Dysfunction in cancer families increases risk of child behavior problems
When a cancer diagnosis is made, it can affect every member of the family that is involved; children of parents who have been diagnosed with cancer have been found to develop emotional and behavioral problems. A recent study published in Cancer has investigated the prevalence of these problems, as well as what predictors may exist for these changes.
Many newly diagnosed cancer patients have dependent children living with them. Around 21% of all newly diagnosed patients are aged 25-54, which suggests that a significant number of children will experience a parent having this illness. While some children are able to cope well, others can develop emotional and behavioral problems.
The American Cancer Society (ACS) identify certain symptoms as emotional and behavioral changes that can occur in children following a parent's cancer diagnosis, including:
- Unable to handle the feelings of sadness
- Thinks of suicide or hurting themselves
- Becomes more irritable and easily angered
- Has changing grades at school
- Withdraws or isolates themselves
- Acts different than usual
- Has appetite changes or low energy levels
- Shows less interest in activities
- Has trouble concentrating or sleeping.
The study, led by Birgit Möller, Ph.D., of the University Medical Center Hamburg-Eppendorf and the University Medical Center Münster in Germany, aimed to examine emotional and behavioral problems in children of cancer patients and identify predictors of these problems.
Cancer families examined
The team assessed 235 families in which at least one parent had been diagnosed with cancer. The 235 families were comprised of 402 parents and 324 children, and were asked to complete questionnaires that assessed their emotional and behavioral health.
Children with a parent who has been diagnosed with cancer can begin to act differently and become isolated.
The researchers found that the children of cancer patients had higher average levels of emotional and behavioral symptoms, compared with those found in a normal control population.
They also found that family dysfunction was the best predictor of emotional and behavioral problems, from both the parents' and the children's perspectives. Dr. Möller says that the level of family functioning predicts children's behavioral and emotional symptoms more than any other tested variable, including illness-related factors.
The researchers also say that the results suggest the families most in need of psychosocial support can be identified through screening for child mental health problems and family dysfunction in oncological and psychosocial treatment units. Dr. Möller adds:
"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."
The study's strengths and weaknesses are acknowledged by the researchers. They say that a comprehensive approach was used in analyzing both healthy and ill parents along with every child member of each family. The sample of participants used was spread across different sites. However, the sample used overrepresented people with high socioeconomic status and did not examine certain medical variables, such as poor prognosis.
Children 'learn through their parents' behavior'
For future study, the team recommends that the focus should be on the identification of child-related potential risk and resilience factors, such as pre-existing problems in children and their temperament.
The ACS say that "children take cues about cancer from parents and other adults. How a child reacts to a cancer diagnosis often depends on how their parents or other close adults handle the crisis. Kids learn through their parents' behavior."
If the parents' behavior is itself dysfunctional, the study suggests that it is most likely that the child's response to a cancer diagnosis is going to be dysfunctional in itself, manifesting itself in emotional and behavioral problems.
The position of the ACS is that if the right kind of help is available, both parents and their children can and do learn to cope well with cancer and its treatments. This new study has helped to suggest ways in which the right kind of help can be made more readily available.
Written by James McIntosh
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