Skip to main content
Top
Published in: European Child & Adolescent Psychiatry 6/2006

01-09-2006 | ORIGINAL CONTRIBUTION

Emotional and behavioural difficulties in children of parents with multiple sclerosis

A controlled study in Greece

Authors: Stavroula Diareme, PhD, John Tsiantis, MD, DPM, FRC Psych, Gerasimos Kolaitis, MD, Spyros Ferentinos, PhD, Emmanuel Tsalamanios, Elena Paliokosta, MD, Sophia Anasontzi, MA, Eirini Lympinaki, Msc, Dimitris C. Anagnostopoulos, MD, PhD, Costas Voumvourakis, MD, Dr. med. Georg Romer

Published in: European Child & Adolescent Psychiatry | Issue 6/2006

Login to get access

Abstract

Emotional and behavioural problems were investigated in children who have a parent with multiple sclerosis (MS), in relation to factors such as family dysfunction, parental depression and illness-related characteristics. The participants were 56 MS patients, their spouses and one randomly selected child aged 4–17 years, and a comparison group of 64 children and both their parents, none of whom reported somatic illness. Emotional and behavioural problems in the children were identified by reporting of both parents and self-report using the Achenbach’s Child Behaviour Checklist and Youth Self Report respectively. Parental depression and family dysfunction were explored using the Beck Depression Inventory and Family Assessment Device, respectively. The data were analysed using independent samples t-tests for between-group comparisons, Pearson r correlations between children’s problems and family dysfunction or parental depression, and multiple regression analyses for identifying predictors for children’s problems. Children whose parents, especially mothers, had MS presented greater emotional and behavioural problems than comparison children. Children’s problems were positively associated with maternal depression and family dysfunction. Family dysfunction predicted children’s overall and externalizing problems, while the severity of impairment of the ill mother predicted children’s internalizing problems. Implications of these findings for clinical practice are discussed.
Footnotes
1
The study sample selection criteria and the measurement instruments were selected within the context of the multisite research project, supported by a European Union grant—“Mental Health Prevention in a Target Group at Risk: Children of Somatically Ill Parents (COSIP)” (QLGT—2001—02378).
 
2
No significant differences were revealed based either on mother’s or father’s report (CBCL) of child problems. However, for reasons of brevity, P values presented in this paragraph in the parentheses are based only on mother’s report.
 
3
Inventory of Parent and Peer Attachment (IPPA) [5]; Family Crisis Oriented Personal Scales (F-COPES) [20]; KINDL [22]; KIDCOPE Interview [31]
 
