[Brothers of children with a neurological disease: difficulties and affective needs. Study of a clinical sample].
BACKGROUND
Feelings of envy and jealousy among brothers belonging to families with a child affected by a chronic neuromotor impairment have rarely been studied and literature on this subject is sparce. The interest of this work arises in particular from our experience with families and children suffering from this kind of disability.


OBJECTIVE
The individuation of frequency and characteristics of overt or "hidden" emotional problems in brothers of handicapped children. Needs of the handicapped child lead to the partial disinvestment of the "healthy" one. We therefore focused our attention on the defensive mechanisms involved.


METHODS
The work was carried out in the Rehabilitation Unit of our Department of Child Neuropsychiatry. We selected all the families in which a son exhibited severe neuromotor impairment, and we proposed some sessions with the parents and the healthy children. Only 10 families with 11 children accepted these sessions. We asked the other families to fill-in the Achenbach checklist (CBCL). Assessment of the 11 children seen was made with talks, drawing and playing sessions, and with an interview of the parents at the beginning and at the end of the sessions.


RESULTS
We present the data of 33 CBCL filled-in and returned and of 11 psychodiagnostic observations. The CBCL showed 6 pathological and 5 borderline (with high psychopathological risk) total T scores. Among the 11 clinically observed children, 4 revealed a relevant psychopathological profile, so an individual psychotherapeutic therapy was proposed. These children expressed their emotional problems by difficult peer relationships, attention and concentration deficits and failure at school. Moreover, we found a significant correlation between a relevant child psychopathology, the fragile personality structure of the parents, and problems in the parental couple.


CONCLUSIONS
These data stress the importance that must be given to emotional problems of handicapped children's brothers. Very often these children aren't able to express these problems, because either the parents' mental space is full of fears for the sick child's prognosis and care, and their "free" time is filled with hospitalisations, check-ups and rehabilitation. Our experience shows that giving attention and space for thoughts encourages emotional and relational movements, with a transforming value that leads to enhanced integration of emotional experiences.
Balottin
U
U
Child Neuropsychiatry Unit, Department of Clinical and Biological Sciences, University of Insubria, Macchi Foundation Hospital, Varese, Italy.
Termine
C
C
Quadrelli
M
M
Brondolo
S
S
Baratelli
S
S
Zambonin
F
F
D000293:Adolescent; D000339:Affect; D000342:Affective Symptoms / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology; D002675:Child, Preschool; D002908:Chronic Disease; D003674:Defense Mechanisms; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007578:Jealousy; D008297:Male; D008393:Marriage; D009468:Neuromuscular Diseases / Q000523:psychology* / Q000534:rehabilitation; D010287:Parent-Child Relations; D010552:Personality Assessment / Q000706:statistics & numerical data; D011594:Psychometrics; D018570:Risk Assessment; D012801:Sibling Relations; D035781:Siblings / Q000523:psychology*