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Effects of Parental Chronic Illness on Children’s Psychosocial and Educational Functioning: a Literature Review

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Abstract

A good number of children grow up in households where a parent has been diagnosed with medical chronic illness. Parental chronic illness is stressful for children and adolescents and may have some potential impact on children’s adjustment and functioning. Some emerging research conducted in the fields of medicine, nursing, and family studies has suggested that children of chronically ill parents are at an increased risk for adjustment difficulties and emotional and behavioral problems. However, this topic has been neglected in school psychology literature. This review aims to provide an overview on research with respect to the effects of parental chronic illness on children’s psychosocial and educational functioning and help school psychology researchers and practitioners understand the impact of parents’ illness on children’s outcomes and factors (e.g., typology of illness, family functioning, parenting, child cognitive appraisal and coping strategies, etc.) that may moderate and mediate the relationship. Mixed findings in the literature reflect the complex and dynamic nature of this issue. Implications and recommendations for interventions will be discussed.

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References

  • Aldridge, J., & Becker, S. (1999). Children as carers: the impact of parental illness and disability on children’s caring roles. Journal of Family Therapy, 21, 303–320.

    Article  Google Scholar 

  • Anderson, C. A., & Hammern, C. L. (1993). Psychosocial outcomes of children of unipolar depressed, bipolar, medically ill, and normal women: a longitudinal study. Journal of Consulting and Clinical Psychology, 61, 448–454.

    Article  PubMed  Google Scholar 

  • Annunziato, R. A., Rakotomihamina, V., & Rubacka, J. (2007). Examining the effects of maternal chronic illness on child well-being in single parent families. Developmental & Behavioral Pediatrics, 28, 386–391.

    Article  Google Scholar 

  • Armistead, L., Klein, K., & Forehand, R. (1995). Parental physical illness and child functioning. Clinical Psychology Review, 15, 409–422.

    Article  Google Scholar 

  • Asen, K. (1985). Illness and family. Journal of the Royal Society of Medicine, 78(suppl. 8), 21–25.

    PubMed  PubMed Central  Google Scholar 

  • Barkmann, C., Romer, G., Watson, M., & Schulte-Markwort, M. (2007). Parental physical illness as a risk for psychosocial maladjustment in children and adolescents: epidemiological findings from a national survey in Germany. Psychosomatics: Journal of Consultation and Liaison Psychiatry, 48, 476–481.

    Article  Google Scholar 

  • Barnes, H. L., & Olson, D. H. (1985). Parent-adolescent communication and the circumplex model. Child Development, 56, 438–447.

    Article  Google Scholar 

  • Bell, K., & Ristovski-Slijepcevic, S. (2011). Metastatic cancer and mothering: being a mother in the face of a contracted future. Medical Anthropology, 30, 629–649.

    Article  PubMed  Google Scholar 

  • Biggar, H., Forehand, R., & Family Health Research Project Group (1998). The relationship between maternal HIV status and child depressive symptoms: do maternal depressive symptoms play a role? Behavior Therapy, 29, 409–422.

    Article  Google Scholar 

  • Birenbaum, L. K., Yancey, D. Z., Phillips, D. S., Chand, N., & Huster, G. (1999). School-age children’s and adolescent’s adjustment when a parent has cancer. Oncology Nurse Forum, 26, 1639–1645.

    Google Scholar 

  • Brennan, J. (2004). Cancer in context: a practical guide to supportive care. New York: Oxford University Press.

    Google Scholar 

  • Bultmann, J. C., Beierlein, V., Romer, G., Moller, B., Koch, U., & Bergelt, C. (2014). Parental cancer: health-related quality of life and current psychosocial needs of cancer survivors and their children. International Journal of Cancer, 135, 2668–2677.

    Article  PubMed  Google Scholar 

  • Burns, M. K. (2011). School psychology research: combining ecological theory and prevention science. School Psychology Review, 1, 132–139.