Literature
1.
go back to reference Achenbach TM (1991a) Manual for the child behaviour checklist and 1991 child behaviour profile. University of Vermont, Department of Psychiatry, Burlington, VT Achenbach TM (1991a) Manual for the child behaviour checklist and 1991 child behaviour profile. University of Vermont, Department of Psychiatry, Burlington, VT
2.
go back to reference Achenbach TM (1991b) Integrative guide to the 1991 CBCL/4-18, YSR and TRF profiles. University of Vermont, Department of Psychiatry, Burlington, VT Achenbach TM (1991b) Integrative guide to the 1991 CBCL/4-18, YSR and TRF profiles. University of Vermont, Department of Psychiatry, Burlington, VT
3.
go back to reference Armistead L, Klein K, Forehand R (1995) Parental physical illness and child functioning. Special issue: the impact of the family on child adjustment and psychopathology. Clin Psychol Rev 15(5):409–422CrossRef Armistead L, Klein K, Forehand R (1995) Parental physical illness and child functioning. Special issue: the impact of the family on child adjustment and psychopathology. Clin Psychol Rev 15(5):409–422CrossRef
4.
go back to reference Armsden G, Lewis FM (1993) The child’s adaptation to parental medical illness: theory and clinical implications. Patient Educ Couns 22(3):153–165PubMedCrossRef Armsden G, Lewis FM (1993) The child’s adaptation to parental medical illness: theory and clinical implications. Patient Educ Couns 22(3):153–165PubMedCrossRef
5.
go back to reference Armsden GC, Greenberg MT (1987) The inventory of parent and peer attachment: relationships to well-being in adolescence. J Youth Adolescence 16(5):427–454CrossRef Armsden GC, Greenberg MT (1987) The inventory of parent and peer attachment: relationships to well-being in adolescence. J Youth Adolescence 16(5):427–454CrossRef
6.
go back to reference Armstrong J (1988) Emotional functioning of Multiple Sclerosis patients from a family life cycle stage perspective. Dissertation Abstracts International: 48/10b Armstrong J (1988) Emotional functioning of Multiple Sclerosis patients from a family life cycle stage perspective. Dissertation Abstracts International: 48/10b
7.
go back to reference Arnaud (1992) Some psychological characteristics of children of Multiple Sclerosis. Psychosom Med 21(1):8–22 Arnaud (1992) Some psychological characteristics of children of Multiple Sclerosis. Psychosom Med 21(1):8–22
8.
go back to reference Beck AT, Ward C, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiat 4:53–63 Beck AT, Ward C, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiat 4:53–63
9.
go back to reference Blackford KA (1992) Strategies for intervention and research with children or adolescents who have a parent with Multiple Sclerosis. Axon: 50–54 Blackford KA (1992) Strategies for intervention and research with children or adolescents who have a parent with Multiple Sclerosis. Axon: 50–54
10.
go back to reference Brennan PA, Brocque RL, Hammen C (2003) Maternal depression, parent-child relationships, and resilient outcomes in adolescence. J Am Acad Child Adol Psychiat 42:1469–1477CrossRef Brennan PA, Brocque RL, Hammen C (2003) Maternal depression, parent-child relationships, and resilient outcomes in adolescence. J Am Acad Child Adol Psychiat 42:1469–1477CrossRef
11.
go back to reference Brennan PA, Hammen C, Andersen MJ, Bor W, Najman JM, Williams GM (2000) Chronicity, severity and timing or maternal depressive symptoms: Relationships with child outcomes at age 5. Developmental Psychopathology 36: 759–766 Brennan PA, Hammen C, Andersen MJ, Bor W, Najman JM, Williams GM (2000) Chronicity, severity and timing or maternal depressive symptoms: Relationships with child outcomes at age 5. Developmental Psychopathology 36: 759–766
12.
go back to reference Deatrick JA, Brennan D, Cameron ME, (1998). Mothers with multiple sclerosis and their children-effects of fatigue and exacerbations on maternal. support Nurs Res 47(4):205–210PubMedCrossRef Deatrick JA, Brennan D, Cameron ME, (1998). Mothers with multiple sclerosis and their children-effects of fatigue and exacerbations on maternal. support Nurs Res 47(4):205–210PubMedCrossRef
