Adolescent older siblings of children with sickle cell disease: Parent-child interaction, 'parentification,' and peer relationships

Adolescent siblings of children with sickle cell disease (SCD) have a unique role in their families and communities. Little past research has addressed their interactions with important others and psychological and behavioral functioning. The present study examined parent-child interaction, family helping, peer relationships, and behavior of African American adolescent older siblings of SCD patients, and the social support received by parents. Quantitative measures (Background Information Questionnaire, California Inventory for Family Assessment, Family Helping Inventory, Inventory of Parent and Peer Attachment Part III, Child Behavior Checklist, and Multidimensional Scale of Social Support) and additional open-ended questions were used to assess the functioning of these adolescents (n = 15) in comparison to their peers (Non-SCD) (n = 32).; Nonnormality in the sample distribution led to the use of nonparametric tests for data analysis. The results revealed no significant differences between the SCD and comparison group for parent-child interaction (as perceived by the adolescent), family helping by adolescent older siblings, behavior problems of adolescent older siblings, and social support experienced by parents. Although differences in the two groups' total peer attachment scores were not significant, analysis of individual scales revealed that the SCD group had more communication with peers than did the Non-SCD group. Parents and adolescent older siblings of children with SCD identified areas of support and suggestions for other families that have a child with SCD. Their comments addressed the importance of kinship network support; communication and honesty between parents and adolescents; and religious faith.; Disease aspects of SCD, age of younger siblings, and ethnicity factors are discussed as potential reasons for similarity in findings between the two groups. In addition, the small sample size, regional support for families treated at a comprehensive sickle cell center, and narrowness of inclusion characteristics were possible influences on the results. The findings are interpreted with reference to Rolland's (1994) Family Systems - Illness Model. Families with SCD seem to demonstrate healthy psychological functioning and resilience in the face of the adversity that SCD represents. Directions for future research include examining larger samples of families in which a child has SCD and further exploration of the themes that were raised by families in the qualitative segment of the present research.