title: How are the kids holding up? A systematic review and meta-analysis on the psychosocial impact of maternal breast cancer on children.
abstract: BACKGROUND
  Having a mother diagnosed with breast cancer can be a distressing time for a child. This review examines the impact maternal breast cancer has on the psychosocial functioning of children and what factors possibly moderate this relationship.
  
  
  METHODS
  Using PRISMA guidelines, five electronic databases were systematically searched for published studies examining maternal breast cancer and the psychosocial functioning of children.
  
  
  RESULTS
  A total of 15 studies contributed to the analysis. Results from a random effects meta-analysis show that children experience marginally elevated internalizing problems (standardized mean difference=.14, 95% CI .00, .28), significantly fewer total problem behaviors (standardized mean difference=-.13, 95% CI -.23, -.03), and no changes in externalizing problems (standardized mean difference=-.07, 95% CI -.19, .05) relative to comparison groups. Consistent with this, the narrative review suggests the children may experience elevated depression, anxiety and mental distress yet show more social competence and little aggressive or disruptive behavior. Significant moderating variables included informant type (i.e., self-ratings vs mother's ratings vs other's ratings) and comparison group used (i.e., controls vs normative data). There is also evidence that illness severity and maternal mental health may impact the results.
  
  
  CONCLUSIONS
  The results suggest that children may be at risk for internalizing-type problems, especially when their mother experiences depression and has serious medical complications. Research using larger and more diverse samples is needed to fully understand how maternal breast cancer impacts children.
authors: Department of Social Sciences, Augustana Faculty, University of Alberta, 4901-46 Ave., Camrose, AB T4V2R3, Canada. Electronic address: purcstep@ualberta.ca.
authors: Rebecca
authors: R
authors: Purc-Stephenson
authors: Department of Educational Psychology, Faculty of Education, University of Alberta, 11210-87 Ave., Edmonton, AB T6G 2R3, Canada. Electronic address: welde@ualberta.ca.
authors: Annelise
authors: A
authors: Lyseng
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000523:psychology*; D001943:Breast Neoplasms; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009035:Mothers / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*
keywords: Breast cancer; Children; Meta-analysis; Psychosocial functioning; Systematic review