    Google Scholar 

  • Burns, M. K., Warmbold-Brann, K., & Zaslofsky, A. F. (2015). Ecological theory in school psychology review. School Psychology Review, 44, 249–261.

    Article  Google Scholar 

  • Call, D. A. (1990). School-based group: a valuable support for children of cancer patients. Journal of Psychosocial Oncology, 8, 97–118.

    Article  Google Scholar 

  • Chen, Y. C. (2014). Exploration of the short-term and long-term effects of parental illness on children’s educational and behavioral functioning using a large Taiwanese sample. Western Journal of Nursing Research, 36, 664–684.

    Article  PubMed  Google Scholar 

  • Chen, Y. C., & Fish, M. C. (2013a). Demands of maternal chronic illness and children’s educational functioning: an exploratory study. Child and Adolescent Social Work Journal, 30, 257–274.

    Article  Google Scholar 

  • Chen, Y. C., & Fish, M. C. (2013b). Parental involvement of mothers with chronic illness and children’s academic achievement. Journal of Family Issues, 34, 583–606.

    Article  Google Scholar 

  • Chi, P., Li, X., Tam, C. C., Du, H., Zhao, G., & Zhao, J. (2015). Parenting mediates the impact of caregivers’ distress on children’s well-being in families affected by HIV/AIDS. AIDS and Behavior, 19, 2130–2139.

    Article  PubMed  PubMed Central  Google Scholar 

  • Compas, B. E., Worsham, N. L., Epping-Jordan, J. E., Grant, K. E., Mireault, G., Howell, D. C., & Malcarne, V. L. (1994). When mom or dad has cancer: markers of psychological distress in cancer patients, spouses and children. Health Psychology, 13, 507–515.

    Article  PubMed  Google Scholar 

  • Davey, M. P., Askew, J., & Godette, K. (2003). Parent and adolescents responses to non-terminal parental cancer: a retrospective multiple-case pilot study. Family Systems and Health, 21, 245–258.

    Article  Google Scholar 

  • De Judicibus, M. A., & McCabe, M. P. (2006). The impact of parental multiple sclerosis on the adjustment of children and adolescents. Family Therapy, 33, 79–97.

    Google Scholar 

  • Diareme, S., Tsiantis, J., Romer, G., Tsalamanios, E., Anasontzi, S., Paliokosta, E., & Kolaitis, G. (2007). Families, Systems, & Health, 1, 98–118.

    Article  Google Scholar 

  • Dura, J., & Beck, S. J. (1988). A comparison of family functioning when mothers have chronic pain. Pain, 35, 79–89.

    Article  PubMed  Google Scholar 

  • Dutra, R., Forehand, R., Armistead, L., Brody, G., Morse, E., Morse, P. S., & Clark, L. (2000). Child resiliency in inner-city families affected by HIV: the role of family variables. Behaviour Research and Therapy, 38, 471–468.

    Article  PubMed  Google Scholar 

  • Family Health Project Research Group (1998). The family health project: a multidisciplinary longitudinal investigation of children whose mothers are HIV infected. Clinical Psychology Review, 18, 839–856.

    Article  Google Scholar 

  • Forehand, R., Steele, R., Armistead, L., Morse, E., Simon, P., & Clark, L. (1998). The family health project: psychological adjustment of children whose mothers are HIV infected. Journal of Consulting and Clinical Psychology, 66, 513–520.

    Article  PubMed  Google Scholar 

  • Goodman, R. (1999). The extended version of the strengths and difficulties questionnaire as a guide to child psychiatric caseness and consequent burden. Journal of Child Psychology and Psychiatry, 40, 791–799.

    Article  PubMed  Google Scholar 

  • Grabiak, B. R., Bender, C. M., & Puskar, K. R. (2007). The impact of parental cancer on the adolescent: an analysis of the literature. Psycho-Oncology, 16, 127–137.

