Adolescent Siblings of Cancer Survivors

Abstract

This thesis reports on the psychological adjustment of adolescent siblings of cancer survivors in New Zealand. In contrast to most previous research which is concentrated on the first two to four years following diagnosis, this study focuses on the time following discharge off treatment. This thesis reports on two studies, a quantitative questionnaire study (N = 31), and a qualitative interview study (N = 10). The first study was quantitative and explored the impact of different family dynamics and coping strategies on three main psychological adjustment outcomes: depression, self-esteem and wellbeing. Participants were aged 12 to 18, predominantly female (N = 20), and their siblings had completed treatment between three months ago and 16 years ago. Findings from the questionnaire study indicated that depression scores in the CES-DC scale were above the cut-off score for depression for 76% of this sample. Regression analysis suggested that increased depression was significantly predicted by lower optimism, being alienated by peers, smaller family size, and by unfair parental differential treatment when parents were perceived as being relatively more affectionate and more controlling of the child who had cancer. Higher self-esteem was predicted by higher optimism. Wellbeing was highest when participants were optimistic and when their relationship with their sibling was low in warmth. The second study reports the findings of semi-structured interviews with10 siblings who had participated in study one. Thematic analysis identified six themes related to their experience of having a sibling who had cancer. These themes were named: stress and distress; I wasn’t anyone’s priority; coping; feeling involved; it’s not all negative; and connection and disconnection. These themes helped give a rich context to some of the quantitative findings in study one. Overall the findings suggest that adolescent siblings of cancer survivors in New Zealand may be at risk of developing problems with low mood. Promoting optimism may be an important part of supporting positive adjustment in siblings. In addition, the various relationships siblings hold, within and outside the family seem to be important for predicting psychological adjustment. The implications of these findings for siblings, their family members, and professionals working with their families are briefly discussed.