Psychological Functioning of Siblings in Families of Children with Chronic Health Conditions: A Meta-Analysis

OBJECTIVE: The aim of this meta-analysis was to provide an up-to-date review of the literature to enhance our understanding of how chronic health conditions (CHCs) affect siblings, both positively and negatively. METHODS: PsycINFO and Medline were systematically searched. Inclusion criteria were as follows: (a) peer-reviewed, empirical research report; (b) sample n ≥ 10; and (c) reports statistics on siblings' internalizing problems, externalizing problems, and/or positive self-attributes. RESULTS: Overall, there was a significant small negative effect of CHCs on siblings (d(+) = -.10). Siblings of children with CHCs had more internalizing problems (d(+) = .17), more externalizing problems (d(+) = .08), and less positive self-attributes (d(+) = -.09) than comparisons. Older siblings and siblings of children with life-threatening and/or highly intrusive CHCs were more at risk for psychological problems. CONCLUSIONS: This study identified several mechanisms through which CHCs affect siblings. Future research should focus on parent-child dynamics and the longitudinal development of positive self-attributes and internalizing problems as well as on identifying what works in services for siblings of children with CHCs.