13.
go back to reference Diareme S, Tsalamanios E, Paliokosta H, Anasontzi S, Kolaitis G, Voumvourakis C, Tsiantis A, Tsiantis J (2005) Implementing a preventive counselling service for children of parents with Multiple Sclerosis in a Southern European country. In: Romer G, Kenbacher C, Milea S, Piha J, Steck B, Thastum M, Tsiantis J, Watson M (eds) Children of somatically ill parents. International perspectives of family-oriented mental health prevention. Final Report of a European Project (RTD Project: QLG4-CT-2001-02378) within the frame of Quality of Life and Management of Living Resources Programme, Public Health and Health Services Research of the European Union, pp. 297–314 Diareme S, Tsalamanios E, Paliokosta H, Anasontzi S, Kolaitis G, Voumvourakis C, Tsiantis A, Tsiantis J (2005) Implementing a preventive counselling service for children of parents with Multiple Sclerosis in a Southern European country. In: Romer G, Kenbacher C, Milea S, Piha J, Steck B, Thastum M, Tsiantis J, Watson M (eds) Children of somatically ill parents. International perspectives of family-oriented mental health prevention. Final Report of a European Project (RTD Project: QLG4-CT-2001-02378) within the frame of Quality of Life and Management of Living Resources Programme, Public Health and Health Services Research of the European Union, pp. 297–314
14.
go back to reference Ebers G (2001) Natural history of Multiple Sclerosis. J Neur Neurosurg Psychiat 71(suppl II):ii16–ii19 Ebers G (2001) Natural history of Multiple Sclerosis. J Neur Neurosurg Psychiat 71(suppl II):ii16–ii19
15.
go back to reference Epstein NB, Baldwin LM, Bishop DS (1983) The McMaster family assessment device. J Marriage Fam Therapy 9:171–180 Epstein NB, Baldwin LM, Bishop DS (1983) The McMaster family assessment device. J Marriage Fam Therapy 9:171–180
16.
go back to reference Fuller G, Manford M (2000) An illustrated colour text neurology. Xxxx, Harcourt Publishers Limited Fuller G, Manford M (2000) An illustrated colour text neurology. Xxxx, Harcourt Publishers Limited
17.
go back to reference Kalb R (1998) Multiple Sclerosis. A guide for families. New York, Demos Kalb R (1998) Multiple Sclerosis. A guide for families. New York, Demos
18.
go back to reference Karnofsky DA, Burchenal JH (1949) The clinical evaluation of chemotherapeutic agents in cancer. In: McLead CM (ed) Evaluation of chemotherapeutic agents. Columbia University Press, New York Karnofsky DA, Burchenal JH (1949) The clinical evaluation of chemotherapeutic agents in cancer. In: McLead CM (ed) Evaluation of chemotherapeutic agents. Columbia University Press, New York
19.
go back to reference Lindsay K, Bone I, Callander B (1991) Neurology and neurosurgery illustrated, 2nd edn. Churchill Livingstone Lindsay K, Bone I, Callander B (1991) Neurology and neurosurgery illustrated, 2nd edn. Churchill Livingstone
20.
go back to reference McCubbin HI, Patterson JM (1981) Systematic assessment of family stress, resources and coping: tools for research, education and clinical intervention. St. Paul, MN, University of Minnesota McCubbin HI, Patterson JM (1981) Systematic assessment of family stress, resources and coping: tools for research, education and clinical intervention. St. Paul, MN, University of Minnesota
21.
go back to reference Power PW (1985) Family coping behaviours in chronic illness: a rehabilitation perspective. Rehabilitation Literature 46:3–4, 78–83 Power PW (1985) Family coping behaviours in chronic illness: a rehabilitation perspective. Rehabilitation Literature 46:3–4, 78–83
22.
go back to reference Ravens-Sieberer U, Bullinger M (2000) Manual: KINDL questionnaire for measuring health-related quality of life in children and adolescents. Hamburg University, Hamburg, Germany Ravens-Sieberer U, Bullinger M (2000) Manual: KINDL questionnaire for measuring health-related quality of life in children and adolescents. Hamburg University, Hamburg, Germany
23.
go back to reference Romer G, Bakmann C, Schulte-Markwort, Thomalla G, Riedesser P (2002) Children of somatically ill parents: a methodological review. Clin Child Psychol Psychiat 7(1):17–38CrossRef Romer G, Bakmann C, Schulte-Markwort, Thomalla G, Riedesser P (2002) Children of somatically ill parents: a methodological review. Clin Child Psychol Psychiat 7(1):17–38CrossRef
