title: Brief report: psychological symptoms in healthy female siblings of adolescents with and without chronic conditions.
abstract: OBJECTIVE
  To examine the psychological impact of having a sibling with a chronic condition on healthy adolescent females and to explore the potential moderating role of birth order on this relationship.
  
  
  METHODS
  We compared selected Brief Symptom Index subscales (anxiety, depression, interpersonal sensitivity, hostility) and global severity scores (GSI) in two groups of healthy, inner-city female adolescents matched for sibling age, gender, birth order, and age spacing: 34 sisters of males and females ages 13-19 years with chronic health conditions (ILLSIBS) and 34 sisters of males and females in the same age range without conditions (WELLSIBS).
  
  
  RESULTS
  ILLSIBS generally had more symptoms than WELLSIBS. MANOVA yielded significant three-way interactions of sibling illness status, birth order, and gender for the anxiety, hostility, and GSI. A similar pattern was nonsignificant for the two other subscales. Among younger sisters in general and among older sisters of males only, ILLSIBS had higher scores; however, ILLSIBS who were older sisters of females did not differ significantly in symptom levels from the comparable group of WELLSIBS.
  
  
  CONCLUSIONS
  Psychological symptoms in sisters of inner-city, male and female adolescents are related to sibling health status. However, the combination of sibling gender and birth order may modify this relationship and should be considered when evaluating psychological risk or designing interventions.
authors.affiliation: Department of Pediatrics, Albert Einstein College of Medicine, Jack & Pearl Resnick Campus, 1300 Morris Park Avenue, NR 7S-15, Bronx, New York 10461, USA. ejsilver@aecom.yu.edu.
authors.forename: E J
authors.initials: EJ
authors.lastname: Silver
authors.forename: M J
authors.initials: MJ
authors.lastname: Frohlinger-Graham
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001722:Birth Order; D002908:Chronic Disease / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009679:Nuclear Family / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D000297:Psychology, Adolescent; D012494:Sampling Studies; D012647:Self-Assessment; D012737:Sex Factors; D013315:Stress, Psychological / Q000523:psychology