title: Parental depression and family environment predict distress in children before stem cell transplantation.
abstract: 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.
authors.affiliation: Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, TN 38105-2794, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Jobe-Shields
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Alderfer
authors.forename: Maru
authors.initials: M
authors.lastname: Barrera
authors.forename: Kathryn
authors.initials: K
authors.lastname: Vannatta
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Currier
authors.forename: Sean
authors.initials: S
authors.lastname: Phipps