    Article  PubMed  Google Scholar 

  • Grant, K. E., & Compas, B. E. (1995). Stress and anxious-depressed symptoms among adolescents: searching for mechanisms of risk. Journal of Consulting and Clinical Psychology, 63, 1015–1021.

    Article  PubMed  Google Scholar 

  • Grant, K. E., Compas, B. E., Thurm, A. E., McMahon, S. D., Gipson, P. Y., Campbell, A. J., & Westerholm, R. I. (2006). Stressors and child and adolescent psychopathology: evidence of moderating and mediating effects. Clinical Psychology Review, 26, 257–283.

    Article  PubMed  Google Scholar 

  • Greening, K. (1992). The “bear essentials” program: helping young children and their families cope when a parent has cancer. Journal of Psychosocial Oncology, 10, 47–61.

    Article  Google Scholar 

  • Heiney, S. P., Bryant, L. H., Walker, L. H., Parrish, R. S., Provenzano, F. J., & Kelly, K. E. (1997). Impact of parental anxiety on child emotional adjustment when a parent has cancer. Oncology Nursing Forum, 24, 655–661.

    PubMed  Google Scholar 

  • Hirsch, B. J., Moos, R. H., & Reischl, T. M. (1985). Psychosocial adjustment of adolescent children of a depressed, arthritic, or normal parent. Journal of Abnormal Psychology, 94, 154–164.

    Article  PubMed  Google Scholar 

  • Hocking, M. C., & Lochman, J. E. (2005). Applying the transactional stress and coping model to sickle cell disorder and insulin-dependent diabetes mellitus: identifying psychosocial variables related to adjustment and intervention. Clinical Child and Family Psychology Review, 8, 221–246.

    Article  PubMed  Google Scholar 

  • Hoke, L. A. (2001). Psychosocial adjustment in children of mothers with breast cancer. Psycho-Oncology, 10, 361–369.

    Article  PubMed  Google Scholar 

  • Horner, R. (2013). Interventions for children coping with parental multiple sclerosis: a systematic review. Journal of the American Association of Nursing Practitioners, 25, 309–313.

    Article  Google Scholar 

  • Howell, K. H., Barrett-Becker, E. P., Burnside, A. N., Wamser-Nanney, R., Layne, C. M., & Kaplow, J. B. (2015). Children facing parental cancer versus parental death: the buffering effects of positive parenting and emotional expression. Journal of Child and Family Studies, 25(1), 152–164 Advanced online publication.

    Article  Google Scholar 

  • Jantzer, V., GroB, J., Stute, F., Parzer, P., Brunner, R., Willig, K., & Resch, F. (2013). Risk behaviors and externalizing behaviors in adolescents dealing with parental cancer—a controlled longitudinal study. Psycho-Oncology, 22, 2611–2616.

    Article  PubMed  Google Scholar 

  • Johnston, M., Martin, D., Martin, M., & Gumaer, J. (1992). Long-term parental illness and children: perils and promises. School Counselor, 39, 225–231.

    Google Scholar 

  • Korneluk, Y. G., & Lee, C. M. (1998). Children’s adjustment of parental physical illness. Clinical Child and Family Psychology Review, 1, 179–193.

    Article  PubMed  Google Scholar 

  • Kotchick, B. A., Summers, P., Forehand, R., & Steele, R. G. (1997). The role of parental and extrafamilial social support in the psychosocial adjustment of children with a chronically ill father. Behavior Modification, 21, 409–432.

    Article  PubMed  Google Scholar 

  • Lester, P., Stein, J. A., & Bursch, B. (2003). Developmental predictors of somatic symptoms in adolescents of parents with HIV: a 12-month follow-up. Journal of Developmental and Behavioral Pediatrics, 24, 242–250.

    Article  PubMed  Google Scholar 

  • Lewis, F. M. (2007). Parental cancer and dependent children: selected issues for future research. Psycho-Oncology, 16, 97–98.

