Comparative Study of Child-Parent Relations in Families of Adolescents With Multiple Sclerosis and Cerebral Palsy

The diagnoses of multiple sclerosis (MS) and cerebral palsy (CP) imply the need for continuous long-term monitoring. Personal qualities formed during puberty, such as autonomy, self-sufficiency and a sense of responsibility, play a significant role in the further dynamics of the course of the disease, adaptation and social integration of adolescents. The analysis of the specifics of child-parent interaction in adolescents with MS and CP is important not only to increase the effectiveness of current therapeutic measures, but also to ensure favorable conditions for their future functioning. Aim: to study the features of child-parent relations in the families of adolescents with multiple sclerosis and cerebral palsy. Materials and Methods: the study included 128 people (64 adolescents from full families and 64 of their mothers), who formed an experimental group (families of adolescents with MS) and a comparison group (families of adolescents with CP). Characteristics and criteria for inclusion of adolescents with MS (n=32) in the experimental group: age from 12 to 17 years (mean age 14.41 (±0.36)); remitting form of MS without exacerbation; mild neurological deficit (EDSS < 4.0); absence of depression, decreased intelligence; complete family. The comparison group was formed based on the principle of homogeneity of demographic and social characteristics and includes 32 adolescents with cerebral palsy aged 12 to 17 (average age 14.01 (±0.37)) with a diagnosis of cerebral palsy, mild neurological deficit (GMFCS level I-II), lack of depression and decreased intelligence from full families. Psychodiagnostic techniques used in the study: Analysis of family anxiety; Family Adaptation and Cohesion Scales (FACES-3); Beck Depression Inventory (BDI); The Parental Attitude test questionnaire. Results: guilt is most common among children with CP (68.8%, as opposed to MS p=0.0406), anxiety dominates among adolescents with MS (75.00%, as opposed to cerebral palsy p=0.0403). Mothers of adolescents with MS have the highest prevalence of anxiety (46.90% clinically significant indicators on the scale of "general family anxiety", as opposed to CP p=0.0023; 56.30% clinically significant indicators on the scale of "anxiety", as opposed to CP p=0.0001). Most families with adolescents with MS belong to an unbalanced type of family system – a "chaotically enmeshed" one. In the families of adolescents with CP, medium-balanced types prevail, mainly "chaotically connected". The majority of mothers of adolescents with MS (68.80%) showed symptoms of mild to moderate depression, while similar manifestations among mothers of adolescents with CP are less common (21.90%, p=0.0006). Parents of adolescents with MS have a pronounced tendency to cooperate with their children, a tendency to increased control over the child's behavior, and a desire to reduce psychological distance from the teenager. Mothers of adolescents with CP are more likely to limit their children's independence, while maintaining an adequate psychological distance from the teenager, and prefer a democratic parenting style. Conclusions: a significant factor uniting the families of adolescents with MS and CP is the inability of the family system to functionally cope with the effects of stress factors, one of which is the adolescent crisis. In situations of increased stress, families tend not to change their dysfunctional ways of interacting, but to reinforce maladaptive behavior. The data obtained can provide a basis for determining priority areas of psychological support for families of chronically ill adolescents who have difficulty adapting to stress.