24.
go back to reference Romer G, Saha R, Haagen M, Pott, M, Baldus, C (in press) Differential family functioning, family coping and children’s psychological adjustment when a parent is physically ill—a multi perspective study. Family Process Romer G, Saha R, Haagen M, Pott, M, Baldus, C (in press) Differential family functioning, family coping and children’s psychological adjustment when a parent is physically ill—a multi perspective study. Family Process
25.
go back to reference Romer G, Stock M, Baldus C, Diareme S, Grether A, Gubba L, Kienbacher C, Manninen H, Oancea C, Schmitt F, Stancescu D, Steck B, Thastum M, Tsalamanios E, Haagen M (2005) Lessons learned from implementing preventive mental health services for children of somatically ill parents in various medical settings: a transnational multicentre perspective. In: Romer G, Kenbacher C, Milea S, Piha J, Steck B, Thastum M, Tsiantis J, Watson M (eds) Children of somatically ill parents. International perspectives of family-oriented mental health prevention. Final Report of a European Project (RTD Project: QLG4-CT-2001-02378) within the frame of Quality of Life and Management of Living Resources Programme, Public Health and Health Services Research of the European Union, pp 297–314 Romer G, Stock M, Baldus C, Diareme S, Grether A, Gubba L, Kienbacher C, Manninen H, Oancea C, Schmitt F, Stancescu D, Steck B, Thastum M, Tsalamanios E, Haagen M (2005) Lessons learned from implementing preventive mental health services for children of somatically ill parents in various medical settings: a transnational multicentre perspective. In: Romer G, Kenbacher C, Milea S, Piha J, Steck B, Thastum M, Tsiantis J, Watson M (eds) Children of somatically ill parents. International perspectives of family-oriented mental health prevention. Final Report of a European Project (RTD Project: QLG4-CT-2001-02378) within the frame of Quality of Life and Management of Living Resources Programme, Public Health and Health Services Research of the European Union, pp 297–314
26.
go back to reference Roussos A, Francis K, Zoubou V, Kiprianos S, Prokopiou A, Richardson C (2001) The standardization of Achenbach’s Youth Self-Report in Greece in a national sample of high school students. Eur Child Adoles Psychiat 10: 47–53 CrossRef Roussos A, Francis K, Zoubou V, Kiprianos S, Prokopiou A, Richardson C (2001) The standardization of Achenbach’s Youth Self-Report in Greece in a national sample of high school students. Eur Child Adoles Psychiat 10: 47–53 CrossRef
27.
go back to reference Roussos A, Karantanos G, Richardson C, Hartman C, Karajiannis D, Kyprianos S, Lazaratou H, Mahaira O, Tassi M, Zoubou V (1999). Achenbach’s child behaviour checklist and Teacher’s report form in a normative sample of Greek children 6–12 years old. Eur Child Adoles Psychiat 8(3):165–172CrossRef Roussos A, Karantanos G, Richardson C, Hartman C, Karajiannis D, Kyprianos S, Lazaratou H, Mahaira O, Tassi M, Zoubou V (1999). Achenbach’s child behaviour checklist and Teacher’s report form in a normative sample of Greek children 6–12 years old. Eur Child Adoles Psychiat 8(3):165–172CrossRef
28.
go back to reference Rutter M (1966) Children of sick parents. An environmental and psychiatric study. Oxford University Press, London Rutter M (1966) Children of sick parents. An environmental and psychiatric study. Oxford University Press, London
29.
go back to reference Schag CC, Heinrich RL, Ganz PA (1984) Karnofsky performance status revisited: reliability, validity, and guidelines. J Clin Oncol 2:187–193PubMed Schag CC, Heinrich RL, Ganz PA (1984) Karnofsky performance status revisited: reliability, validity, and guidelines. J Clin Oncol 2:187–193PubMed
30.
go back to reference Sheeber L, Hops H, Alpert A, Davis B, Andrews J (1997) Family support and conflict: prospective relations to adolescent depression. J Abnorm Child Psych 25:333–344CrossRef Sheeber L, Hops H, Alpert A, Davis B, Andrews J (1997) Family support and conflict: prospective relations to adolescent depression. J Abnorm Child Psych 25:333–344CrossRef