    Article  PubMed  Google Scholar 

  • Lewis, F. M., & Darby, E. L. (2003). Adolescent adjustment and maternal breast cancer: a test of the “faucet hypothesis”. Journal of Psychosocial Oncology, 21(4), 81–104.

    Article  Google Scholar 

  • Lewis, F. M., & Hammond, M. A. (1996). The father’s, mother’s, and adolescent’s functioning with breast cancer. Family Relations, 15, 456–465.

    Article  Google Scholar 

  • Lewis, F. M., Woods, N. F., Hough, E. E., & Bensley, L. S. (1989). The family’s functioning with chronic illness in the mother: the spouse’s perspective. Social Science and Medicine, 29, 1261–1269.

    Article  PubMed  Google Scholar 

  • Lewis, F. M., Brandit, P. A., Cochrane, B. B., Griffith, K. A., Grant, M., Haase, J. E., & Shands, M. E. (2015). The enhancing connections programs: a six-state randomized clinical trial of a cancer parenting program. Journal of Counseling and Clinical Psychology, 83, 13–23.

    Article  Google Scholar 

  • Lindqvist, B., Schmitt, F., Santalahti, P., Romer, G., & Piha, J. (2007). Factors associated with the mental health of adolescents when a parent has cancer. Scandinavian Journal of Psychology, 48, 345–351.

    Article  PubMed  Google Scholar 

  • Mauseth, T., & Hjalmhult, E. (2016). Adolescents’ experiences on coping with parental multiple sclerosis: a grounded theory study. Journal of Clinical Nursing, 25, 856–865.

    Article  PubMed  Google Scholar 

  • Mikail, S. F., & von Baeyer, C. L. (1990). Pain, somatic focus, and emotional adjustment in children of chronic headache sufferers and controls. Social Science Medicine, 31, 51–59.

    Article  PubMed  Google Scholar 

  • Moller, B., Barkman, C., Krattenmacher, T., Kuhne, F., Bergelt, C., Beierlein, V., & Romer, G. (2014). Children of cancer patients. Cancer, 120(15), 2361–2370 Advanced online publication.

    Article  PubMed  Google Scholar 

  • National Center for Chronic Disease Prevention and Health Promotion (2009). The power of prevention: Chronic illness…the public health challenge of the 21st century. Retrieved from http://www.cdc.gov/chronicdisease/pdf/2009-power-of-prevention.pdf

  • Nelson, E., Sloper, P., Charlton, A., & While, D. (1994). Children who have a parent with cancer: a pilot study. Journal of Cancer Education, 9, 30–36.

    Article  PubMed  Google Scholar 

  • Osborn, T. (2007). The psychosocial impact of parental cancer on children and adolescents: a systematic review. Psycho-Oncology, 16, 101–126.

    Article  PubMed  Google Scholar 

  • Pakenham, K. I., & Cox, S. (2014). The effects of parental illness and other ill family members on the adjustment of children. Annual Behavioral Medicine, 48, 424–437.

    Article  Google Scholar 

  • Pedersen, S., & Revenson, T. A. (2005). Parental illness, family functioning, and adolescent well-being: a family ecology framework to guide research. Journal of Family Psychology, 19, 404–419.

    Article  Google Scholar 

  • Phillips, F. (2014). Adolescents living with a parent with advanced cancer: a review of the literature. Psycho-Oncology, 23, 1323–1339.

    Article  PubMed  Google Scholar 

  • Rainville, F., Dumont, S., Simard, S., & Savard, M. H. (2012). Psychosocial distress among adolescents living with a parent with advanced cancer. Journal of Psychosocial Oncology, 30, 519–534.

    Article  PubMed  Google Scholar 

  • Razaz, N., Joseph, K. S., Boyce, W. T., Guhn, M., Forer, B., Carruthers, R., & Tremlett, H. (2015). Children of chronically ill parents: relationship between parental multiple sclerosis and childhood developmental health. Multiple Sclerosis Journal, 22(11), 1452–1462 Advanced online publication.

