Family dysfunction a strong predictor of emotional problems in children of cancer patients

A cancer diagnosis affects the whole family, and a significant number of children of cancer patients may be at risk for emotional and behavioral problems. A new analysis published early online in Cancer, a peer-reviewed journal of the American Cancer Society, suggests that family dysfunction may increase a child's risk of experiencing such problems after learning of a parent's illness.

Approximately 21% of all newly diagnosed cancer patients are between the ages of 25 and 54 years, and many may have dependent children living with them at home. While most children and adolescents cope well with a parent's illness, some can become highly distressed or develop psychosocial issues. Therefore, it is important to know which factors may affect a children's adjustment to a parent's cancer diagnosis and to develop specific screening tools and healthcare programs for children who may go on to experience problems.

In a recent study led by Birgit Möller, PhD, of the University Medical Center Hamburg-Eppendorf and the University Medical Center Münster in Germany, 235 families—including 402 parents and 324 children aged 11 to 21 years—completed questionnaires that assessed emotional and behavioral health. At least one parent in each family was diagnosed with cancer.

The researchers found that, compared with norms, children of cancer patients showed increased average levels of emotional and behavioral symptoms. From both the parents' and the children's perspectives, the best predictor of emotional and behavioral problems was general family dysfunction. "This means that in view of a life-threatening disease in a parent, the level of family functioning predicts children's behavioral and emotional symptoms more than any other tested variable including illness-related factors," Dr. Möller explained.

Dr. Möller noted that screening for child mental health problems, family dysfunction, and parental depression can be easily adopted into cancer care so that families in need of support can be identified. "Additional training of oncologists, interdisciplinary approaches, and family-based mental health liaison services are recommended to meet the needs of minor children and their families and to minimize negative long-term effects in children," she said. Dr. Möller and her team have developed a preventive counseling program—called the Children of Somatically Ill Parents (COSIP) program—that focuses on family communication, affective involvement of family members, flexible problem solving, mutual support, and parenting issues.