Parental depression and family environment predict distress in children before stem cell transplantation.
OBJECTIVE
To examine parental symptoms of depression, family environment, and interaction of these parent and family factors in explaining severity of distress in children scheduled to undergo stem cell or bone marrow transplantation.


METHODS
A self-report measure of illness-related distress, adjusted to reflect the experience of medical diagnosis and associated stressors was completed by 146 youth scheduled to undergo stem cell or bone marrow transplantation. Measures of parental depressive symptoms and family environment (cohesion, expressiveness, and conflict) were completed by the resident parent.


RESULTS
Parental symptoms of depression, family cohesion, and family expressiveness emerged as significant predictors of child-reported distress. Additionally, significant parental depression x family cohesion and parental depression x family expressiveness interactions emerged as predictors of the intensity of the child's distress. When parental depressive symptomatology was high, child distress was high regardless of family environment. However, when parental depressive symptomatology was low, family cohesion and expression served as protective factors against child distress.


CONCLUSIONS
Parental depressive symptomatology and family functioning relate to child distress in an interactive manner. These findings inform future directions for research, including interventions for parents aimed at promoting child adjustment during the pediatric cancer experience.
Jobe-Shields
Lisa
L
Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, TN 38105-2794, USA.
Alderfer
Melissa A
MA
Barrera
Maru
M
Vannatta
Kathryn
K
Currier
Joseph M
JM
Phipps
Sean
S