    Article  PubMed  PubMed Central  Google Scholar 

  • Reid, W. J., & Crisafulli, A. (1990). Marital discord and child behavior problems: a meta-analysis. Journal of Abnormal Child Psychology, 18, 105–117.

    Article  PubMed  Google Scholar 

  • Rolland, J. S. (1987). Chronic illness and the life cycles: a conceptual framework. Family Process, 26, 203–221.

    Article  PubMed  Google Scholar 

  • Rolland, J. S. (1999). Parental illness and disability: a family system framework. Journal of Family Therapy, 21, 242–266.

    Article  Google Scholar 

  • Rotheram-Borus, M. J., Lee, M. B., Gwadz, M., & Draimin, B. (2001). An intervention for parents with their adolescent children. American Journal of Public Health, 91, 1294–1302.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rotheram-Borus, M. J., Lee, M., Lin, Y. Y., & Lester, P. (2004). Six-year intervention outcomes for adolescent children of parents with the human immunodeficiency virus. Archives of Pediatrics and Adolescent Medicine, 158, 742–748.

    Article  PubMed  Google Scholar 

  • Shaffer, A., Jones, D. J., Kotchick, B. A., Forehand, R., & The Family Health Project Research Group (2001). Telling the children: disclosure of maternal HIV infection and its effects on child psychosocial adjustment. Journal of Child and Family Studies, 10, 301–313.

    Article  Google Scholar 

  • Siegel, K., Mesagno, F. P., Karus, D., Christ, G., Banks, K., & Moynihan, R. (1992). Psychological adjustment of children with a terminally ill parent. Journal of American Academy of Child and Adolescent Psychiatry, 31, 327–333.

    Article  Google Scholar 

  • Siegel, K., Karus, D., & Ravei, V. H. (1996). Adjustment of children facing the death of a parent due to cancer. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 442–450.

    Article  Google Scholar 

  • Sieh, D. S., Meijer, A. M., Oort, F. J., Visser-Meily, J. M. A., & Van der Leij, D. A. V. (2010). Problem behavior in children of chronically ill parents: a meta-analysis. Clinical Child and Family Psychology Review, 13, 384–397.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sieh, D. S., Visser-Meily, J. M. A., Oort, F. J., & Meijer, A. M. (2012). The diurnal salivary cortisol pattern of adolescents from families with single, ill and healthy parents. Journal of Psychosomatic Research, 72, 288–292.

    Article  PubMed  Google Scholar 

  • Sieh, D. S., Visser-Meily, J. M. A., & Meijer, A. M. (2013). Differential outcomes of adolescents with chronically ill and healthy parents. Journal Child and Family Studies, 22, 209–218.

    Article  Google Scholar 

  • Sieh, D. S., Oort, F. J., Visser-Meily, J. M. A., & Meijer, A. M. (2014). Mediators for internalizing problems in adolescents of parents with chronic medical conditions. Journal of Developmental Disabilities, 26, 67–82.

    Article  Google Scholar 

  • Steele, R. G., Forehand, R., & Armistead, L. (1997). The role of family processes and coping strategies in the relationship between parental chronic illness and childhood internalizing problems. Journal of Abnormal Child Psychology, 25, 83–94.

    Article  PubMed  Google Scholar 

  • Stein, J. A., Riedel, M., & Rotheram-Borus, M. J. (1999). Parentification and its impact on adolescent children of parents with AIDS. Family Process, 38, 193–208.

    Article  PubMed  Google Scholar 

  • Stein, J. A., Rotheram-Borus, M. J., & Lester, P. (2007). Impact of parentification on long-term outcomes among children of parents with HIV/AIDS. Family Process, 46, 317–333.