31.
go back to reference Spirito A (2004) Personal Communication and Correspondence with the author of KIDCOPE. Child and Family Psychiatry, Rhode Island Hospital, Providence, RI, USA Spirito A (2004) Personal Communication and Correspondence with the author of KIDCOPE. Child and Family Psychiatry, Rhode Island Hospital, Providence, RI, USA
32.
go back to reference Steck B, Amsler F, Kappos L, Burgin D (2001) Gender-specific differences in the process of coping in families with a parent affected by a chronic somatic disease (e.g. Multiple Sclerosis). Psychopathology 34:236–244PubMedCrossRef Steck B, Amsler F, Kappos L, Burgin D (2001) Gender-specific differences in the process of coping in families with a parent affected by a chronic somatic disease (e.g. Multiple Sclerosis). Psychopathology 34:236–244PubMedCrossRef
33.
go back to reference Tsalamanios E, Paliokosta E, Anasontzi S, Kolaitis G, Diareme S, Tsiantis J (2003) When the parent is ill: the psychosocial impact of Multiple Sclerosis on children and families: literature overview child and adolescent: mental health and psychopathology (in Greek) 6 (1): 43–56 Tsalamanios E, Paliokosta E, Anasontzi S, Kolaitis G, Diareme S, Tsiantis J (2003) When the parent is ill: the psychosocial impact of Multiple Sclerosis on children and families: literature overview child and adolescent: mental health and psychopathology (in Greek) 6 (1): 43–56
34.
go back to reference Tzemos J (1984) The standardization of the Beck Questionnaire for the Greek population (in Greek). Doctoral Dissertation, Athens University Medical School Tzemos J (1984) The standardization of the Beck Questionnaire for the Greek population (in Greek). Doctoral Dissertation, Athens University Medical School
35.
go back to reference Watson M, St James-Roberts I, Ashley S, Tilney C, Brougham B, Edwards L, Boldus C, Romer G. (2006) Factors associated with emotional and behavioural problems among school age children of breast cancer patients. Brit J Cancer 94(1):43–50PubMedCrossRef Watson M, St James-Roberts I, Ashley S, Tilney C, Brougham B, Edwards L, Boldus C, Romer G. (2006) Factors associated with emotional and behavioural problems among school age children of breast cancer patients. Brit J Cancer 94(1):43–50PubMedCrossRef
36.
go back to reference Weinert C, Catanzaro ML (1994) Challenging assumption about Multiple Sclerosis. Rehabil Nurs Res 3:122–129 Weinert C, Catanzaro ML (1994) Challenging assumption about Multiple Sclerosis. Rehabil Nurs Res 3:122–129
37.
go back to reference Wineman NM (1990) Adaptation to Multiple Sclerosis: the role of social support, functional disability, and perceived uncertainty. Nurs Res 39(5):294–299PubMed Wineman NM (1990) Adaptation to Multiple Sclerosis: the role of social support, functional disability, and perceived uncertainty. Nurs Res 39(5):294–299PubMed
38.
go back to reference Worsham N, Compas B, Sydney E (1997) Children’s coping with parental illness. In: Wolichik, Sandler (eds) Handbook of children’s coping: linking theory and intervention. New York Plenum Press, pp 195–213 Worsham N, Compas B, Sydney E (1997) Children’s coping with parental illness. In: Wolichik, Sandler (eds) Handbook of children’s coping: linking theory and intervention. New York Plenum Press, pp 195–213
Metadata
Title
Emotional and behavioural difficulties in children of parents with multiple sclerosis
A controlled study in Greece
Authors
Stavroula Diareme, PhD
John Tsiantis, MD, DPM, FRC Psych
Gerasimos Kolaitis, MD
Spyros Ferentinos, PhD
Emmanuel Tsalamanios
Elena Paliokosta, MD
Sophia Anasontzi, MA
Eirini Lympinaki, Msc
Dimitris C. Anagnostopoulos, MD, PhD
Costas Voumvourakis, MD
Dr. med. Georg Romer
Publication date
01-09-2006
Publisher
Steinkopff-Verlag
Published in
European Child & Adolescent Psychiatry / Issue 6/2006
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-006-0534-7

Other articles of this Issue 6/2006

European Child & Adolescent Psychiatry 6/2006 Go to the issue

ORIGINAL CONTRIBUTION

Autism and developmental delay