title: Associations of child adjustment with parent and family functioning: comparison of families of women with and without breast cancer.
abstract: OBJECTIVE
  To examine the impact of maternal breast cancer on the emotional and behavioral functioning of school-age children; evaluate whether child adjustment is associated with variations in distress, marital satisfaction, and parenting behavior evidenced by mothers and fathers; and determine whether these associations differ from families that are not contending with cancer.
  
  
  METHODS
  Participants included 40 children (age 8-16 years) of mothers with breast cancer along with their parents as well as 40 families of comparison classmates not affected by parental illness. Questionnaires assessing the domains of interest were administered in families' homes.
  
  
  RESULTS
  Mothers with breast cancer and their spouses reported higher levels of distress than comparison parents; child internalizing problems were inversely associated with parental adjustment in both groups. No group differences were found in any indicators of family functioning, including parent-child relationships. Warm and supportive parenting by both mothers and fathers were associated with lower levels of child internalizing behavior, but only in families affected by breast cancer.
  
  
  CONCLUSIONS
  These results suggest that children of mothers with breast cancer, such as most children, may be at risk for internalizing behavior when parents are distressed. These children may particularly benefit from interactions with mothers and fathers who are warm and supportive, and maintenance of positive parenting may partially account for the apparent resilience of these youth.
authors.affiliation: Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA. kathryn.vannatta@nationwidechildrens.org
authors.forename: Kathryn
authors.initials: K
authors.lastname: Vannatta
authors.forename: Rachelle R
authors.initials: RR
authors.lastname: Ramsey
authors.forename: Robert B
authors.initials: RB
authors.lastname: Noll
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Gerhardt
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms; D002648:Child; D002653:Child Behavior Disorders; D005190:Family / Q000523:psychology*; D005220:Fathers / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D010287:Parent-Child Relations; D018454:Spouses / Q000523:psychology; D013315:Stress, Psychological; D011795:Surveys and Questionnaires