    Article  PubMed  Google Scholar 

  • Stoeckel, M., & Weissbrod, D. (2015). Growing up with an ill parent: an examination of family characteristics and parental illness features. Families, Systems, & Health, 4, 356–362.

    Article  Google Scholar 

  • Stoeckel, M., Weissbrod, D., & Ahrens, A. (2015). The adolescent response to parental illness: the influence of dispositional gratitude. Journal of Child and Family Studies, 24, 1501–1509.

    Article  Google Scholar 

  • Tompkins, T. L., & Wyatt, G. E. (2008). Child psychosocial adjustment and parenting in families affected by maternal HIV/AIDS. Journal of Child and Family Studies, 17, 823–838.

    Article  Google Scholar 

  • Umberger, W. (2014). Children of parents with chronic noncancer pain: a comprehensive review of the literature. Journal of Child and Adolescent Psychiatric Nursing, 27, 26–34.

    Article  PubMed  Google Scholar 

  • United States Census Bureau (2014). Fertility of women in the Unites States: 2014. Retrieved from http://www.census.gov/hhes/fertility/data/cps/2014.html

  • Verhaeghe, S., Defloor, T., & Grypdonck, M. (2005). Stress and coping among families of patients with traumatic brain injury: a review of the literature. Journal of Clinical Nursing, 14, 1004–1012.

    Article  PubMed  Google Scholar 

  • Visser, A., Huizinga, G. A., Hoekstra, H. J., van der Graaf, W. T. A., Klip, E. C., Pras, E., & Hoekstra-Weebers, J. E. H. M. (2005). Emotional and behavioral functioning of children of a parent diagnosed with cancer: a cross-informant perspective. Psycho-Oncology, 14, 746–758.

    Article  PubMed  Google Scholar 

  • Visser, A., Huizinga, G. A., Hoekstra, H. J., van der Graaf, W. T., Gazendam-Donofrio, S. M., & Hoekstra-Weebers, J. E. (2007). Emotional and behavioral problems in children of parents recently diagnosed with cancer: a longitudinal study. Acta Oncology, 46, 67–76.

    Article  Google Scholar 

  • Visser-Meily, A., Post, M., Meijer, A. M., van de Port, I., Maas, C., & Lindeman, E. (2005). When a parent has a stroke: clinical course and prediction of mood, behavior problems, and health status of their young children. Stroke, 36, 2436–2440.

    Article  PubMed  Google Scholar 

  • Watson, M., St. James-Roberts, I., Ashley, S., Tilney, C., Brougham, B., Edwards, L., & Romer, G. (2006). Factors associated with emotional and behavioral problems among school age children of breast cancer patients. British Journal of Cancer, 94, 43–50.

    Article  PubMed  PubMed Central  Google Scholar 

  • Welch, A. S., Wadsworth, M. E., & Compas, B. E. (1996). Adjustment of children and adolescent to parental cancer: parents’ and children’s perspectives. Cancer, 77, 1409–1418.

    Article  PubMed  Google Scholar 

  • Xu, J. Q., Murphy, S. L., Kochanek, K. D., & Bastian, B. A. (2016). Deaths: final data for 2013. National Vital Statistics Reports, 64(2), 1–119 Hyattsville, MD: National Center for Health Statistics.

    PubMed  Google Scholar 

  • Zhao, J., Chi, P., Li, X., Tam, C. C., & Zhao, G. (2014). Extracurricular interest as a resilience building block for children affected by parental HIV/AIDS. AIDS Care, 26, 758–762.

    Article  PubMed  Google Scholar 

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Acknowledgment

I thank my research assistant Erika Zywocinski for her assistance in the process of screening articles in school psychology related journals.

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Correspondence to Cliff Yung-Chi Chen.

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Chen, C.YC. Effects of Parental Chronic Illness on Children’s Psychosocial and Educational Functioning: a Literature Review. Contemp School Psychol 21, 166–176 (2017). https://doi.org/10.1007/s40688-016-0109-7

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