title: Coping and family functioning predict longitudinal psychological adaptation of siblings of childhood cancer patients.
abstract: OBJECTIVE
  To assess associations of coping and family functioning with psychosocial adjustment in siblings of pediatric cancer patients at 1, 6, 12, and 24 months after diagnosis.
  
  
  METHODS
  Eighty-three siblings (ages 7-19 years) participated. Effects on anxiety, quality of life, behavioral-emotional problems, and emotional reactions to the illness were investigated. Data-analysis was performed with multilevel mixed modeling.
  
  
  RESULTS
  Psychosocial functioning was impaired at 1 month but ameliorated over time. Adjustment problems were associated with high family adaptation and cohesion, older age, and female gender. Lower anxiety, insecurity, loneliness, and illness involvement were related to siblings' ability to remain optimistic. Insecurity and illness involvement were positively related to reliance on the medical specialist and a tendency to seek information about the illness.
  
  
  CONCLUSIONS
  Siblings of pediatric cancer patients are most affected by the illness in the first months. Children at risk may be identified according to sibling age and gender and according to long-term family adaptation processes and sibling coping abilities.
authors.affiliation: Pediatric Psychosocial Department, Academic Medical Center, University of Amsterdam.
authors.forename: Bregje A
authors.initials: BA
authors.lastname: Houtzager
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Oort
authors.forename: Josette E H M
authors.initials: JE
authors.lastname: Hoekstra-Weebers
authors.forename: Huib N
authors.initials: HN
authors.lastname: Caron
authors.forename: Martha A
authors.initials: MA
authors.lastname: Grootenhuis
authors.forename: Bob F
authors.initials: BF
authors.lastname: Last
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000339:Affect; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D003071:Cognition; D005190:Family / Q000523:psychology*; D005500:Follow-Up Studies; D006801:Humans; D009369:Neoplasms; D011446:Prospective Studies; D035781:Siblings / Q000523:psychology*; D011795:Surveys and Questionnaires