairs. While maternal sensitivity was higher with older siblings and mothers displayed more positive emotions when interacting with their younger siblings, attachment quality was not associated with birth order. Therefore, a shift toward a more contextual, family-based perspective of attachment is recommended to further understand how attachment strategies are created and maintained within the child's everyday context.     

Age and Gender Variations in Healthy Immigrant Effect: a Population Study of Immigrant Well-Being in Canada

The healthy immigrant effect (HIE) is the phenomenon in which immigrants show better health than their native-born counterparts but this healthier condition declines with length of residence. This study investigated whether (1) immigrants also show better adaptation than non-immigrants as well as better health, (2) length of residence affects their health and adaptation differently, and (3) differential outcomes are found for different age and gender groups. Utilizing the Canadian Community Health Survey (2011–2012) data, immigrants (N?=?17,555) and non-immigrants (N?=?103,579) were divided into adolescents (15–19 years old), adults (20–49), older adults (50–64), and seniors (65–74) to examine their subjective general and mental health, diagnosed chronic and psychological illnesses, and self-reported daily stress, life satisfaction and sense of belonging. After controlling for key demographics, HIE was found to be more robust in health than adaptation. In general, recent immigrants reported better health conditions than long-term immigrants; however, the two did not differ with daily stress or life satisfaction. The older adult immigrants were the only segment of the immigrant population who did not display HIE; within the immigrant population, working-aged long-term adult immigrants were those experiencing negative well-being in both health and adaptation compared to the same-aged recent immigrants. Regarding diagnosed psychological illnesses, immigrants yielded no difference by age, gender, or length of residence, indicating ‘reluctant’ views on seeking professional help for mental health were persistently held by both recent and long-immigrants. The findings suggest that health policy needs to take into consideration age-related life stages, and enhancement of mental health awareness for immigrant well-being.     

Relationship between Disabilities and Adoption Outcomes in African American Children

Although many children adopted from the public child welfare system have special needs, little is known about the experiences of African American adopted children with disabilities and their families. The purpose of this study is to explore different categories of disabilities, including chronic health issues; emotional, mental, or behavioral (EMB) disorders; and intellectual or developmental disabilities (IDDs) on adoption outcomes in a sample of African American children. Data were from the Post-Permanency Round II Survey collected in 2008. A random sample of 412 adoptive parents or legal guardians self-reported their children’s disability diagnoses and family caregiving experiences. Hierarchical regression modelling was used to investigate the relationship between child disability and child and parental outcomes. Results indicated that chronic health issues (β?=?.10, p?<?.05), EMB disorders (β?=?.16, p?<?.01), and IDDs (β?=?.12, p?<?.05) were positively associated with parental burden. In addition, asthma (β?=?.10, p?<?.05), from the larger physical health issue category, was also associated with parental burden. However, none of the disability categories was significantly related with caregiver commitment or adoption dissolution. Future research should disentangle the definitions of special needs or disabilities.     

Mental Health Symptoms and Parenting Stress of Parents of Court-Involved Youth

Youth involved in the juvenile justice system are at risk for emotional and behavioral problems. However, research with court-involved adolescents has neglected to examine the mental health of their parents, who may also have significant personal and parenting stress. This sample consisted of 144 parent–adolescent dyads. Adolescents (aged 11–17 years) identified by court officials were referred to the study to receive mental health treatment. Parents and adolescents completed surveys about their mental health diagnoses, treatment, and family relationships. Using the clinical cut-off for the global severity index of the Symptom Checklist-90-Revised, bivariate and multiple logistic regression analyses were performed to examine group differences between parents with and without significant mental health symptoms. Results indicated that 35% of parents endorsed clinically significant mental health symptoms. Parents with clinically significant symptoms, compared to those without, reported significantly greater parenting stress (p?<?.05), and were more likely to have received prior mental health treatment (54 vs. 25%; p?<?.05) and a psychiatric diagnosis (52 vs. 19%; p?<?.05). Our findings revealed that more than one in three parents of court-involved adolescents are currently experiencing significant mental health symptoms. Improved mental health screening and intervention that incorporates the unique needs of families is recommended, including the possible use of family-based approaches as well as individualized treatment for the parents of court-involved youth.     

Understanding of ASD by Siblings is Associated with Warmth and Hostility in the Sibling Relationship

Autism Spectrum Disorder (ASD) impacts not only the child with ASD, but also the entire family system, including siblings. The present study examined perceptions of the sibling relationship in brothers and sisters of children with ASD, as well as how understanding of autism (symptoms, long-term implications of the disorder) in siblings of children with ASD is related to the sibling’s perceptions of quality of the sibling relationship. Siblings (N?=?44, Mean Age?=?10.4 years, SD?=?2.6) of children with ASD were administered an interview assessing their understanding of ASD and self-report questionnaires measuring their perception of the sibling relationship quality. The more siblings understood about ASD, the more hostility they reported by their sibling with ASD. Age of the sibling, conversely, was negatively associated with both hostile and warm behavior by the brother or sister with ASD towards the sibling. More understanding of autism may be associated with more contention within the sibling relationship, whereas older siblings may spend less time with their brother or sister with autism. Results have implications for improving sibling relationship quality, as well as elucidating the complexity of sibling relationships. These findings have further implications for the development of support systems with use of coping skills for improving the quality of the sibling relationship.