title: Family cohesion and expressiveness promote resilience to the stress of pediatric bone marrow transplant: a preliminary report.
abstract: The effect of perceived family environment as a determinant of adjustment in children undergoing bone marrow transplant (BMT) was assessed in a prospective, longitudinal study. Measures of patients' social competence, behavior problems, and self-esteem, along with perceived family conflict, cohesion, and expressiveness, were obtained before hospital admission for BMT and again in the period 6 to 12 months post-BMT. Significant declines were observed in post-BMT social competence and overall self-concept. Before BMT, perceptions of family conflict showed a moderate inverse correlation with patient adjustment, whereas family cohesion and expressiveness were unrelated or were weakly related with adjustment measures. In contrast, all pre-BMT family environment variables were highly predictive of adjustment post-BMT. Using a cross-lagged correlational approach, it was determined that perceived family cohesion and expressiveness act as protective factors, promoting resilience to the stresses of BMT, whereas family conflict acts directly as a risk factor that adversely affects adjustment regardless of stress level.
authors.affiliation: Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee 38101-0318, USA.
authors.forename: S
authors.initials: S
authors.lastname: Phipps
authors.forename: R K
authors.initials: RK
authors.lastname: Mulhern
mesh_terms: D000223:Adaptation, Psychological; D000275:Adjustment Disorders / Q000523:psychology; D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005190:Family / Q000523:psychology*; D005192:Family Health; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012649:Self Concept; D012917:Social Adjustment; D013315:Stress, Psychological / Q000523:psychology*